Ishizu Takashi, Hong Zhang, Matsunaga Tsuneaki, Kaneko Yoko, Taru Yoshinori
Department of Nephrology, Tsukuba Central Hospital, 1589-3 Kashiwada-cho, Ushiku, Ibaraki, Japan.
Ther Apher Dial. 2013 Apr;17 Suppl 1:22-8. doi: 10.1111/1744-9987.12042.
To examine the efficacy of long-term administration of lanthanum carbonate, changes in serum Ca, phosphate, whole parathyroid hormone (wPTH), and ALP were examined in 40 patients who were able to tolerate dosage of lanthanum carbonate over a continuous period of 24 months. Concurrently, concomitant administration of other phosphate binders, cinacalcet, vitamin D, etc., was also examined. After 24 months, serum phosphorus levels (P levels) had decreased to within management target of guidelines, from 6.16 ± 1.44 mg/dL to 5.58 ± 1.15 mg/dL, and this effect was maintained for 2 years. There were no changes in Ca level. wPTH did not change significantly but tended to increase at 12 months. The dose of concomitantly administered calcium carbonate and sevelamer hydrochloride was reduced. The P-lowering function of lanthanum carbonate still held steady at 24 months following the start of dosage. Because of the rising trend seen in wPTH, dose of cinacalcet and/or vitamin D need to be modulated. Reducing the number of concomitantly administered phosphate binder tablets was desirable from the standpoint of patient adherence.
为了研究长期服用碳酸镧的疗效，我们对40例能够连续24个月耐受碳酸镧剂量的患者进行了血清钙、磷、全甲状旁腺激素（wPTH）和碱性磷酸酶（ALP）变化的检测。同时，还对其他磷结合剂、西那卡塞、维生素D等的联合使用情况进行了检测。24个月后，血清磷水平（P水平）从6.16±1.44mg/dL降至指南管理目标范围内，降至5.58±1.15mg/dL，且该效果维持了2年。钙水平无变化。wPTH虽无显著变化，但在12个月时有升高趋势。碳酸钙和盐酸司维拉姆的联合给药剂量减少。碳酸镧的降磷功能在开始给药24个月后仍保持稳定。由于wPTH有上升趋势，需要调整西那卡塞和/或维生素D的剂量。从患者依从性的角度来看，减少联合使用的磷结合剂片剂数量是可取的。
