Hemstreet B A
School of Pharmacy, University of Colorado Health Sciences Center, Denver 80262-0238, USA.
Ann Pharmacother. 2001 Mar;35(3):360-4. doi: 10.1345/aph.10117.
To assess the potential for the development of aluminum toxicity in patients with renal insufficiency or chronic renal failure who are taking sucralfate.
Clinical literature accessed through MEDLINE (1966-December 1999) and International Pharmaceutical Abstracts (1970-December 1999). Key search terms included sucralfate, renal failure, renal insufficiency, and end-stage renal disease.
Urinary excretion is an important route of elimination for systemically absorbed aluminum. Accumulation of aluminum in patients with impaired renal function may lead to significant toxicity. A potential source of aluminum is the antiulcer medication sucralfate. Studies and case reports evaluating the use and toxicity of sucralfate in patients with normal renal function, as well as those with renal failure or renal insufficiency, were reviewed.
Aluminum accumulation and toxicity have been reported with the use of sucralfate in patients with compromised renal function. The risk of toxicity most likely represents a long-term complication of sucralfate use in this patient population. Toxicity may be enhanced by concurrent use of other aluminum-containing medications, such as phosphate binders or antidiarrheal preparations. These medications, in addition to sucralfate, should be avoided if possible in patients with end-stage renal disease. Patients with renal failure or renal insufficiency who are undergoing prolonged sucralfate therapy should be monitored for potential signs of aluminum toxicity.
评估服用硫糖铝的肾功能不全或慢性肾衰竭患者发生铝中毒的可能性。
通过MEDLINE（1966年 - 1999年12月）和国际药学文摘（1970年 - 1999年12月）检索临床文献。关键检索词包括硫糖铝、肾衰竭、肾功能不全和终末期肾病。
尿排泄是全身吸收铝的重要排泄途径。肾功能受损患者体内铝的蓄积可能导致显著的毒性。铝的一个潜在来源是抗溃疡药物硫糖铝。对评估硫糖铝在肾功能正常患者以及肾衰竭或肾功能不全患者中的使用和毒性的研究及病例报告进行了综述。
有报道称，肾功能受损患者使用硫糖铝会导致铝蓄积和中毒。中毒风险很可能是该患者群体长期使用硫糖铝的并发症。同时使用其他含铝药物，如磷结合剂或止泻制剂，可能会增强毒性。对于终末期肾病患者，应尽可能避免使用这些药物以及硫糖铝。接受硫糖铝长期治疗的肾衰竭或肾功能不全患者应监测铝中毒的潜在迹象。
