[Effect of Rhubarb Combined Medicinal Activated Carbon on Levels of Serum Phosphorus, Calci- um-Phosphorus Product, and Parathyroid Hormone in Hemodialysis Patients with Hyperphosphatemia].

Objective To study the effect of rhubarb combined medicinal activated carbon on levels of serum phosphorus and calcium-phosphorus product, as well as parathyroid hormone in hemodi- alysis patients with hyperphosphatemia. Methods Totally 126 hemodialysis patients with hyperphos- phatemia who had received treatment of calcium containing phosphorus binders were assigned to the treatment group and the control group according to random digit table, 63 in each group. Patients in the treatment group took rhubarb (80 mg/kg, twice per day, soaked in 150 mL boiled water, taken before dinner) combined with medicinal activated carbon (1. 5 g each time, thrice per day, taken during dinner). Those in the control group took medicinal activated carbon (1. 5 g each time, thrice per day, taken during dinner). The therapeutic course for all was 8 weeks. Levels of serum calcium , phosphorus, calcium- phosphorus product and parathyroid hormone were detected in the two groups before treatment, and at week 2, 4, 6, and 8 after treatment. Adverse reactions of gastrointestinal tract were observed as well. Results Twelve patients dropped out in the treatment group and the rest 51 completed the study. Nine patients dropped out in the treatment group and the rest 54 completed the study. Compared with before treatment in the same group, levels of serum phosphorus , calcium-phosphorus product, parathyroid hor- mone began to decline from week 2 to 8 in the treatment group (P <0. 05) ; and they began to decline from week 4 to 8 in the control group (P <0. 05). Compared with the control group, levels of serum phos- phorus, calcium-phosphorus product, parathyroid hormone obviously decreased in the treatment group (P <0.05). But there was no statistical difference in serum calcium level (P >0.05) between the two groups. Main adverse reactions of gastrointestinal tract mainly included abdominal distention, diarrhea, anal pedant expansion, and constipation. Compared with the control group, the incidence of abdominal distention and constipation, as well as the total incidence of gastrointestinal reactions all decreased in the treatment group (X2 =6. 815,7. 011 ,7.077, P <0. 05). Conclusion In addition to previous phosphorus binders therapy, rhubarb combined medicinal activated carbon could effectively reduce levels of serum phosphorus, calcium-phosphorus product, parathyroid hormone in hemodialysis patients with hyperphos- phatemia, and lessen complications of gastrointestinal tract.