The formation of advanced glycation end-products (AGEs) is accelerated in the presence of diabetes mellitus and uremia. AGEs have been strongly implicated in the pathogenesis of vascular complications. We previously reported that switching from calcium carbonate to sevelamer hydrochloride lowered serum AGEs levels and led to a reduced risk of vascular complications in dialysis patients. However, constipation is considered to be a non-negligible adverse effect of sevelamer hydrochloride monotherapy. In this study, we examined the effect of low-dose sevelamer hydrochloride on the serum concentrations of AGEs. Twenty-one patients receiving dialysis three times per week for more than three months were included and sevelamer hydrochloride (1.5 g/day) was added without changing the dose of calcium carbonate. Serum levels of AGEs, lipids, phosphorus, calcium, and intact PTH were measured during the study period. Glucose-derived AGEs (Glc-AGEs), which are normally contained in food, and glyceraldehyde-derived AGEs (Glycer-AGEs), which are generated in vivo and are highly toxic, were measured by ELISA. Serum Glc-AGEs significantly decreased from 16.03±10.53 U/mL to 5.57±4.40 U/mL after 24 weeks. Patients were divided into two groups depending on their initial mean serum Glycer-AGEs levels. In the high level group, Glycer-AGEs significantly decreased from 8.49±1.12 U/mL to 6.74±0.84 U/mL after 24 weeks, whereas no significant change was observed in the low level group. Treatment with sevelamer hydrochloride significantly decreased non-HDL cholesterol levels and increased HDL cholesterol levels. Serum phosphorus levels decreased by approximately 0.8 mg/dL, and serum calcium levels were unchanged. It has been reported that Glc-AGEs orally taken into the body subsequently enhance the production of highly toxic Glycer-AGEs. The decreased serum AGEs levels may be attributed to the adsorption removal of dietary AGEs as well as a reduction in oxidative stress as a result of the removal of other substances including oxidants by sevelamer hydrochloride. The present study demonstrated that even low-dose sevelamer hydrochloride, which reduces abdominal symptoms, can significantly decrease serum AGEs levels and improve the serum lipid profile. These results suggest that low-dose sevelamer hydrochloride could reduce the risk of vascular complications in dialysis patients. To avoid calcium overload, treatment with low doses of sevelamer hydrochloride as a basal agent may also be beneficial for dialysis patients.