Weifang Medical University, Weifang, People's Republic of China.
Department of Nephrology, Qianfoshan Hospital, Shandong University, No. 16766 Jingshi Road, Jinan, 250014, Shandong, People's Republic of China.
J Nephrol. 2019 Apr;32(2):265-272. doi: 10.1007/s40620-018-00571-1. Epub 2018 Dec 26.
The relationship between oral activated charcoal (OAC) and hyperphosphatemia and vascular calcification is not completely clear. We observed and recorded the effects of OAC on hyperphosphatemia and vascular calcification in stage 3-4 chronic kidney disease (CKD).
In a randomized controlled study, we included 97 patients with stage 3-4 CKD. In the first phase of the experiment, the patients were randomly divided into the OAC group and placebo group. The endpoint of this phase was the development of hyperphosphatemia. The patients with hyperphosphatemia were selected into the second phase of the study. These patients underwent coronary artery multidetector computed tomography (MDCT) and were randomly divided into three groups: the OAC group, the calcium carbonate (CC) group and the lanthanum carbonate (LC) group.
The first and second phases of the experiment were followed for 12 months. In the first phase of the experiment, there was a statistically significant difference in the proportion of patients with hyperphosphatemia between the OAC and placebo groups (28.57% vs. 79.17%, X = 24.958, P = 0.000). In the second phase, the differences in coronary calcification score (CACS) between the OAC group, the CC group and the LC group were statistically significant (525.5 ± 104.2 vs 688.1 ± 183.7 vs 431.4 ± 122.5, P < 0.01).
Oral activated charcoal effectively delays the onset of hyperphosphatemia in patients with chronic kidney disease. OAC appears to delay the development of vascular calcifications in stage 3-4 CKD patients.
口服活性碳(OAC)与高磷血症和血管钙化之间的关系尚不完全清楚。我们观察并记录了 OAC 对 3-4 期慢性肾脏病(CKD)患者高磷血症和血管钙化的影响。
在一项随机对照研究中,我们纳入了 97 例 3-4 期 CKD 患者。在实验的第一阶段,患者被随机分为 OAC 组和安慰剂组。该阶段的终点为高磷血症的发生。高磷血症患者被选入研究的第二阶段。这些患者接受了冠状动脉多排螺旋 CT(MDCT)检查,并被随机分为三组:OAC 组、碳酸钙(CC)组和碳酸镧(LC)组。
实验的第一和第二阶段均随访 12 个月。在实验的第一阶段,OAC 组和安慰剂组的高磷血症患者比例有统计学差异(28.57%比 79.17%,X²=24.958,P=0.000)。在第二阶段,OAC 组、CC 组和 LC 组的冠状动脉钙化评分(CACS)差异有统计学意义(525.5±104.2 比 688.1±183.7 比 431.4±122.5,P<0.01)。
口服活性碳可有效延缓慢性肾脏病患者高磷血症的发生。OAC 似乎可延缓 3-4 期 CKD 患者血管钙化的发展。