Nicotinic Acid May Improve Hyperphosphatemia in HD
A new study, performed by Xianhua Liu, MD. and other scientists and published in Medicine, has found that nicotinic acid and its derivatives and analogs can remarkably reduce serum phosphorus in CKD patients undergoing hemodialysis. However, there are adverse effects associated with the use of these compounds.
Meta-analysis of 12 preclinical and clinical trials by the team of scientists showed that:
- The concentration of serum phosphorus declined by notable levels during 4 to 8 weeks of treatment, but not afterwards.
- There was a significant decline of the calcium x phosphorus product during 4 weeks, 8 weeks and 12 weeks drug exposure time settings and there was no rebound effect.
- Treatment with niacin also seemed to improve lipid profile as triglycerides decreased a lot while mean levels of high-density lipoproteins increased after 8 weeks of treatment.
- There were adverse effects from treatment among 41% of the patients undergoing treatment, and 8% of them had diarrhea. The implication here is that future studies must look at the long-term effects of treating patients with nicotinic acid.
Dr. Liu, speaking on behalf of the team of scientists concluded, “Our results suggest that nicotinic acid is probably effective in reducing serum phosphorus levels of dialysis patients. It can be a good alternative (or add on) to the traditional phosphate binders, with a different action mechanism, requires limited exposure time, and has additive antilipemic effects.”
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Liu X, Yang R, Dai B, Zhang H, Wang J, and Ma N. Nicotinic acid and related compounds: A meta-analysis of their use for hyperphosphatemia in dialysis patients. Med. doi:10.1097/MD.0000000000010117