Gotoh Junichi, Kukita Kazutaka, Tsuchihashi Seiichiro, Hattori Masahiro, Iida Junichi, Horie Takashi, Onodera Kazuhiko, Furui Hidenori, Tamaki Toru, Meguro Junichi, Yonekawa Motoki, Kawamura Akio
Sapporo Hokuyu Hospital, Sapporo, Japan.
Ther Apher Dial. 2013 Apr;17 Suppl 1:9-14. doi: 10.1111/1744-9987.12043.
Data of 36 months were accumulated regarding the effects of lanthanum carbonate (LA) on serum phosphate concentrations in dialysis patients. Fifty-three patients (average age and dialysis history 58.4 years and 9.1 years) were included in this study who have been receiving outpatient treatment since March 2009, and who have been unable to maintain serum phosphate concentrations of ≤6.0 mg/dL via traditional therapeutic agents used for hyperphosphatemia. Patients were given dosage of LA in addition to, or instead of, co-hyperphosphatemia treatments already being received. Mean dosages of calcium carbonate (CC) and sevelamer hydrochloride (SH) before starting LA administration were 1301.9 mg and 2462.3 mg, respectively. Dosage of LA for all cases was 750 mg at initial dose; 1528.3 mg at 5 months; and 1416.7 mg at 30 months. Dosage of other phosphate binders were 905.7 mg of CC and 820.8 mg of SH at 5 months; and 687.5 mg of CC and 1031.3 mg of SH at 30 months. Serum phosphorus levels (P levels) were significantly decreased at 1 month of LA administration, and continued until 30 months of La treatment. These results suggest that LA successfully controlled serum P and Ca concentrations simultaneously within target ranges without affecting serum intact parathyroid hormone concentration, although further long-term prospective cohort study on LA would be required.
收集了36个月来碳酸镧(LA)对透析患者血清磷酸盐浓度影响的数据。本研究纳入了53例患者(平均年龄和透析史分别为58.4岁和9.1年),这些患者自2009年3月以来一直在接受门诊治疗,并且无法通过用于高磷血症的传统治疗药物将血清磷酸盐浓度维持在≤6.0mg/dL。患者在接受已有的高磷血症联合治疗基础上,加用LA或用LA替代这些治疗。开始使用LA前,碳酸钙(CC)和盐酸司维拉姆(SH)的平均剂量分别为1301.9mg和2462.3mg。所有病例LA的初始剂量为750mg;5个月时为1528.3mg;30个月时为1416.7mg。5个月时其他磷结合剂的剂量为CC 905.7mg和SH 820.8mg;30个月时为CC 687.5mg和SH 1031.3mg。LA给药1个月时血清磷水平(P水平)显著下降,并持续至LA治疗30个月。这些结果表明,LA成功地将血清P和Ca浓度同时控制在目标范围内,且不影响血清完整甲状旁腺激素浓度,尽管还需要对LA进行进一步的长期前瞻性队列研究。