Effect of switching from sevelamer hydrochloride to lanthanum carbonate on metabolic acidosis in dialysis patients
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概要
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Treatments for hyperphosphatemia in dialysis patients include dietary therapy and oral administration of phosphate binders;however, it has recently been suggested that oral administration of sevelamer hydrochloride, a phosphate binder, may causemetabolic acidosis. Owing to the decreased supply of sevelamer hydrochloride after the Eastern Japan Great EarthquakeDisaster on March 11, 2011, hyperphosphatemia patients switched to another phosphate binder, lanthanum carbonate. Here,we retrospectively evaluated the effect of this medication substitution on metabolic acidosis in patients on maintenance hemodialysis.32 patients, who underwent maintenance hemodialysis at Nagasaki Kidney Center in Japan, were enrolled in ourstudy and followed to evaluate the effect of switching medication on metabolic acidosis at 3 months after switching from sevelamerhydrochloride to lanthanum carbonate. The mean dose of sevelamer hydrochloride prior to the earthquake disaster was3 g/day, and the mean dose of lanthanum carbonate thereafter was 0.9 g/day. Three months after the medication waschanged, the concentration of bicarbonate ion did not increase significantly (p = 0.186), whereas pH and base excess increasedsignificantly (p = 0.007 and p = 0.036, respectively). In this study, although the HCO3- level was not significantlychanged, the pH and base excess were significantly increased. Our findings indicate that lanthanum carbonate ameliorates metabolic acidosis.
- 長崎大学医学部の論文
長崎大学医学部 | 論文
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