Efficacy and Safety of Phosphate-Lowering Agents for Adult Patients with CKD Requiring Dialysis: A Network Meta-Analysis.

IF 8.5 1区 医学 Q1 UROLOGY & NEPHROLOGY
Masatoshi Nishimoto, Takeshi Hasegawa, Miho Murashima, Hisashi Noma, Hiroki Nishiwaki, Shunsuke Yamada, Aya Mizukami, Hirotaka Saito, Hiroshi Kimura, Masatomo Taniguchi, Takayuki Hamano, Masafumi Fukagawa
{"title":"Efficacy and Safety of Phosphate-Lowering Agents for Adult Patients with CKD Requiring Dialysis: A Network Meta-Analysis.","authors":"Masatoshi Nishimoto, Takeshi Hasegawa, Miho Murashima, Hisashi Noma, Hiroki Nishiwaki, Shunsuke Yamada, Aya Mizukami, Hirotaka Saito, Hiroshi Kimura, Masatomo Taniguchi, Takayuki Hamano, Masafumi Fukagawa","doi":"10.2215/CJN.0000000665","DOIUrl":null,"url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":" ","pages":"676-696"},"PeriodicalIF":8.5000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097192/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Journal of the American Society of Nephrology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2215/CJN.0000000665","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/14 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
降磷酸盐药物治疗成人慢性肾病透析患者的疗效和安全性:一项网络荟萃分析
背景:有必要更新每一种降磷酸盐药物对透析患者的影响。方法:从CENTRAL、MEDLINE、EMBASE和ClinicalTrial.gov数据库中提取口服降磷酸盐药物治疗需要维持性透析的成人患者的随机对照试验(rct)。治疗期需要8周或更长时间,并根据Cochrane协作方法评估偏倚风险。结果为全因死亡率、心血管死亡率、胃肠道(GI)事件、骨折、冠状动脉钙评分(CACS)、血清钙、磷酸盐、完整甲状旁腺激素(iPTH)和碳酸氢盐水平。使用多变量随机效应模型进行网络荟萃分析以评估比较有效性。采用累积排序曲线(SUCRA)下的表面来评估降磷剂的排序。结果:共纳入70项随机对照试验,涉及15551名受试者。评估了11种降磷剂,包括钙基剂、七维拉默、双羟色胺、镧、氢氧化铁、柠檬酸铁、泰纳诺、镁、烟酰胺、铝和硫糖铝。与钙基药物相比,Sevelamer与较低的全因死亡率显著相关[风险比(95%可信区间{CI}): 0.59(0.37-0.94)],根据SUCRA,估计氢氧化铁和tenapanor在降低全因死亡率方面排名较高。烟酰胺组发生胃肠道事件的风险最高,其次是氢氧化铁。与钙基药物相比,镧基和氢氧化铁基药物的CACS显著降低[标准化平均差(95% CI)分别为-0.26(-0.52 ~ -0.01)和-0.50(-0.95 ~ -0.06)]。接受钙基药物治疗的患者血清钙水平较高,血清iPTH水平较低。除西维拉默外,所有其他药物的血清碳酸氢盐水平均高于安慰剂。结论:与钙基药物相比,sevelamer与较低的全因死亡率相关,而氢氧化铁和镧与CACS进展较慢相关。在选择降磷酸盐剂时应考虑潜在的益处和危害(PROSPERO: CRD42022328388)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
12.20
自引率
3.10%
发文量
514
审稿时长
3-6 weeks
期刊介绍: The Clinical Journal of the American Society of Nephrology strives to establish itself as the foremost authority in communicating and influencing advances in clinical nephrology by (1) swiftly and effectively disseminating pivotal developments in clinical and translational research in nephrology, encompassing innovations in research methods and care delivery; (2) providing context for these advances in relation to future research directions and patient care; and (3) becoming a key voice on issues with potential implications for the clinical practice of nephrology, particularly within the United States. Original manuscript topics cover a range of areas, including Acid/Base and Electrolyte Disorders, Acute Kidney Injury and ICU Nephrology, Chronic Kidney Disease, Clinical Nephrology, Cystic Kidney Disease, Diabetes and the Kidney, Genetics, Geriatric and Palliative Nephrology, Glomerular and Tubulointerstitial Diseases, Hypertension, Maintenance Dialysis, Mineral Metabolism, Nephrolithiasis, and Transplantation.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信