The impact of sevelamer in aluminum phosphide poisoning: a preliminary study on mortality

Q4 Medicine

Medicina Clinica Practica Pub Date : 2025-09-23 DOI:10.1016/j.mcpsp.2025.100520

Kiandokht Khorshidi , Maral Ramezani , Mitra Rahimi , Shahin Shadnia , Babak Mostafazadeh , Peyman Erfan Talab Evini

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Abstract

Background

Aluminum phosphide (ALP) poisoning, commonly referred to as rice tablet poisoning, is among the deadliest forms of poisoning. Treatment for aluminum phosphide poisoning is limited to supportive care, as no specific antidote is currently available. Sevelamer is being repurposed as an antidote for phosphine gas poisoning. This study seeks to assess the impact of sevelamer treatment on patients’ outcomes and overall prognosis.

Method

This single-blind trial was conducted on patients suffering from aluminum phosphide poisoning (Oct 2023–Dec 2024). Participants were split into two groups: the control group received standard treatment, while the intervention group received standard treatment plus 2.4 g sevelamer carbonate initially, followed by 800 mg tablets every 8 hours. Data were collected using a study-specific checklist covering demographics, clinical symptoms, lab findings, patient outcomes, hospital stay duration, disease history, and secondary complications.

Results

The control group comprised 19 males (63.3%) and 11 females (36.7%). The sevelamer group, 26 males (81.25%) and 6 females (18.75%). This study demonstrated that sevelamer decreased mortality rates (56.25% compared to 86.7%) and enhanced ejection fraction (from 35.8% to 47.5% post-treatment). On the first day, it significantly raised blood PH (7.13 vs 7.23) and PO2 levels (34 vs 53.67).

Conclusion

This study suggests that sevelamer may serve as an effective antidote for treating aluminum phosphide poisoning. Further research is necessary to confirm its efficacy, determine optimal dosing strategies, and assess potential side effects in clinical settings.

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sevelamer对磷化铝中毒的影响：对死亡率的初步研究

磷化铝（ALP）中毒，通常被称为米片中毒，是最致命的中毒形式之一。磷化铝中毒的治疗仅限于支持性护理，因为目前没有特定的解毒剂。塞弗拉默被重新用作磷化氢气体中毒的解毒剂。本研究旨在评估sevelamer治疗对患者预后和总体预后的影响。方法对2023年10月~ 2024年12月磷化铝中毒患者进行单盲试验。参与者分为两组：对照组接受标准治疗，干预组最初接受标准治疗加2.4 g碳酸七维拉姆，随后每8小时服用800 mg片。数据收集使用研究特定清单，包括人口统计学、临床症状、实验室结果、患者结局、住院时间、病史和继发并发症。结果对照组男性19例（63.3%），女性11例（36.7%）。sevelamer组雄性26只（81.25%），雌性6只（18.75%）。该研究表明，sevelamer降低了死亡率（56.25%比86.7%），并提高了射血分数（治疗后从35.8%提高到47.5%）。第一天，血PH值（7.13 vs 7.23）和PO2水平（34 vs 53.67）显著升高。结论西维拉默是治疗磷化铝中毒的有效解毒剂。需要进一步的研究来确认其疗效，确定最佳给药策略，并评估临床环境中的潜在副作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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