Zhou Tianbiao, Li Hongyan, Xie Weiji, Lin Zhijun
Department of Nephrology, the Second Affiliated Hospital of Shantou University Medical College, 515041, Shantou, China.
Department of Nephrology, Huadu District People's Hospital of Guangzhou, Southern Medical University, Guangzhou, 510800, China.
Afr Health Sci. 2018 Sep;18(3):689-696. doi: 10.4314/ahs.v18i3.27.
The purpose of this study was to compare the effects of phosphate binders lanthanum carbonate (LC) versus sevelamer hydrochloride (SH) in end-stage renal disease (ESRD) patients undergoing hemodialysis.
Studies including randomized controlled trials (RCTs) comparing phosphate binders lanthanum carbonate versus sevelamer hydrochloride, in ESRD patients undergoing hemodialysis, were identified using a pre-defined search strategy. Phosphate, calcium, calcium-phosphorus product, intact parathyroid hormone, alkaline phosphatase, total cholesterol, and triglyceride were extracted and compared by RevMan 5.1 (The Cochrane Collaboration, Oxford, UK).
Six studies were identified. Meta-analysis showed that SH treatment reduced levels of phosphate, intact parathyroid hormone, and total serum alkaline phosphatase (ALP) when compared with LC treatment. Furthermore, patients on SH treatment tended to have reduced calcium levels, calcium-phosphorus product, total cholesterol, and triglyceride when compared to patients treated with LC, but there was no statistical difference.
SH treatment of patients with ESRD is more effective compared to LC treatment. However, more well-designed random control trails are required for confirmation.
本研究旨在比较碳酸镧（LC）与盐酸司维拉姆（SH）这两种磷结合剂对接受血液透析的终末期肾病（ESRD）患者的疗效。
采用预先定义的检索策略，查找比较碳酸镧与盐酸司维拉姆这两种磷结合剂对接受血液透析的ESRD患者疗效的随机对照试验（RCT）。提取磷、钙、钙磷乘积、全段甲状旁腺激素、碱性磷酸酶、总胆固醇和甘油三酯的数据，并使用RevMan 5.1（英国牛津Cochrane协作网）进行比较。
共纳入6项研究。荟萃分析表明，与LC治疗相比，SH治疗可降低磷、全段甲状旁腺激素和血清总碱性磷酸酶（ALP）水平。此外，与接受LC治疗的患者相比，接受SH治疗的患者的钙水平、钙磷乘积、总胆固醇和甘油三酯有降低趋势，但差异无统计学意义。
与LC治疗相比，SH治疗ESRD患者更有效。然而，需要更多设计良好的随机对照试验来证实这一结论。
