Efectividad y seguridad del hidróxido de aluminio en hemodiálisis y Atención Farmacéutica. Resultados de práctica clínica

Abstract

Resumen Objetivo: Caracterizar los niveles séricos de fósforo, calcio, hormona paratiroidea y aluminio, para evaluar la efectividad y seguridad del hidróxido de aluminio en hemodiálisis y promover intervenciones, desde el programa de Atención Farmacéutica, que permitan mejorar la toma de decisiones farmacoterapéuticas. Método: Estudio exploratorio, descriptivo, retrospectivo, unicéntrico y de resultados de práctica clínica en pacientes en hemodiálisis pertenecientes al programa de Atención Farmacéutica de un hospital. Resultado: Una población de 15 pacientes fueron incluidos en el estudio. Las medias ± desviaciones típicas de los parámetros analíticos fueron: 6.60 ± 2.45 mg/dl para fósforo, 9.09 ± 0.80 mg/dl para calcio, 127.24± 193.80 pg/ml para hormona paratiroidea intacta y 31.72 ± 9.74 μg/l para aluminio. El 73% presentaron hiperfosfatemia, 86% reportaron niveles de aluminio dentro de la zona gris (20 – 60 μg/l), 93% presentaron niveles normales de calcio sérico conformes a las recomendaciones y 73% reportaron niveles de hormona paratiroidea intacta por debajo del nivel normal recomendado (menor a 150 pg/ml). En cuanto al tratamiento prescrito con hidróxido de aluminio (tabletas de 200 mg y/o frascos de suspensión de 5,5% p/p) se tuvo que la dosis media fue 990.79 mg al día, con una desviación típica de 558.34 mg. Conclusión: Se evidencian los parámetros séricos de interés, la efectividad y seguridad del hidróxido de aluminio en el grupo de pacientes estudiado. Además, se destaca la importancia del Programa de Atención Farmacéutica para la toma de decisiones farmacoterapéuticas en la práctica clínica. Otros estudios son necesarios.

Abstract Objective: To characterise serum levels of phosphorus, calcium, parathyroid hormone and aluminium, in order to evaluate the effectiveness and safety of aluminium hydroxide in haemodialysis and to promote interventions, from the Pharmaceutical Care programme, to improve pharmacotherapeutic decision-making.

Methods: Exploratory, descriptive, retrospective, single-centre, retrospective, single-centre study of clinical practice outcomes in haemodialysis patients belonging to the Pharmaceutical Care programme of a hospital.

Results: A patient population of 15 patients was included in the study. The means ± standard deviations of the analytical parameters were: 6.60 ± 2.45 mg/dl for phosphorus, 9.09 ± 0.80 mg/dl for calcium, 127.24± 193.80 pg/ml for intact parathyroid hormone and 31.72 ± 9.74 μg/l for aluminium. Seventy-three per cent had hyperphosphataemia, 86% reported aluminium levels within the grey zone (20 – 60 μg/l), 93% had normal serum calcium levels according to recommendations and 73% reported intact parathyroid hormone levels below the recommended normal level (less than 150 pg/ml). Regarding the prescribed treatment with aluminium hydroxide (200 mg tablets and/or 5.5% w/w suspension bottles) the mean dose was 990.79 mg per day, with a standard deviation of 558.34 mg.

Conclusion: The serum parameters of interest, effectiveness and safety of aluminium hydroxide in the studied group of patients are evidenced. In addition, the importance of the Pharmaceutical Care Programme for pharmacotherapeutic decision-making in clinical practice is highlighted. Further studies are needed

Objective: To characterise serum levels of phosphorus, calcium, parathyroid hormone and aluminium, in order to evaluate the effectiveness and safety of aluminium hydroxide in haemodialysis and to promote interventions, from the Pharmaceutical Care programme, to improve pharmacotherapeutic decision-making. Methods: Exploratory, descriptive, retrospective, single-centre, retrospective, single-centre study of clinical practice outcomes in haemodialysis patients belonging to the Pharmaceutical Care programme of a hospital. Results: A patient population of 15 patients was included in the study. The means ± standard deviations of the analytical parameters were: 6.60 ± 2.45 mg/dl for phosphorus, 9.09 ± 0.80 mg/dl for calcium, 127.24± 193.80 pg/ml for intact parathyroid hormone and 31.72 ± 9.74 μg/l for aluminium. Seventy-three per cent had hyperphosphataemia, 86% re ported aluminium levels within the grey zone (20 - 60 μg/l), 93% had normal serum calcium levels according to recommendations and 73% reported intact parathyroid hormo ne levels below the recommended normal level (less than 150 pg/ml). Regarding the prescribed treatment with aluminium hydroxide (200 mg tablets and/or 5.5% w/w suspension bottles) the mean dose was 990.79 mg per day, with a standard deviation of 558.34 mg. Conclusion: The serum parameters of interest, effectiveness and safety of aluminium hydroxide in the studied group of patients are evidenced. In addition, the importance of the Pharmaceutical Care Programme for phar macotherapeutic decision-making in clinical practice is highlighted. Further studies are needed.