摘要
高磷血症常见于慢性肾脏病(CKD)和终末期肾病(ESRD)患者,是ESRD患者心血管事件和死亡的独立危险因素,因此控制高磷血症非常重要。降磷治疗使用的磷结合剂可分为含钙磷结合剂和不含钙磷结合剂。目前使用较多的有碳酸钙、醋酸钙、碳酸镧、氢氧化铝及司维拉姆等。对上述药物的临床研究产生了一些新认识,如各类降磷药物在降磷效果上并无明显差别;含钙磷结合剂与高钙血症、较低的血清甲状旁腺素水平、较高的血管钙化评分有关;透析患者接受磷结合剂治疗可使全因死亡风险下降;不含钙磷结合剂与含钙磷结合剂比较,CKD患者的全因死亡率下降可达22%。
Hyperphosphatemia is very common in patients with chronic kidney disease （CKD） and end stage of renal disease （ESRD） ,and also is an independent factor for ESRD patients＇ CVD events and death.Thus it is very important to control hyperphosphatemia.Phosphate binders are divided into calcium-based or non-calcium-based phosphate binders, such as calcium carbonate, calcium acetate,lanthanum carbonate, aluminum hydroxide and sevelamer.There is no difference among those phosphate binders in decreasing phosphate.Calcium-based phosphate binders is related to hypercalcemia,lower iPTH level and higher score of vascular calcification.In dialysis patients phosphate binder therapy can decrease the risk of all-cause mortality.Compared with calcium-based phosphate binders, non-calcium-based phosphate binders can decrease the all-cause mortality by 22% in dialysis patients. The aim of this paper is to review the new understanding of phosphate binders in patients with CKD and ESRD
出处
《肾脏病与透析肾移植杂志》
CAS
CSCD
北大核心
2014年第2期171-175,共5页
Chinese Journal of Nephrology,Dialysis & Transplantation
关键词
慢性肾脏病
高磷血症
含钙磷结合剂
不含钙磷结合剂
chronic kidney disease hyperphosphatemia calcium-based phosphate binders non-calcium-basedphosphate binders
