碳酸镧药物在高磷血症中的应用进展

Progress on Clinical Application of Lanthanum Carbonate in Hyperphosphatamia

高磷血症是慢性肾脏疾病(CKD)常见病发症,其血磷水平可通过磷结合剂进行控制。传统磷结合剂常含钙、铝成分,虽能有效降低血清磷,但增加钙磷乘积,引起心血管钙化,铝在体内积累而产生毒副作用。因此,发展了新型血磷结合剂如碳酸镧磷、柠檬酸铁、镁盐、司维拉姆和考来替兰等。这些磷结合剂降磷效果优于钙系磷结合剂,能有效控制血清磷水平,却不升高血钙,降低了血管钙化风险。

Hyperphosphatemia is common in chronic kidney disease(CKD) and the serum phosphorus level can be controlled by phosphate binders. The traditional calcium-based phosphate binder and non-calcium phosphate binder such as alumium-based phosphate binder can effectively decrease serum phosphorus, but calcium-based phosphate binders tend to promote hypercalcemia and calcium over loading, and accelerate cardiovascular calcification, aluminum can accumulates in the body and results in toxic effect. Therefore, new phosphate binders, such as lanthanum carbonate, ferric citrate, magnesium salt, sevelamer, colestilan, etc, have developed. They are more effective than the calcium carbonate in controlling serum phosphorus levels without elevating blood calcium level, and not raising the risk of vascular calcification.