ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2014, Vol. 23 ›› Issue (2): 171-175.

• 论文 • 上一篇    下一篇

慢性肾脏病患者应用磷结合剂的新认识

  

  • 出版日期:2014-04-28 发布日期:2014-04-28

New understanding of phosphate binders in CKD patients

  • Online:2014-04-28 Published:2014-04-28

摘要:

摘要 高磷血症常见于慢性肾脏病(CKD)和终末期肾病(ESRD)患者,研究显示它是ESRD患者心血管事件和死亡的独立危险因素,控制高磷血症非常重要。降磷治疗使用的磷结合剂可分为含钙的磷结合剂和不含钙的磷结合剂。目前广为使用的有碳酸钙、醋酸钙、碳酸镧、氢氧化铝、司维拉姆等。围绕以上药物的临床研究不断推出,新的认识包括降磷药物在降磷效果上并无明显差别,含钙磷结合剂与高钙血症和低iPTH有关,可能与较高的血管钙化评分有关。透析患者接受磷结合剂治疗可以使全因死亡风险下降,而不含钙磷结合剂与含钙磷结合剂比较,全因死亡率下降22%。

关键词: 慢性肾脏病, 高磷血症, 含钙磷结合剂, 不含钙磷结合剂

Abstract:

ABSTRACT Hyperphosphatemia is very common in patients with chronic kidney disease (CKD) and end stage of renal disease (ESRD), and also is an independent factor for ESRD patients’ CVD events and death. Thus it is very important to control hyperphosphatemia. Phosphate binders are divided into calcium-based or non-calcium-based phosphate binders, such as calcium carbonate, calcium acetate, lanthanum carbonate, aluminum hydroxide and sevelamer. There is no difference among those phosphate binders in decreasing phosphate. Calcium-based phosphate binders is related to hypercalcemia, lower iPTH level and higher score of vascular calcification. In dialysis patients phosphate binder therapy can decrease the risk of all-cause mortality. Compared with calcium-based phosphate binders, non-calcium-based phosphate binders can decrease the all-cause mortality by 22% in dialysis patients. The aim of this paper is to review the new understanding of phosphate binders in patients with CKD and ESRD

Key words: chronic kidney disease, hyperphosphatemia, calcium-based phosphate binders, non-calcium-based phosphate binders