Kishi Yuichiro, Obara Yoshihiro, Hara Keiko, Yamashiro Hiromitsu, Kurosawa Norio, Takada Daisuke
Department of Nephrology, Sakura Memorial Hospital, Saitama, Japan.
Ther Apher Dial. 2014 Jun;18 Suppl 1:9-13. doi: 10.1111/1744-9987.12197.
In this study, we investigated the clinical effects of long-term administration of the phosphorus (P) binder lanthanum carbonate (LC), which was launched in Japan in 2009. The subjects were 58 dialysis patients who began receiving LC, and we evaluated the clinical effects for up to 36 months after treatment initiation. The average serum P concentration remained low during the 36-month study period, with a significant reduction from 6.25 mg/dL at the start of the study to 4.94 mg/dL after 36 months (P < 0.001). A significant reduction was also observed in the average serum calcium concentration after 36 months (P < 0.05), but not in the serum intact parathyroid hormone concentration. Significant reductions were also observed in the average serum total protein, albumin and potassium concentrations (P < 0.05). The dosages of LC increased by approximately 1.9-fold after 36 months, in contrast, the dosages of concomitantly used sevelamer hydrochloride and Ca carbonate preparations decreased. These results indicate that LC could be used to treat hyperphosphatemia without causing hypercalcemia, and would be useful for long-term treatment with hemodialysis patients.
在本研究中，我们调查了2009年在日本上市的磷（P）结合剂碳酸镧（LC）长期给药的临床效果。研究对象为58例开始接受LC治疗的透析患者，我们评估了治疗开始后长达36个月的临床效果。在为期36个月的研究期间，血清P平均浓度一直较低，从研究开始时的6.25mg/dL显著降至36个月后的4.94mg/dL（P<0.001）。36个月后血清钙平均浓度也显著降低（P<0.05），但血清完整甲状旁腺激素浓度未降低。血清总蛋白、白蛋白和钾的平均浓度也显著降低（P<0.05）。相比之下，36个月后LC的剂量增加了约1.9倍，同时使用的盐酸司维拉姆和碳酸钙制剂的剂量减少。这些结果表明，LC可用于治疗高磷血症而不引起高钙血症，对血液透析患者的长期治疗有益。
