SciELO - Scientific Electronic Library Online

 
vol.37 número3Perfil genético molecular del gen CTNS en una población persa con cistinosis nefropáticaEstudio de las variables asociadas a la activación local del complemento en la nefropatía IgA idiopática índice de autoresíndice de assuntospesquisa de artigos
Home Pagelista alfabética de periódicos  

Serviços Personalizados

Journal

Artigo

Indicadores

Links relacionados

  • Em processo de indexaçãoCitado por Google
  • Não possue artigos similaresSimilares em SciELO
  • Em processo de indexaçãoSimilares em Google

Compartilhar


Nefrología (Madrid)

versão On-line ISSN 1989-2284versão impressa ISSN 0211-6995

Resumo

CARAVACA, Francisco; CARAVACA-FONTAN, Fernando; AZEVEDO, Lilia  e  LUNA, Enrique. How to assess the efficacy of phosphate binders. Nefrología (Madr.) [online]. 2017, vol.37, n.3, pp.311-319. ISSN 1989-2284.  https://dx.doi.org/10.1016/j.nefro.2016.11.012.

Background and aims:

The efficacy of phosphate binders is difficult to be estimated clinically. This study analyzes the changes in serum phosphate and urinary phosphate excretion after the prescription of phosphate binders (PB) in patients with chronic kidney disease stage 4-5 pre-dialysis, and the usefulness of the ratio between total urinary phosphate and protein catabolic rate (Pu/PCR) for estimating the efficacy of PB.

Methods:

This retrospective observational cohort study included adult chronic kidney disease patients. Biochemical parameters were determined baseline and after 45-60 days on a low phosphate diet plus PB (“binder” subgroup = 260 patients) or only with dietary advice (“control” subgroup = 79 patients).

Results:

Phosphate load (total urinary excretion) per unit of renal function (Pu/GFR) was the best parameter correlated with serum phosphate levels (R2 = 0.61). Mean ± SD level of Pu/PCR was 8.2 ± 2.3 mg of urinary phosphate per each g of estimated protein intake. After treatment with PB, serum phosphate levels decreased by 11%, urinary phosphate 22%, protein catabolic rate 7%, and Pu/PCR 15%. In the control subgroup, Pu/PCR increased by 20%. Urinary phosphate and urea nitrogen excretion correlated strongly, both baseline and after PB or dietary advice.

Conclusions:

The proposed parameter Pu/PCR may reflect the rate of intestinal phosphate absorption, and therefore, its variations after PB prescription may be a useful tool for estimating the pharmacological efficacy of these drugs.

Palavras-chave : Chronic kidney disease; Hyperphosphatemia; Phosphaturia; Phosphate binders.

        · resumo em Espanhol     · texto em Espanhol     · Espanhol ( pdf )