磷結合劑概論

Introduction of Phosphate Binders

許巧縈(Chiao-Ying Hsu) ； 吳麥斯(Mai-Szu Wu) ； 陳錫賢(Hsi-Hsien Chen)

《腎臟與透析》 27卷3期 (2015/09) Pp. 111-114

https://doi.org/10.6340/KD.2015.27(3).03

摘要

高血磷症是慢性腎衰竭相當重要的併發症，與病人的心血管死亡風險相關，必須配合服用磷結合劑治療。含鋁的磷結合劑因鋁沈積的副作用已被淘汰，含鈣的磷結合劑因副作用少且經濟效益高而成為臨床使用的主流，但因鈣化疑慮促成不含鈣鋁的磷結合劑問世，包括磷能解、磷減樂以及碳酸鑭，其價格上的負擔是無法普及的主因。另外，近年有含鐵的磷結合劑Velphoro及檸檬酸鐵在美國核准上市，未來可期待更多選擇配合使用，以達到更優越的血磷調控。

關鍵字

磷結合劑 ； 高血磷症 ； 磷能解 ； 碳酸鑭 ； 檸檬酸鐵

並列摘要

Hyperphosphatemia is a very important complication of chronic kidney disease, highly associated with cardiovascular mortality. Most patients must use oral phosphate binders to control their serum phosphate levels. Aluminum containing agents have been eliminated from the market for unaffordable aluminum toxicity. Calcium-based phosphate binders are most widely used in current clinical practice, mainly because of fewer side effects and cost effectiveness. However, concerns of calcium load and calcification promote the usage of non-calcium-based binders, including Sevelamer hydrochloride, Sevelamer carbonate, and Lanthanum carbonate. High cost is the main concern of these new agents. Furthermore, new iron-based phosphate binders, Velphoro (sucroferric oxyhydroxide) and Ferric citrate, get FDA approval in recent years. We can expect more choices of phosphate binders in the future to improve serum phosphate control.

並列關鍵字

ferric citrate ； hyperphosphatemia ； lanthanum carbonate ； phosphate binders ； sevelamer