含钙的磷结合剂对比(摘要翻译稿).docVIP

A Comparison of Calcium-Based Phosphorus Binders for Patients with Chronic Kidney Disease 慢性肾病患者使用含钙的磷结合剂疗效对比 Michael Emmett, MD The author is with the Department of Internal Medicine, Baylor University Medical Center, Dallas, Texas. 作者：Michael Emmett, 医学博士，美国德克萨斯州达拉斯，Baylor大学医学中心，内科 Hyperphosphatemia in patients with end-stage renal disease ESRD is associated with secondary hyperparathyroidism andrenal osteodystrophy, and is independently associated with an increased risk of mortality. Therefore, tight control of serum phosphorus is considered essential in these patients. 终末期肾病（ESRD）患者的高磷血症与继发性甲状旁腺功能亢进和肾性骨病具有相关性，并且与死亡率的增加具有独立的相关性。因此，严格控制这些患者的血磷被认为是必不可少的。 Ideally, the best phosphorus binder would be inexpensive, nontoxic, well tolerated, and potent. Currently, calcium-based binders are generally considered first-line agents for the treatment of hyperphosphatemia in ESRD. However, excessive calcium absorption may produce hypercalcemia and possibly soft-tissue and vascular deposition. 理想情况下，最好的磷结合剂应该具备价格低廉、无毒、耐受性好、有效等特点。通常，含钙的磷结合剂常被作为一线用药，用于治疗终末期肾病患者的高磷血症。然而，过量钙的吸收，会导致高钙血症，并且可能引起软组织和血管的钙沉积。 Calcium carbonate is a widely used effective, inexpensive, over-the-counter phosphate binder. Calcium acetate is an alternative phosphorus binder that is a more soluble and efficient phosphate binder. 碳酸钙是一种被广泛使用的、有效的、价格低廉的OTC磷结合剂。醋酸钙是一种替代性的磷结合剂，它的溶解性更好，是更有效的磷结合剂。 Equimolar doses of calcium acetate bind twice as much phosphorus as calcium carbonate. As a result, phosphorus binding can be achieved with a lower dose of calcium. 同等单位剂量的醋酸钙，与碳酸钙相比，能够结合两倍的磷。带来的结果是，低剂量的钙就可以达到有效结合磷的目的。 The NKF/K-DOQI guidelines state that the total dose of elemental calcium provided by calcium-based phosphate binders should not exceed 1,500 mg/day. NKF（美国国家肾脏病基金会）K-DOQI指南规定，服用含钙的磷结合剂，元素钙的总剂量应小于1500mg/天。 Calcium acetate more readily permits optimal phosphorus binding within these guidelines. 醋酸钙作为最佳的磷结合剂，更加符合该指南的要求。 2006年5月 美国《透析与肾移植》杂志