用于预防和治疗慢性病-矿物质和骨疾病 (CKD-MBD) 的酸结合剂
Patrizia Natale1,2, Suetonia C Green3, Marinella Ruospo1
1Sydney School of Public Health, The University of Sydney, Sydney, Australia.
The Cochrane database of systematic reviews
|June 27, 2025
概括
与安慰剂相比,酸盐结合剂如塞维拉默和对慢性病 (CKD) 患者有不确定的影响. 塞维拉默可能会降低透析患者的死亡率和高血与相比,但会增加便秘的风险.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 药理学 药理学是指药理学的学科.
- 基于证据的医学基于证据的医学.
背景情况:
- 酸盐结合剂用于降低慢性病 (CKD) 患者的血清酸盐水平.
- 这次更新的综述综合了自2011年和2018年之前出版以来关于酸盐结合剂的益处和危害的新证据.
研究的目的:
- 评估酸盐结合剂对CKD患者的益处和危害.
- 为了相互比较不同酸盐结合剂的作用.
主要方法:
- 随机对照试验 (RCT) 和准RCT的系统审查和元分析.
- 包括患有CKD (任何GFR) 的成年人,将酸盐结合剂与安慰剂,常规护理或其他结合剂相比较至少八周.
- 关键结局包括死亡率,心血管死亡,高血症,胃肠道症状,血清酸盐和血管化.
主要成果:
- 与透析患者的结剂相比,塞维拉可能会降低全因死亡率和高血症,但会增加便秘风险.
- 在CKD患者中,兰可以减少高血症,而和血清酸盐相比略低,而安慰剂相比略低,但会增加恶心和便秘.
- 其他对比的证据和对心血管死亡或冠状动脉分数的影响很少或不确定,确定性低至非常低.
结论:
- 塞维拉默和在特定的患者群体 (透析,慢性病) 中显示出潜在的益处,但与增加的胃肠道副作用有关.
- 对大多数结果的证据确定性低至非常低,这凸显了进一步高质量的研究的必要性.
- 酸盐结合剂对心血管结果和血管化的影响仍然不确定,特别是在对比比较中.
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