The active content in Nephsev®(Sevelamer Carbonate), a polymeric amine that binds to phosphate and          is meant for oral administration. Sevelamer Carbonate an anion exchange resin, polymeric structure is as  Sevelamer Hydrochloride, in which Carbonate replaces chloride as the counter ion. While the counter ions  differs for the two salt, the polymer itself, the active moiety involved in phosphate binding, is the same.  Sevelamer Carbonate is chemically called as poly(allylamine-co-N,N’-diallyl-1,3diamino-2-hydroxypropane)  carbonate salt. Sevelamer Carbonate is hygroscopic and  insoluble in water. Patients with CKD retain  phosphorus that can develop Hyperphosphatemia. When the product of serum calcium and phosphorus  concentrations (Ca*P) surpasses 55 mg/dL, there is increased risk that ectopic calcification may occur.  Hyperphosphatemia plays a role in the development of secondary hyperparathyroidism in renal insufficiency.  Management of Hyperphosphatemia includes Diet, Dialysis and use of Phosphate Binders. Sevelamer  Carbonate taken with meals has been shown to control Serum Phosphorus concentrations in patients with  CKD who are on dialysis.                                                                                                                                    Nephsev® (Sevelamer Carbonate) is used to lower high blood Phosphorus (phosphate) levels in patients who are on dialysis due to severe kidney disease. Dialysis removes some phosphate from your blood, but it is difficult to remove enough to keep your phosphate levels balanced. Decreasing blood phosphate levels can help keep your bones strong, prevent unsafe buildup of minerals in your body, and possibly decrease the risk of heart disease and strokes that can result from high phosphate levels. Nephsev® (Sevelamer Carbonate) works by holding onto phosphate from the diet so that it can pass out of your body.