Yoshida Tadashi, Morimoto Kohkichi, Kaburagi Noriko, Fujino Teppei, Takemitsu Tomoko Yamashita, Yamashita Norimasa, Oya Mototsugu
Apheresis and Dialysis Center, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
Seigakai Shibuya Station Clinic, Tokyo, Japan.
Int Urol Nephrol. 2022 Apr;54(4):861-872. doi: 10.1007/s11255-021-02952-1. Epub 2021 Jul 15.
Iron-based phosphate binders, including ferric citrate hydrate (FCH) and sucroferric oxyhydroxide (SFOH), have been used for the treatment of hyperphosphatemia in end-stage renal disease patients on dialysis. However, the long-term efficacy and safety of these agents have not yet been clearly elucidated.
Laboratory data of 56 hemodialysis patients who had been prescribed either FCH (n = 33) or SFOH (n = 23) were retrospectively examined.
We showed that both FCH and SFOH significantly and consistently decreased serum phosphate concentrations in the patients undergoing maintenance hemodialysis during the 36-month observation period. Serum levels of calcium, intact parathyroid hormone, as well as hemoglobin levels were unaltered. No overshoot of parameters of iron metabolism, such as transferrin saturation and serum ferritin levels, was observed, and serum ferritin level remained under 300 ng/mL in most patients. A trend towards decrease in the doses of erythropoiesis-stimulating agents used and frequency of intravenous iron use was observed in both treatment groups. No severe adverse drug reactions were observed in either the patients receiving FCH or SFOH.
The results of the present study suggest that the iron-based phosphate binders, FCH and SFOH, decrease serum phosphate concentrations consistently and are safe to use over the long-term in maintenance hemodialysis patients.
铁基磷酸盐结合剂，包括水合柠檬酸铁（FCH）和羟基氧化蔗糖铁（SFOH），已被用于治疗接受透析的终末期肾病患者的高磷血症。然而，这些药物的长期疗效和安全性尚未得到明确阐明。
回顾性检查了56例接受FCH（n = 33）或SFOH（n = 23）治疗的血液透析患者的实验室数据。
我们发现，在36个月的观察期内，FCH和SFOH均能显著且持续地降低维持性血液透析患者的血清磷酸盐浓度。血清钙、完整甲状旁腺激素以及血红蛋白水平未发生改变。未观察到铁代谢参数（如转铁蛋白饱和度和血清铁蛋白水平）的过度升高，并且大多数患者的血清铁蛋白水平保持在300 ng/mL以下。两个治疗组均观察到促红细胞生成素使用剂量和静脉补铁频率有下降趋势。接受FCH或SFOH治疗的患者均未观察到严重的药物不良反应。
本研究结果表明，铁基磷酸盐结合剂FCH和SFOH能持续降低血清磷酸盐浓度，并且在维持性血液透析患者中长期使用是安全的。
