Gosik Robert, Danel Krzysztof
Department of Chemistry, Faculty of Food Technology, University of Agriculture, Kraków, Poland.
Mini Rev Med Chem. 2021;21(19):3052-3061. doi: 10.2174/1389557521666210616161728.
It is estimated that by 2040, Chronic Kidney Disease (CKD) will be the 5th main cause of global deaths. It has been suggested that hyperphosphatemia is among the main factors leading to the increased risk of death. This review focuses on potential and currently used Phosphate Binders (PB). Aluminum hydroxide is presently not recommended due to potential aluminum toxicity. Calciumcontaining phosphate binders (CCPB) can cause calcium overload, resulting in hypercalcemia and an increased risk of cardiovascular diseases. Magnesium and calcium complexes were suggested to be as effective as sevelamer in the reduction of serum phosphate, with the potential to slow down the process of calcification. However, limited studies have been conducted in this area. Although sevelamer seemed to have a positive influence on cardiovascular calcification and arterial stiffness, its influence on mortality was unclear. Sevelamer crystal accumulation in the Gastrointestinal tract (GI) can cause gastrointestinal bleeding. Lanthanum carbonate seemed to lower all-cause mortality and reduce the chance of hypercalcemia, even though a deposit in the GI tract was observed. Colestilan, like sevelamer, reduced LDL cholesterol. Sucroferric oxyhydroxide had a lower pill burden than other PBs and it seemed to reduce serum FGF-23. Ferric citrate improved parameters that are related to anemia but can cause iron overload. Bixalomer appeared to have fewer gastrointestinal side effects than sevelamer. Nano-lanthanum hydroxide and SBR759 may have an interesting future as PBs. In conclusion, the development of new PBs should also take into consideration their potential to function as protection modifiers.
据估计，到2040年，慢性肾脏病（CKD）将成为全球第五大主要死因。有人认为高磷血症是导致死亡风险增加的主要因素之一。本综述聚焦于潜在的和目前使用的磷结合剂（PB）。由于潜在的铝毒性，目前不推荐使用氢氧化铝。含钙磷结合剂（CCPB）可导致钙超载，从而引起高钙血症并增加心血管疾病风险。镁钙复合物在降低血清磷方面被认为与司维拉姆同样有效，且有可能减缓钙化进程。然而，该领域的研究有限。尽管司维拉姆似乎对心血管钙化和动脉僵硬度有积极影响，但其对死亡率的影响尚不清楚。司维拉姆晶体在胃肠道（GI）的积聚可导致胃肠道出血。碳酸镧似乎能降低全因死亡率并减少高钙血症的发生几率，尽管在胃肠道有沉积现象。考来替兰与司维拉姆一样，可降低低密度脂蛋白胆固醇。羟基氧化铁蔗糖的片剂负担低于其他磷结合剂，且似乎能降低血清成纤维细胞生长因子23（FGF - 23）。柠檬酸铁改善了与贫血相关的指标，但可导致铁超载。比沙洛默的胃肠道副作用似乎比司维拉姆少。纳米氢氧化镧和SBR759作为磷结合剂可能有广阔的前景。总之，新型磷结合剂的研发还应考虑其作为保护调节剂的潜在功能。
