柠檬酸铁可以降低肾透析患者对多种药物的需求

Ferric citrate may reduce dialysis patients' need for multiple medications

日期:

2014年7月24日,

来源: 美国肾脏病学会(ASN)

翻译：蓝山

简介:

研究人员在进行了一项研究后报告说，枸橼酸铁能有效降低血液中的磷含量，同时增加铁的储存，减少对透析患者静脉注射铁和贫血药物的需求。这种药物可以帮助减少与肾脏疾病相关的并发症和费用。

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完整的故事

一种叫做铁柠檬酸的药物可以减少透析患者服用多种治疗肾病并发症的药物。临床试验结果出现在即将出版的《美国肾脏学会杂志》(JASN)上，表明这种药物是安全有效的，甚至可以帮助降低成本。

 

美国有40多万患者接受透析治疗肾脏疾病。大多数患者需要服用与磷结合的药物，以减少这种矿物质在体内的毒性积聚。他们还必须服用治疗贫血的药物，这在肾病患者中很常见，因为需要健康的肾脏才能产生刺激红细胞生成的激素。病人也往往缺铁。

 

透析患者通常需要服用3种不同的药物来克服这3种与肾脏疾病相关的并发症: 结合磷的药物，促红细胞生成素刺激剂(ESA)，促进血液细胞的生成，以及静脉(IV)铁。Julia Lewis，医学博士(Vanderbilt University School of Medicine)和她的合作研究小组的同事们进行了一项441人的随机临床试验，以测试一种叫做铁柠檬酸盐的化合物结合磷的潜力，增加铁的储存，并减少IV铁和ESAs的使用。

 

患者随机接受柠檬酸铁或另一种磷结合剂治疗52周。接着是4周的时间，在此期间，服用柠檬酸铁的患者再次被随机分配到继续服用药物或改用安慰剂。

 

研究人员发现，柠檬酸铁可以有效降低血磷水平，同时增加铁的储存，减少对铁和ESAs的需求。刘易斯博士说:“柠檬酸铁结合了食物中的磷元素，同时也增加了血液中的铁元素，从而使病人需要更少的铁和药物，从而使他们的骨髓产生更多的血细胞。”她还指出，透析患者经常会经历许多严重的不良医疗事件，其中很多都需要住院治疗，而与目前可用的磷酸盐结合药物相比，柠檬酸铁与这些事件的联系更少。“虽然对病人有益，但据估计，柠檬酸铁也能降低透析患者的护理成本，减少静脉注射铁和ESA的使用，以及住院治疗。”

 

 

　

Ferric citrate may reduce dialysis patients' need for multiple medications

Date:

July 24, 2014

Source:

American Society of Nephrology (ASN)

Summary:

Ferric citrate effectively reduced blood phosphorus levels while increasing iron stores and decreasing the need for intravenous iron and anemia medications in dialysis patients, researchers report after conducting a study. The medication may help reduce complications and costs associated with kidney disease care.

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FULL STORY

A medication called ferric citrate may reduce dialysis patients' need to take multiple drugs that treat complications related to kidney disease. Clinical trial results appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN) indicate that the medication is safe and effective and may even help cut costs.

 

More than 400,000 patients in the United States are on dialysis to treat their kidney disease. Most of these patients need to take medications that bind to phosphorus in their food to reduce toxic buildup of the mineral in their bodies. They also must take drugs to treat anemia, which commonly arises in patients with kidney disease because healthy kidneys are needed to generate the hormone that stimulates red blood cell production. Patients also tend to be iron deficient.

Dialysis patients usually have to take 3 different medications to overcome these 3 complications related to kidney disease: drugs that bind phosphorus, erythropoietin-stimulating agents (ESA) that boost blood cell production, and intravenous (IV) iron. Julia Lewis, MD (Vanderbilt University School of Medicine) and her colleagues in the Collaborative Study Group conducted a 441-patient randomized clinical trial to test the potential of a compound called ferric citrate to bind phosphorus, increase iron stores, and reduce the usage of IV iron and ESAs.

Patients were randomized to receive either ferric citrate or another phosphorus-binding agent for 52 weeks. This was then followed by a 4-week period in which patients taking ferric citrate were again randomized to either continue on the medication or switch to placebo.

The study investigators found that ferric citrate effectively reduced blood phosphorus levels while increasing iron stores and decreasing the need for IV iron and ESAs. "Ferric citrate binds the phosphorus in food and also increases iron in the blood, and it allows patients to need less or no IV iron and medicines to make their bone marrow produce more blood cells," said Dr. Lewis. She also noted that patients on dialysis often experience many serious adverse medical events, many of which require hospitalization, and that ferric citrate was linked with fewer of these events compared with currently available phosphorus-binding medications. "While benefiting patients, ferric citrate is estimated to also actually reduce the cost of caring for dialysis patients by reducing IV iron and ESA usage, as well as hospitalizations."

https://www.sciencedaily.com/releases/2014/07/140724171755.htm