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Effects of sevelamer hydrochloride combined with low calcium dialysate on serum high-density lipoprotein, phosphorus, calcium-phosphate product and adverse reactions in patients undergoing hemodialysis |
ZHU Xueli, SU Dongmei, CHEN Zhiyu, and WEN Yue |
Department of Nephrology, West China Hospital, Sichuan University, Chengdu 610041, China |
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Abstract Objective To investigate the effects of sevelamer hydrochloride combined with low calcium dialysate on high-density lipoprotein, phosphorus, and calcium-phosphorus product of serum and adverse reactions in patients undergoing hemodialysis.Methods Eighty patients with chronic renal failure who underwent hemodialysis in the Department of Nephrology of our hospital between January 2016 and January 2018 were randomly divided into the control group (treated with conventional hemodialysis, n=40) and the experimental group (treated with sevelamer hydrochloride combined with low calcium dialysate, n=40). The course of treatments for both groups was 12 weeks. The changes of lipid metabolism indexes (TC, TG, LDL-C, HDL-C), blood calcium, serum phosphorus, serum calcium-phosphorus product and adverse reactions in both groups were observed.Results There was no significant change in serum calcium concentrations after treatment in the experimental group (P>0.05). The serum calcium concentration (2.75±0.35) mmol/L in the control group was significantly higher after treatment (P<0.05).After treatment, the levels of TC (4.12±0.86) mmol/L, TG (1.21±0.64) mmol/L and LDL-C (2.14±0.38) mmol/L in the experimental group were significantly lower than those in the control group, while HDL-C was significantly higher than that in the control group (P<0.05). The total incidence of adverse reactions was 31.82% in the experimental group, which was significantly higher than 18.18% in the control group (P<0.05).Conclusions Sevelamer hydrochloride combined with low calcium dialysate can significantly improve the levels of serum high-density lipoprotein, serum phosphorus and serum calcium-phosphorus product in patients undergoing hemodialysis, with significant curative effect but without serious adverse reactions.
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Received: 13 August 2018
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[1] |
王玉柱, 叶朝阳, 金其庄. 中国血液透析用血管通路专家共识[J].中国血液净化, 2014, 13(8):549-558.
|
[2] |
蔡 砺, 刘惠兰, 吴 华,等.高通量血液透析可以有效地清除β2微球蛋白和改善维持性血液透析患者的慢性炎症状态[J]. 中国血液净化, 2010, 9(1):25-28.
|
[3] |
徐 斌, 张 文, 龚德华,等.国产高通量透析器在血液透析治疗中的有效性和安全性评估[J]. 肾脏病与透析肾移植杂志, 2012, 21(6):524-529.
|
[4] |
迟荣玲. 长期维持性血液透析的临床进展[J].中国社区医师, 2016, 32(33):7-8.
|
[5] |
郁胜强, 汤晓静. 血液透析技术改善高磷血症的体会[J].肾脏病与透析肾移植杂志, 2015, 24(3):257-258.
|
[6] |
Lin C J, Pan C F, Chuang C K, et al. Effects of Sevelamer Hydrochloride on Uremic Toxins Serum Indoxyl Sulfate and P-Cresyl Sulfate in Hemodialysis Patients.[J]. J Clinic Med Res, 2017, 9(9):765-770.
|
[7] |
郭 静, 池艳春, 陈 曦,等. 低钙透析液联合醋酸钙对血液透析患者高磷血症的影响[J]. 现代生物医学进展, 2014, 14(8):1522-1524.
|
[8] |
Ikee R, Toyoyama T, Endo T, et al. Impact of sevelamer hydrochloride on serum magnesium concentrations in hemodialysis patients[J]. Magnes Res,2016,29(4):184.
|
[9] |
李 伟, 周 乐. 慢性肾衰竭钙磷代谢紊乱的诊断及中西医结合治疗[J].中华肾病研究电子杂志, 2013(5):246-250.
|
[10] |
张 明, 谷红霞, 魏春华,等.醋酸钙与碳酸钙对血液透析患者高磷血症的疗效比较[J]. 中国综合临床, 2013, 29(12):1285-1286.
|
[11] |
吴其顺, 王文燕, 何建强,等.高通量血液透析联合血液透析滤过序贯治疗慢性肾衰竭临床观察[J]. 山东医药, 2017(37):87-89.
|
[12] |
Habbous S, Przech S, Acedillo R, et al. The efficacy and safety of sevelamer and lanthanum versus calcium-containing and iron-based binders in treating hyperphosphatemia in patients with chronic kidney disease: a systematic review and meta-analysis[J]. Nephrol Dial Transplant, 2017, 32(1):111.
|
[13] |
丁红莲, 汪裕伟, 杨沿浪. 维持性血液透析患者高磷血症的相关因素分析[J].安徽医药, 2016, 20(1):143-144.
|
[14] |
徐梦露, 徐旭东.维持性血透患者高磷血症的现状与治疗进展[J]. 中国中西医结合肾病杂志, 2016, 17(6):557-559.
|
[15] |
苗畅贤, 谢宪敏, 丛志华.低钙透析液对维持性血液透析患者钙磷代谢及甲状旁腺激素的影响[J]. 实用临床医药杂志, 2017, 21(3):29-31.
|
[16] |
Kim J, Olson K, Butani L. Sevelamer crystals in the mucosa of the gastrointestinal tract in a teenager with end-stage renal disease[J]. Pedi Nep, 2016, 31(2):339-341.
|
[17] |
张 兵, 汤 娜, 熊 怡.低浓度钙透析液对维持性血液透析患者继发性甲状旁腺功能亢进及颈动脉粥样硬化的影响[J].河北医学, 2017, 23(2):243-247.
|
|
|
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