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Genzyme's sevelamer carbonate (Renvela) successfully and significantly reduced serum phosphorus for hyperphosphalemic patients who have chronic kidney disease but are not on dialysis. This was the primary end point for the study, which also showed that sevelamer carbonate significantly reduced calcium phosphorus product and low-density lipoprotein cholesterol. Sevelamer carbonate was welltolerated and exhibited a safety profile similar to sevelamer hydrochloride (Renagel). The multicenter, open-label study included 49 patients in Europe and Australia. In the United States, sevelamer hydrochloride is the most prescribed phosphate binder; sevelamer carbonate is a buffered form of sevelamer hydrochloride that is calcium-free and metal-free. Once FDA-approved, sevelamer carbonate will be available in 800-mg tablets.