Histopathological lesions of the gastrointestinal tract associated with the use of polystyrene sulfonate and sevelamer: a meta-analysis.

IF 4.4 Q1 PATHOLOGY PATHOLOGICA Pub Date : 2024-08-01 DOI:10.32074/1591-951X-994
Gianluca Di Rienzo, Pellegrino Crafa, Marco Delsante, Enrico Fiaccadori, Giuseppe Pedrazzi, Nicoletta Campanini, Emilia Corradini
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Abstract

Background: Gastrointestinal severe adverse events such as ulceration and perforation have been reported for sodium or calcium polystyrene sulfonate and sevelamer. Howewer, their role in the pathogenesis is unclear. Chronic kidney disease is a well known risk factor, while the role of hypertension and/or diabetes is uncertain.

Methods: A meta-analysis of the published literature was conducted to review the clinical features, risk factors and histopathological findings of patients who experienced gastrointestinal adverse events after administration of polystyrene sulfonate or sevelamer.

Results: The meta-analysis indicated that patients were more likely to show necrosis and/or perforation when the resin used was polystyrene sulfonate compared to sevelamer (p < 0.001). Death was more likely in patients taking polystyrene sulfonate compared to sevelamer (p < 0.001).

Discussion: The results show that sevelamer is more likely to lead to inflammation or ulceration in the gastrointestinal tract than polystyrene sulfonate, which is more likely to be associated with severe gastrointestinal adverse events such as necrosis and/or perforation. Polystyrene sulfonate is significantly associated with death compared to sevelamer.

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与使用聚苯乙烯磺酸盐和sevelamer有关的胃肠道组织病理学病变:一项荟萃分析。
背景:据报道,聚苯乙烯磺酸钠或聚苯乙烯磺酸钙和司维拉姆可引起溃疡和穿孔等严重的胃肠道不良反应。但它们在发病机制中的作用尚不明确。慢性肾病是一个众所周知的风险因素,而高血压和/或糖尿病的作用尚不确定:对已发表的文献进行了荟萃分析,回顾了服用聚苯乙烯磺酸盐或司维拉姆后出现胃肠道不良反应的患者的临床特征、风险因素和组织病理学结果:荟萃分析表明,使用聚苯乙烯磺酸盐树脂的患者比使用司维拉姆的患者更容易出现坏死和/或穿孔(P 0.001)。服用聚苯乙烯磺酸盐的患者比服用司维拉姆的患者更容易死亡(P 0.001):讨论:研究结果表明,与聚苯乙烯磺酸盐相比,西维拉姆更容易导致胃肠道炎症或溃疡,而聚苯乙烯磺酸盐更容易导致严重的胃肠道不良事件,如坏死和/或穿孔。与西维拉姆相比,聚苯乙烯磺酸盐与死亡的关系更为密切。
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来源期刊
PATHOLOGICA
PATHOLOGICA PATHOLOGY-
CiteScore
5.90
自引率
5.70%
发文量
108
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