蔗糖羟基氧化铁对透析患者高磷血症的应用进展
Advances in the Use of Sucrose Sucroferric Oxyhydroxide in Hyperphosphatemia in Dialysis Patients
DOI: 10.12677/acm.2025.152548, PDF,   
作者: 张 丽, 杨小娟*：延安大学附属医院肾内科，陕西 延安
关键词: 蔗糖羟基氧化铁；高磷血症；综述；Sucroferric Oxyhydroxide； Hyperphosphatemia； Review
摘要: 高磷血症是慢性肾脏病(Chronic kidney disease, CKD)和终末期肾病(end state rental disease, ESRD)患者透析患者常见的并发症之一，我国透析患者高磷血症患病率很高，但透析患者的血磷达标率却很低。而高磷血症可增加CKD患者心血管死亡率和全因死亡率。因此将血磷水平控制至目标水平是改善CKD患者预后的关键，我国近期新上市一种口服铁基非含钙磷结合剂以治疗透析患者高磷血症。本研究主要综述了高磷血症的发生机制及蔗糖羟基氧化铁治疗高磷血症的有效性、安全性，以期为蔗糖羟基氧化铁治疗高磷血症提供证据支持。
Abstract: Hyperphosphatemia is one of the common complications of dialysis patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). Hyperphosphatemia can increase cardiovascular mortality and all-cause mortality in patients with CKD. Therefore, controlling the blood phosphorus level to the target level is the key to improving the prognosis of CKD patients, and an oral iron-based non-calcium-phosphorus binder has recently been launched in China to treat hyperphosphatemia in dialysis patients. This study mainly reviewed the mechanism of hyperphosphatemia and the efficacy and safety of sucrose sucroferric oxyhydroxide in the treatment of hyperphosphatemia, in order to provide evidence support for the treatment of hyperphosphatemia with sucrose sucroferric oxyhydroxide.
文章引用：张丽, 杨小娟. 蔗糖羟基氧化铁对透析患者高磷血症的应用进展[J]. 临床医学进展, 2025, 15(2): 1886-1891. https://doi.org/10.12677/acm.2025.152548

参考文献

[1] Liu, Z., Yu, X., Yang, J., Jiang, A., Liu, B., Xing, C., et al. (2018) Prevalence and Risk Factors for Vascular Calcification in Chinese Patients Receiving Dialysis: Baseline Results from a Prospective Cohort Study. Current Medical Research and Opinion, 34, 1491-1500. [Google Scholar] [CrossRef] [PubMed]
[2] Gallieni, M., De Luca, N., Santoro, D., Meneghel, G., Formica, M., Grandaliano, G., et al. (2015) Management of CKD-MBD in Non-Dialysis Patients under Regular Nephrology Care: A Prospective Multicenter Study. Journal of Nephrology, 29, 71-78. [Google Scholar] [CrossRef] [PubMed]
[3] Bai, W., Li, J. and Liu, J. (2016) Serum Phosphorus, Cardiovascular and All-Cause Mortality in the General Population: A Meta-Analysis. Clinica Chimica Acta, 461, 76-82. [Google Scholar] [CrossRef] [PubMed]
[4] Zhou, C., Wang, F., Wang, J., Zhang, L. and Zhao, M. (2016) Mineral and Bone Disorder and Its Association with Cardiovascular Parameters in Chinese Patients with Chronic Kidney Disease. Chinese Medical Journal, 129, 2275-2280. [Google Scholar] [CrossRef] [PubMed]
[5] 袁群生, 李雪梅. 2017年KDIGO关于慢性肾脏病矿物质及骨异常临床实践指南更新与解读[J]. 协和医学杂志, 2018, 9(3): 213-218
[6] 张丁心, 陈利群. 新型磷结合剂在慢性肾脏病高磷血症治疗中的应用研究进展[J]. 中国现代医药杂志, 2021, 23(1): 104-108
[7] Hu, M.C. and Moe, O.W. (2022) Phosphate and Cellular Senescence. In: Advances in Experimental Medicine and Biology, Springer, 55-72. [Google Scholar] [CrossRef] [PubMed]
[8] Alizadeh Naderi, A.S. and Reilly, R.F. (2010) Hereditary Disorders of Renal Phosphate Wasting. Nature Reviews Nephrology, 6, 657-665. [Google Scholar] [CrossRef] [PubMed]
[9] Farrow, E.G. and White, K.E. (2010) Recent Advances in Renal Phosphate Handling. Nature Reviews Nephrology, 6, 207-217. [Google Scholar] [CrossRef] [PubMed]
[10] Penido, M.G.M.G. and Alon, U.S. (2012) Phosphate Homeostasis and Its Role in Bone Health. Pediatric Nephrology, 27, 2039-2048. [Google Scholar] [CrossRef] [PubMed]
[11] Peacock, M. (2018) Hypoparathyroidism and the Kidney. Endocrinology and Metabolism Clinics of North America, 47, 839-853. [Google Scholar] [CrossRef] [PubMed]
[12] Marks, J., Debnam, E.S. and Unwin, R.J. (2010) Phosphate Homeostasis and the Renal-Gastrointestinal Axis. American Journal of Physiology-Renal Physiology, 299, F285-F296. [Google Scholar] [CrossRef] [PubMed]
[13] Bergwitz, C. and Jüppner, H. (2010) Regulation of Phosphate Homeostasis by PTH, Vitamin D, and FGF23. Annual Review of Medicine, 61, 91-104. [Google Scholar] [CrossRef] [PubMed]
[14] Price, P.A. and Lim, J.E. (2003) The Inhibition of Calcium Phosphate Precipitation by Fetuin Is Accompanied by the Formation of a Fetuin-Mineral Complex. Journal of Biological Chemistry, 278, 22144-22152. [Google Scholar] [CrossRef] [PubMed]
[15] Herrmann, M., Schäfer, C., Heiss, A., Gräber, S., Kinkeldey, A., Büscher, A., et al. (2012) Clearance of Fetuin-A-Containing Calciprotein Particles Is Mediated by Scavenger Receptor-A. Circulation Research, 111, 575-584. [Google Scholar] [CrossRef] [PubMed]
[16] Komaba, H. and Fukagawa, M. (2016) Phosphate—A Poison for Humans? Kidney International, 90, 753-763. [Google Scholar] [CrossRef] [PubMed]
[17] Suki, W.N., Zabaneh, R., Cangiano, J.L., Reed, J., Fischer, D., Garrett, L., et al. (2007) Effects of Sevelamer and Calcium-Based Phosphate Binders on Mortality in Hemodialysis Patients. Kidney International, 72, 1130-1137. [Google Scholar] [CrossRef] [PubMed]
[18] Patel, L., Bernard, L.M. and Elder, G.J. (2016) Sevelamer versus Calcium-Based Binders for Treatment of Hyperphosphatemia in CKD. Clinical Journal of the American Society of Nephrology, 11, 232-244. [Google Scholar] [CrossRef] [PubMed]
[19] 宋明爱, 闫灵芝. 司维拉姆治疗慢性肾衰竭维持性血液透析患者高磷血症的疗效[J]. 药物评价研究, 2017, 40(9): 1302-1305.
[20] Floege, J., Covic, A.C., Ketteler, M., Mann, J.F.E., Rastogi, A., Spinowitz, B., et al. (2015) Long-Term Effects of the Iron-Based Phosphate Binder, Sucroferric Oxyhydroxide, in Dialysis Patients. Nephrology Dialysis Transplantation, 30, 1037-1046. [Google Scholar] [CrossRef] [PubMed]
[21] 江艳, 黄珍伦, 聂凌. 碳酸镧治疗尿毒症维持性血液透析患者高磷血症的临床观察[J]. 中国药房, 2017, 28(20): 2787-2789.
[22] Makino, M., Kawaguchi, K., Shimojo, H., Nakamura, H., Nagasawa, M. and Kodama, R. (2014) Extensive Lanthanum Deposition in the Gastric Mucosa: The First Histopathological Report. Pathology International, 65, 33-37. [Google Scholar] [CrossRef] [PubMed]
[23] Geisser, P. and Philipp, E. (2010) PA21: A Novel Phosphate Binder for the Treatment of Hyperphosphatemia in Chronic Kidney Disease. Clinical Nephrology, 74, 4-11. [Google Scholar] [CrossRef] [PubMed]
[24] Lanz, M., Baldischweiler, J., Kriwet, B., Schill, J., Stafford, J. and Imanidis, G. (2013) Chewability Testing in the Development of a Chewable Tablet for Hyperphosphatemia. Drug Development and Industrial Pharmacy, 40, 1623-1631. [Google Scholar] [CrossRef] [PubMed]
[25] Wilhelm, M., Gaillard, S., Rakov, V. and Funk, F. (2014) The Iron-Based Phosphate Binder PA21 Has Potent Phosphate Binding Capacity and Minimal Iron Release across a Physiological Ph Range in Vitro. Clinical Nephrology, 81, 251-258. [Google Scholar] [CrossRef] [PubMed]
[26] Liu, J., Zuo, L., Walpen, S., Bernard, L., Marty, M. and Enoiu, M. (2023) Efficacy and Safety of Sucroferric Oxyhydroxide Compared with Sevelamer Carbonate in Chinese Dialysis Patients with Hyperphosphataemia: A Randomised, Open-Label, Multicentre, 12-Week Phase III Study. Nephron, 148, 22-33. [Google Scholar] [CrossRef] [PubMed]
[27] Shima, H., Miya, K., Okada, K., Minakuchi, J. and Kawashima, S. (2018) Sucroferric Oxyhydroxide Decreases Serum Phosphorus Level and Fibroblast Growth Factor 23 and Improves Renal Anemia in Hemodialysis Patients. BMC Research Notes, 11, Article No. 363. [Google Scholar] [CrossRef] [PubMed]
[28] Akizawa, T., Saito, A., Gejyo, F., Suzuki, M., Nishizawa, Y., Tomino, Y., et al. (2014) Low Hemoglobin Levels and Hypo-Responsiveness to Erythropoiesis-Stimulating Agent Associated with Poor Survival in Incident Japanese Hemodialysis Patients. Therapeutic Apheresis and Dialysis, 18, 404-413. [Google Scholar] [CrossRef] [PubMed]
[29] Kuo, K., Hung, S., Lin, Y., Tang, C., Lee, T., Lin, C., et al. (2012) Intravenous Ferric Chloride Hexahydrate Supplementation Induced Endothelial Dysfunction and Increased Cardiovascular Risk among Hemodialysis Patients. PLOS ONE, 7, e50295. [Google Scholar] [CrossRef] [PubMed]
[30] Brookhart, M.A., Freburger, J.K., Ellis, A.R., Wang, L., Winkelmayer, W.C. and Kshirsagar, A.V. (2013) Infection Risk with Bolus versus Maintenance Iron Supplementation in Hemodialysis Patients. Journal of the American Society of Nephrology, 24, 1151-1158. [Google Scholar] [CrossRef] [PubMed]
[31] Litton, E., Xiao, J. and Ho, K.M. (2013) Safety and Efficacy of Intravenous Iron Therapy in Reducing Requirement for Allogeneic Blood Transfusion: Systematic Review and Meta-Analysis of Randomised Clinical Trials. British Medical Journal, 347, f4822. [Google Scholar] [CrossRef] [PubMed]
[32] Doshi, S.M. and Wish, J.B. (2022) Past, Present, and Future of Phosphate Management. Kidney International Reports, 7, 688-698. [Google Scholar] [CrossRef] [PubMed]
[33] Keyer, K. and Imlay, J.A. (1996) Superoxide Accelerates DNA Damage by Elevating Free-Iron Levels. Proceedings of the National Academy of Sciences, 93, 13635-13640. [Google Scholar] [CrossRef] [PubMed]
[34] Floege, J., Covic, A.C., Ketteler, M., Rastogi, A., Chong, E.M.F., Gaillard, S., et al. (2014) A Phase III Study of the Efficacy and Safety of a Novel Iron-Based Phosphate Binder in Dialysis Patients. Kidney International, 86, 638-647. [Google Scholar] [CrossRef] [PubMed]

为你推荐