Tan C C, Harden P N, Rodger R S, Rowe P A, Spooner R J, Junor B J, Briggs J D
Renal Unit and Department of Biochemistry, Western Infirmary, Glasgow, UK.
Nephrol Dial Transplant. 1996 May;11(5):851-3. doi: 10.1093/oxfordjournals.ndt.a027412.
In a previous controlled study we showed that ranitidine significantly reduced the phosphate binding of aluminium hydroxide in patients with renal failure, probably increasing intragastric pH.
In this study we have investigated the effect of ranitidine on the phosphate binding of calcium carbonate in fifteen dialysis patients. Ranitidine 300 mg or a placebo tablet was taken before breakfast for two 4-week periods in a double-blind crossover trial with no washout period. The mean daily dose of calcium carbonate was 2 g and neither the dose nor the patient's diet was changed during the study period. Blood was taken at 2-weekly intervals for serum phosphate, calcium, albumin, and alkaline phosphatase measurements, and at the end of each treatment period for parathyroid hormone (PTH) level.
Serum phosphate concentrations were significantly higher during the ranitidine than the placebo phase, 1. 78 (+/-0.43 SD) versus 1.59 (+/-0.49 SD) mmol/l (P<0.001). Serum calcium, albumin, PTH, and alkaline phosphatase concentrations did not differ between the two treatment periods.
This study shows that ranitidine has a significant adverse effect on the phosphate binding of calcium carbonate in patients with renal failure.
在之前的一项对照研究中，我们发现雷尼替丁可显著降低肾衰竭患者体内氢氧化铝的磷酸盐结合能力，这可能是由于胃内pH值升高所致。
在本研究中，我们调查了雷尼替丁对15名透析患者碳酸钙磷酸盐结合能力的影响。在一项无洗脱期的双盲交叉试验中，患者在早餐前服用300毫克雷尼替丁或一片安慰剂，为期两个4周疗程。碳酸钙的平均每日剂量为2克，在研究期间剂量和患者饮食均未改变。每隔两周采集血液，检测血清磷酸盐、钙、白蛋白和碱性磷酸酶水平，并在每个治疗期结束时检测甲状旁腺激素（PTH）水平。
雷尼替丁治疗期的血清磷酸盐浓度显著高于安慰剂治疗期，分别为1.78（±0.43标准差）mmol/L和1.59（±0.49标准差）mmol/L（P<0.001）。两个治疗期的血清钙、白蛋白、PTH和碱性磷酸酶浓度无差异。
本研究表明，雷尼替丁对肾衰竭患者碳酸钙的磷酸盐结合能力有显著不良影响。
