World J Gastroenterol. 2011 Jun 7;17(21):2681-2. doi: 10.3748/wjg.v17.i21.2681.
Casais et al have reported an inverse correlation between serum phosphate and body weight after administration of sodium phosphate at a dose of 60 g. Our group has already described the relationship between body weight and hyperphosphatemia with these preparations, although our study was not quoted by Casais. We performed a pharmacokinetic study involving 13 volunteers who were divided into two groups on the basis of body weight: group I consisting of seven women with a median weight of 60 kg and group II consisting of five men and one woman with a median weight of 119.2 kg. Group I developed higher peak phosphate levels and maintained these levels above the subjects in Group II for a prolonged time period despite adequate hydration being ensured with frequent monitoring of weight, fluid intake and total body weight. Our study demonstrated that adequate hydration does not protect against the secondary effects of hyperphosphatemia. In the study by Casais et al, 66% of the study subjects were women, the correlation between serum phosphate and gender in their data also appears to be important. Women are at higher risk of acute phosphate nephropathy due to a diminished volume of distribution of the high dose of ingested phosphate. Decreased volume of distribution in women is due to diminished body weight. This is further compounded by decreased creatinine clearance in females.
卡斯泰尔斯等人报告称，在给予 60 克磷酸钠后，血清磷酸盐与体重呈负相关。我们的研究小组已经描述了这些制剂与体重和高磷酸盐血症之间的关系，尽管我们的研究未被卡斯泰尔斯引用。我们进行了一项涉及 13 名志愿者的药代动力学研究，根据体重将志愿者分为两组：I 组包括 7 名体重中位数为 60 公斤的女性，II 组包括 5 名男性和 1 名体重中位数为 119.2 公斤的女性。尽管通过频繁监测体重、液体摄入量和总体重来确保充足的水合作用，但 I 组的志愿者峰值磷酸盐水平更高，且这些水平维持的时间也比 II 组长。我们的研究表明，充足的水合作用并不能防止高磷酸盐血症的继发性影响。在卡斯泰尔斯等人的研究中，66%的研究对象为女性，他们的数据中血清磷酸盐与性别之间的相关性似乎也很重要。由于摄入的高剂量磷酸盐分布容积减少，女性发生急性磷酸盐肾病的风险更高。女性分布容积减少是由于体重减轻所致。女性的肌酐清除率降低进一步加剧了这种情况。
