투석 환자에서 고인산혈증 치료를 위한 경구용인산염 결합제의 임상결과 비교 연구 (Comparative Study of Oral Phosphate Binders for the Management of Hyperphosphatemia in Dialysis Patient)

서지정보

· 발행기관 : 한국병원약사회
· 수록지 정보 : 병원약사회지 / 31권 / 1호 / 610 ~ 620페이지
· 저자명 : 박선희, 최인, 최은주

초록

Hyperphosphatemia, one complication of the end stage renal disease (ESRD), maylead to bone disorders and cardiovascular complications (CVD). The management of hyperphosphatemiatreatment needs dietary restrictions and the initiation of oral phosphate binders. Moststudies have evaluated the degrees of vascular calcification (VC) by examining the changes inserum calcium levels and also the ability to control serum mineral levels between the calciumbasedphosphate binders and non calcium-based ones in dialysis patients. The goal of this studyis to compare the clinical results after administering three oral phosphate binders such as calciumacetate, sevelamer hydrochloride, and lanthanum carbonate. We have retrospectively examined100 out of 222 dialysis patients with electronic medical record (EMR) from 2005 to 2012based on the inclusion criteria. The EMR data consist of mineral levels, bone and cardiovascular bio-markers from the baseline to 12 weeks. According to our results, all phosphate binders havesignificantly decreased serum phosphorus levels after 12 weeks (p<0.05). The serum calcium levelsassociated with VC are not statistically significant differences in each of the three groups(p>0.05). The concentrations of alkaline phosphatase (ALP) associated with bone disorders haveincreased, although not statistically significant, during the sevelamer and lanthanum treatment.
In the sevelamer treated group, the total cholesterol and low density lipoprotein concentrationshave decreased significantly (p<0.05). Larger and prospective studies associated with the preventionsof CVD in dialysis patients are necessary in the future.

영어초록

Hyperphosphatemia, one complication of the end stage renal disease (ESRD), maylead to bone disorders and cardiovascular complications (CVD). The management of hyperphosphatemiatreatment needs dietary restrictions and the initiation of oral phosphate binders. Moststudies have evaluated the degrees of vascular calcification (VC) by examining the changes inserum calcium levels and also the ability to control serum mineral levels between the calciumbasedphosphate binders and non calcium-based ones in dialysis patients. The goal of this studyis to compare the clinical results after administering three oral phosphate binders such as calciumacetate, sevelamer hydrochloride, and lanthanum carbonate. We have retrospectively examined100 out of 222 dialysis patients with electronic medical record (EMR) from 2005 to 2012based on the inclusion criteria. The EMR data consist of mineral levels, bone and cardiovascular bio-markers from the baseline to 12 weeks. According to our results, all phosphate binders havesignificantly decreased serum phosphorus levels after 12 weeks (p<0.05). The serum calcium levelsassociated with VC are not statistically significant differences in each of the three groups(p>0.05). The concentrations of alkaline phosphatase (ALP) associated with bone disorders haveincreased, although not statistically significant, during the sevelamer and lanthanum treatment.
In the sevelamer treated group, the total cholesterol and low density lipoprotein concentrationshave decreased significantly (p<0.05). Larger and prospective studies associated with the preventionsof CVD in dialysis patients are necessary in the future.

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