Oe P L, Lips P, van der Meulen J, de Vries P M, van Bronswijk H, Donker A J
Department of Internal Medicine, Academic Hospital Free University, Amsterdam, The Netherlands.
Clin Nephrol. 1987 Oct;28(4):180-5.
The long-term use of magnesium hydroxide [Mg(OH)2] as a phosphate binder was investigated in 18 patients on chronic hemodialysis. All patients received a basal treatment with oral calcium carbonate. Vitamin D supplements were not used. In period I each patient ingested aluminum hydroxide [Al(OH)3], in period II Mg(OH)2 and in period III Mg(OH)2 and Al(OH)3 together. During period II and III a dialysate devoid of Mg was used. Mg(OH)2 doses were adjusted to prevent severe hypermagnesemia and diarrhea. The mean dose of Mg(OH)2 in period II was 2.4 +/- 0.6 and in period III 2.6 +/- 1.2 g/day. Serum phosphate increased significantly in period II and fell again in period III. Despite a halving of the Al(OH)3 dose in period III, serum Al was similar in period I and period III (55.8 +/- 19.1 vs 57.1 +/- 27.3 microg/l). Parathyroid hormone (PTH) concentration fell in period II and decreased even further in period III. We conclude that oral Mg(OH)2 may reduce the required Al(OH)3 dose, however, without an effect on serum Al concentration. The observed suppression of parathyroid activity needs further study.
对18例慢性血液透析患者进行了氢氧化镁[Mg(OH)₂]作为磷结合剂长期使用情况的研究。所有患者均接受口服碳酸钙基础治疗，未使用维生素D补充剂。在第一阶段，每位患者摄入氢氧化铝[Al(OH)₃]；在第二阶段，摄入Mg(OH)₂；在第三阶段，同时摄入Mg(OH)₂和Al(OH)₃。在第二阶段和第三阶段，使用不含镁的透析液。调整Mg(OH)₂剂量以预防严重高镁血症和腹泻。第二阶段Mg(OH)₂的平均剂量为2.4±0.6g/天，第三阶段为2.6±1.2g/天。血清磷在第二阶段显著升高，在第三阶段再次下降。尽管在第三阶段Al(OH)₃剂量减半，但第一阶段和第三阶段的血清铝水平相似(55.8±19.1对57.1±27.3μg/L)。甲状旁腺激素(PTH)浓度在第二阶段下降，在第三阶段进一步降低。我们得出结论，口服Mg(OH)₂可能会减少所需的Al(OH)₃剂量，然而，对血清铝浓度无影响。所观察到的甲状旁腺活性抑制需要进一步研究。
