Ｎｉｃｅｒｉｔｒｏｌは慢性維持血液透析患者において血清無機リン濃度を低下させる

• 下田 研二

  清湘会聖橋クリニック

• 秋葉 隆

  東京医科歯科大学第2内科

• 松島 照彦

  筑波記念病院内科

• 頼 建光

  東京医科歯科大学第2内科

• 阿部 薫

  清湘会菊川橋クリニック

• 星野 正信

  清湘会菊川橋クリニック

書誌事項

タイトル別名

• Niceritrol decreases serum phosphate levels in chronic hemodialysis patients.

抄録

Since phosphorus retention in hemodialysis (HD) patients is known to be an important factor in the development of secondary hyperparathyroidism and renal osteodystrophy, phosphate binders have been needed for the control of serum phosphate levels (P). However, the calcium-containing phosphate binders that have been used widely can cause a rise in serum calcium levels and cause secondary hypoparathyroidism. We have recently experienced decreases in P after the administration of niceritrol (NT), a prodrug of nicotinic acid, for the treatment of low HDL-cholesteremia (HDL-C) in HD patients. The aim of the present study was to assess the mechanism of the P-lowering effect of NT in comparison with nicomol (NC), another prodrug of nicotinic acid. NT (750 mg/day) or NC (600 mg/day) was given orally to 10 or 14HD patients respectively. Blood samples were collected before the first dialysis of each week for the determination of serum urea nitrogen (UN), Cr, Ca, P, total cholesterol (TC), triglyceride (TG) and HDL-C. Serum nicotinic acid concentration (NAC) by gas chromatograph mass-spectrometry method was determined before, 4 weeks and 8 weeks after the administration of these drugs. After NT administration, P was decreased from 6.2±0.4 mg/dl to 5.1 ±0.4 mg/dl (1st week, p 0.001, Mean ±SE) and 4.5±0.3 mg/dl (2nd weeks, p<0.001) with no change in UN, Cr or Ca levels ; these significant decreases in P lasted for 8 weeks. NAC increased significantly after NT administration from 25.5±1.3 ng/ml to 549.8± 102.2 ng/ml (4 weeks, p < 0.01) and 431.7±51.4 ng/ml (8 weeks, p < 0.01). HDL-C also increased (33.6±4.0 mg/dl vs 42.7±4.6 mg/dl, p<0.05), but TC and TG did not change. In contrast, no significant changes were observed in P, NAC and HDL-C after NC administration. These discrepancies could be ascribed to the differencies in serum NAC levels. These data suggest that NT could be useful for the control of P in HD patients. However further studies are needed to confirm the mechanism of the P-lowering effect of NT.

収録刊行物

• 日本腎臓学会誌

  日本腎臓学会誌 40 (1), 1-7, 1998

  社団法人 日本腎臓学会

キーワード

• niceritrol, phosphate, nicotinic acid, nicomol, HDL-C

詳細情報

• CRID: 1390001204859354752
• NII論文ID: 130004170428
• NII論文ID: 10008361959
• NII書誌ID: AN10131749
• DOI: 10.14842/jpnjnephrol1959.40.1
• ISSN: 18840728
• ISSN: 03852385
• PubMed: 9513376
• Web Site: https://search.jamas.or.jp/link/ui/1998131309
• 本文言語コード: ja
• データソース種別:
  • JaLC
  • PubMed
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可