Breslau N A, Heller H J, Reza-Albarrán A A, Pak C Y
Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, USA.
J Urol. 1998 Sep;160(3 Pt 1):664-8. doi: 10.1016/S0022-5347(01)62749-6.
We examined the physiological effects and tolerance of UroPhos-K, a slow release neutral form of potassium phosphate (155 mg. phosphate and 8 mEq. potassium per tablet) in patients with absorptive hypercalciuria.
A total of 31 patients with absorptive hypercalciuria were studied at baseline and after 3 months of treatment with 4 tablets twice daily of UroPhos-K or placebo (identical in appearance) in a prospective randomized, placebo controlled, double-blind trial during a 4-day inpatient study with a daily constant metabolic diet containing 400 mg. calcium, 100 mEq. sodium and 800 mg. phosphate.
Treatment with UroPhos-K did not cause significant gastrointestinal side effects, increase fasting serum potassium or phosphorus, or reduce hemoglobin or creatinine clearance. It reduced urinary calcium excretion from 277 +/- 72 to 166 +/- 43 mg. per day (p < 0.001), associated with a reduction in serum 1,25-dihydroxyvitamin D concentration from 50 +/- 11 to 42 +/- 9 pg./ml. (p < 0.001). Indexes of intestinal calcium absorption and markers of bone turnover also decreased modestly. None of these changes was seen in the placebo group.
In patients with absorptive hypercalciuria UroPhos-K seems to correct hypercalciuria by a combination of reduced intestinal absorption, bone resorption and improved renal calcium reabsorption. The drug is well tolerated compared to placebo.
我们研究了磷酸钾缓释中性制剂UroPhos-K（每片含155毫克磷酸盐和8毫当量钾）对吸收性高钙尿症患者的生理影响及耐受性。
在一项前瞻性随机、安慰剂对照、双盲试验中，对31例吸收性高钙尿症患者进行了研究。在为期4天的住院研究期间，患者接受每日常量代谢饮食，其中含400毫克钙、100毫当量钠和800毫克磷酸盐。研究分为基线期以及服用UroPhos-K或安慰剂（外观相同）每日两次、每次4片、为期3个月的治疗期。
服用UroPhos-K未引起明显的胃肠道副作用，未使空腹血清钾或磷升高，也未降低血红蛋白或肌酐清除率。它使尿钙排泄量从每日277±72毫克降至166±43毫克（p<0.001），同时血清1,25-二羟维生素D浓度从50±11皮克/毫升降至42±9皮克/毫升（p<0.001）。肠道钙吸收指标和骨转换标志物也有适度下降。安慰剂组未出现这些变化。
对于吸收性高钙尿症患者，UroPhos-K似乎通过减少肠道吸收、骨吸收以及改善肾钙重吸收的联合作用来纠正高钙尿症。与安慰剂相比，该药物耐受性良好。
