Experience of the use of iron oxyhydroxide complex for the treatment of hyperphosphatemia in patients with stage 5 diabetic chronic kidney disease at the stage of starting dialysis therapy
- Autores: Batyushin M.M1, Kastanayan A.A1
-
Afiliações:
- FSBEI he "Rostov State Medical University" of the Ministry of Health of the Russian Federation
- Edição: Nº 4 (2018)
- Páginas: 62-65
- Seção: Articles
- URL: https://journals.eco-vector.com/2075-3594/article/view/272843
- DOI: https://doi.org/10.18565/nephrology.2018.4.62-65
- ID: 272843
Citar
Texto integral
Acesso aberto
Acesso está concedido
Acesso é pago ou somente para assinantes
Acesso está concedido
Acesso é pago ou somente para assinantes
Resumo
Objective. To evaluate the efficacy and safety of the use of iron oxyhydroxide complex (Velphoro 500) in the treatment of hyperphosphatemia in patients with diabetic CKD 5D stage. Materials and methods. The study included 30 patients with diabetic CKD 5D stage (18 men and 12 women, average age was 58.6±11.5 years). The median duration of CKD was 13 years [3; 28], CKD 3A-5 stages - 3.8 years [1; 6.2], DM2 - 18 years [6; 32.5]. Patients underwent initiation of hemodialysis treatment with subsequent follow-up for 2 months. Initially, patients did not receive phosphate-binding drugs (PBDs); they only kept a diet aimed at reducing hyperphosphatemia. Due to inefficiency of dietary therapy, Ca-free PBD was administered - an iron oxyhydroxide complex (Velphoro®500) at the initial dose of 3 tablets/day, followed by dose adjustment after 1, 2, 4, and 8 weeks. Results. The use of the iron oxyhydroxide complex ensured the achievement of target phosphate levels of less than 1.49 mmol/L within 2 months of treatment in 29 of 30 treated patients. In the majority of patients (87%), target phosphate levels were noted after 4 weeks of therapy, in two of them - by the end of the first week. Analysis of possible adverse effects when using the iron oxyhydroxide complex showed that diarrhea was observed in 2 cases out of 30 (6.7%). Diarrhea was mild and resolved spontaneously for 1-3 days. Conclusion. Combined therapy of hyperphosphatemia with the use of iron oxyhydroxide complex in diabetic CKD stage 5D demonstrates its high efficacy and safety in the absence of manifestations of drug-drug interaction with atorvastatin and oral antidiabetic drugs.
Texto integral
Sobre autores
M. Batyushin
FSBEI he "Rostov State Medical University" of the Ministry of Health of the Russian Federation
Email: nephr-roon@rambler.ru
Doctor of Medical Sciences, Prof. at the Department of Internal Diseases № 2
A. Kastanayan
FSBEI he "Rostov State Medical University" of the Ministry of Health of the Russian FederationDoctor of Medical Sciences, Professor, Head of the Department of Internal Diseases № 2
Bibliografia
- Merhi B, Shireman T., Carpenter M.A., Kusek J.W., et al. Serum Phosphorus and Risk of Cardiovascular Disease, All-Cause Mortality, or Graft Failure in Kidney Transplant Recipients: An Ancillary Study of the FAVORIT Trial Cohort. Am. J. Kidney Dis. 2017;70(3):377-385. doi: 10.1053/j.ajkd.2017.04.014.
- Solbu M.D., Thomson P.C., Macpherson S., Findlay M.D., Stevens K.K., Patel R.K., Padmanabhan S., Jardine A.G., Mark P.B. Serum phosphate and social deprivation independently predict all-cause mortality in chronic kidney disease. BMC Nephrol. 2015;16:194.
- Vezzoli G., Arcidiacono T., Rainone F. Terranegra A., Aloia A., Dogliotti E., Mingione A., Soldati L., Spotti D. Hyperparathyroidism as a cardiovascular risk factor in chronic kidney disease: an update from a biological-cellular perspective. G Ital. Nefrol. 2011;28(4):383-392.
- Taketani Y., Koiwa F., Yokoyama K. Management of phosphorus load in CKD patients. Clin Exp Nephrol. 2017;21(1):27-36. doi: 10.1007/s10157-016-1360-y.
- KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int. 2017;7(1):1-59.
- Sprague S.M., Floege J. Sucroferric oxyhydroxide for the treatment of hyperphosphatemia. Expert. Opin. Pharmacother. 2018;19(10):1137-1148. doi: 10.1080/14656566.2018.1491548.
- Alfieri C., Malberti F., Mazzaferro S., Gallieni M., Russo D., Messa P., Cozzolino M. Hyperphosphatemia in dialysis: which binder? G. Ital. Nefrol. 2018;35(5)2018.
- Руденко Л.И., Батюшин М.М., Кастанаян А.А., Воробьев Б.И. Прогнозирование риска развития кардиоваскулярной кальцификации у пациентов, получающих хронический гемодиализ. Нефрология. 2015;19(5):72-76.