CN102946886B - 透析前体组合物 - Google Patents
透析前体组合物 Download PDFInfo
- Publication number
- CN102946886B CN102946886B CN201180030051.3A CN201180030051A CN102946886B CN 102946886 B CN102946886 B CN 102946886B CN 201180030051 A CN201180030051 A CN 201180030051A CN 102946886 B CN102946886 B CN 102946886B
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- dialysis
- precursor composition
- acid
- acid precursor
- salt
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- 238000000502 dialysis Methods 0.000 title claims abstract description 96
- 239000000203 mixture Substances 0.000 title claims abstract description 94
- 239000002243 precursor Substances 0.000 title claims abstract description 70
- 239000002253 acid Substances 0.000 claims abstract description 74
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 claims abstract description 56
- 239000000385 dialysis solution Substances 0.000 claims abstract description 43
- 239000000243 solution Substances 0.000 claims abstract description 36
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 claims abstract description 28
- WQZGKKKJIJFFOK-GASJEMHNSA-N Glucose Natural products OC[C@H]1OC(O)[C@H](O)[C@@H](O)[C@@H]1O WQZGKKKJIJFFOK-GASJEMHNSA-N 0.000 claims abstract description 26
- 239000008103 glucose Substances 0.000 claims abstract description 26
- WQZGKKKJIJFFOK-VFUOTHLCSA-N beta-D-glucose Chemical compound OC[C@H]1O[C@@H](O)[C@H](O)[C@@H](O)[C@@H]1O WQZGKKKJIJFFOK-VFUOTHLCSA-N 0.000 claims abstract description 22
- 159000000003 magnesium salts Chemical class 0.000 claims abstract description 22
- 239000012141 concentrate Substances 0.000 claims abstract description 20
- 238000001035 drying Methods 0.000 claims abstract description 20
- 159000000007 calcium salts Chemical class 0.000 claims abstract description 16
- 239000011780 sodium chloride Substances 0.000 claims abstract description 14
- 239000004615 ingredient Substances 0.000 claims abstract description 12
- -1 hydrogen salt Chemical class 0.000 claims abstract description 11
- XAEFZNCEHLXOMS-UHFFFAOYSA-M potassium benzoate Chemical compound [K+].[O-]C(=O)C1=CC=CC=C1 XAEFZNCEHLXOMS-UHFFFAOYSA-M 0.000 claims abstract description 10
- ZLMJMSJWJFRBEC-UHFFFAOYSA-N Potassium Chemical compound [K] ZLMJMSJWJFRBEC-UHFFFAOYSA-N 0.000 claims abstract description 9
- 239000000470 constituent Substances 0.000 claims abstract description 9
- 239000011591 potassium Substances 0.000 claims abstract description 9
- 229910052700 potassium Inorganic materials 0.000 claims abstract description 9
- 229910052739 hydrogen Inorganic materials 0.000 claims abstract description 8
- 239000001257 hydrogen Substances 0.000 claims abstract description 8
- 238000002360 preparation method Methods 0.000 claims abstract description 7
- 238000002156 mixing Methods 0.000 claims abstract description 6
- KRKNYBCHXYNGOX-UHFFFAOYSA-N citric acid Chemical compound OC(=O)CC(O)(C(O)=O)CC(O)=O KRKNYBCHXYNGOX-UHFFFAOYSA-N 0.000 claims description 21
- 235000002639 sodium chloride Nutrition 0.000 claims description 20
- 230000035699 permeability Effects 0.000 claims description 17
- TWRXJAOTZQYOKJ-UHFFFAOYSA-L Magnesium chloride Chemical compound [Mg+2].[Cl-].[Cl-] TWRXJAOTZQYOKJ-UHFFFAOYSA-L 0.000 claims description 15
- RGHNJXZEOKUKBD-SQOUGZDYSA-N D-gluconic acid Chemical compound OC[C@@H](O)[C@@H](O)[C@H](O)[C@@H](O)C(O)=O RGHNJXZEOKUKBD-SQOUGZDYSA-N 0.000 claims description 12
- 238000000034 method Methods 0.000 claims description 9
- RGHNJXZEOKUKBD-UHFFFAOYSA-N D-gluconic acid Natural products OCC(O)C(O)C(O)C(O)C(O)=O RGHNJXZEOKUKBD-UHFFFAOYSA-N 0.000 claims description 7
- 239000000174 gluconic acid Substances 0.000 claims description 7
- 235000012208 gluconic acid Nutrition 0.000 claims description 7
- UXVMQQNJUSDDNG-UHFFFAOYSA-L Calcium chloride Chemical compound [Cl-].[Cl-].[Ca+2] UXVMQQNJUSDDNG-UHFFFAOYSA-L 0.000 claims description 6
- AGBQKNBQESQNJD-UHFFFAOYSA-N lipoic acid Chemical compound OC(=O)CCCCC1CCSS1 AGBQKNBQESQNJD-UHFFFAOYSA-N 0.000 claims description 6
- 238000007789 sealing Methods 0.000 claims description 6
- FYYHWMGAXLPEAU-UHFFFAOYSA-N Magnesium Chemical compound [Mg] FYYHWMGAXLPEAU-UHFFFAOYSA-N 0.000 claims description 5
- 239000011777 magnesium Substances 0.000 claims description 5
- 229910052749 magnesium Inorganic materials 0.000 claims description 5
- 229940091250 magnesium supplement Drugs 0.000 claims description 5
- PLSARIKBYIPYPF-UHFFFAOYSA-H trimagnesium dicitrate Chemical compound [Mg+2].[Mg+2].[Mg+2].[O-]C(=O)CC(O)(CC([O-])=O)C([O-])=O.[O-]C(=O)CC(O)(CC([O-])=O)C([O-])=O PLSARIKBYIPYPF-UHFFFAOYSA-H 0.000 claims description 5
- FNAQSUUGMSOBHW-UHFFFAOYSA-H calcium citrate Chemical compound [Ca+2].[Ca+2].[Ca+2].[O-]C(=O)CC(O)(CC([O-])=O)C([O-])=O.[O-]C(=O)CC(O)(CC([O-])=O)C([O-])=O FNAQSUUGMSOBHW-UHFFFAOYSA-H 0.000 claims description 4
- 239000001354 calcium citrate Substances 0.000 claims description 4
- 229960004256 calcium citrate Drugs 0.000 claims description 4
- 239000004227 calcium gluconate Substances 0.000 claims description 4
- 235000013927 calcium gluconate Nutrition 0.000 claims description 4
- 229960004494 calcium gluconate Drugs 0.000 claims description 4
- MKJXYGKVIBWPFZ-UHFFFAOYSA-L calcium lactate Chemical compound [Ca+2].CC(O)C([O-])=O.CC(O)C([O-])=O MKJXYGKVIBWPFZ-UHFFFAOYSA-L 0.000 claims description 4
- 239000001527 calcium lactate Substances 0.000 claims description 4
- 235000011086 calcium lactate Nutrition 0.000 claims description 4
- 229960002401 calcium lactate Drugs 0.000 claims description 4
- NEEHYRZPVYRGPP-UHFFFAOYSA-L calcium;2,3,4,5,6-pentahydroxyhexanoate Chemical compound [Ca+2].OCC(O)C(O)C(O)C(O)C([O-])=O.OCC(O)C(O)C(O)C(O)C([O-])=O NEEHYRZPVYRGPP-UHFFFAOYSA-L 0.000 claims description 4
- JVTAAEKCZFNVCJ-UHFFFAOYSA-N lactic acid Chemical compound CC(O)C(O)=O JVTAAEKCZFNVCJ-UHFFFAOYSA-N 0.000 claims description 4
- 239000004337 magnesium citrate Substances 0.000 claims description 4
- 229960005336 magnesium citrate Drugs 0.000 claims description 4
- 235000002538 magnesium citrate Nutrition 0.000 claims description 4
- 235000013337 tricalcium citrate Nutrition 0.000 claims description 4
- LLSDKQJKOVVTOJ-UHFFFAOYSA-L calcium chloride dihydrate Chemical compound O.O.[Cl-].[Cl-].[Ca+2] LLSDKQJKOVVTOJ-UHFFFAOYSA-L 0.000 claims description 3
- 229940052299 calcium chloride dihydrate Drugs 0.000 claims description 3
- TWPAUQVDOXJGMP-UHFFFAOYSA-N calcium;2-oxopentanedioic acid Chemical compound [Ca].OC(=O)CCC(=O)C(O)=O TWPAUQVDOXJGMP-UHFFFAOYSA-N 0.000 claims description 3
- 238000007865 diluting Methods 0.000 claims description 3
- 235000019136 lipoic acid Nutrition 0.000 claims description 3
- OVGXLJDWSLQDRT-UHFFFAOYSA-L magnesium lactate Chemical compound [Mg+2].CC(O)C([O-])=O.CC(O)C([O-])=O OVGXLJDWSLQDRT-UHFFFAOYSA-L 0.000 claims description 3
- 239000000626 magnesium lactate Substances 0.000 claims description 3
- 235000015229 magnesium lactate Nutrition 0.000 claims description 3
- 229960004658 magnesium lactate Drugs 0.000 claims description 3
- 229960002663 thioctic acid Drugs 0.000 claims description 3
- WMFHUUKYIUOHRA-UHFFFAOYSA-N (3-phenoxyphenyl)methanamine;hydrochloride Chemical compound Cl.NCC1=CC=CC(OC=2C=CC=CC=2)=C1 WMFHUUKYIUOHRA-UHFFFAOYSA-N 0.000 claims description 2
- 235000015165 citric acid Nutrition 0.000 claims description 2
- 239000004310 lactic acid Substances 0.000 claims description 2
- 235000014655 lactic acid Nutrition 0.000 claims description 2
- 235000001055 magnesium Nutrition 0.000 claims description 2
- WSKWESCCQFXQKT-UHFFFAOYSA-L magnesium;2-oxopentanedioate Chemical compound [Mg+2].[O-]C(=O)CCC(=O)C([O-])=O WSKWESCCQFXQKT-UHFFFAOYSA-L 0.000 claims description 2
- 238000011049 filling Methods 0.000 claims 1
- 239000003978 infusion fluid Substances 0.000 claims 1
- 229960001031 glucose Drugs 0.000 description 23
- 239000008280 blood Substances 0.000 description 19
- 210000004369 blood Anatomy 0.000 description 19
- 235000008504 concentrate Nutrition 0.000 description 16
- 210000004379 membrane Anatomy 0.000 description 12
- 239000012528 membrane Substances 0.000 description 12
- BVKZGUZCCUSVTD-UHFFFAOYSA-M Bicarbonate Chemical compound OC([O-])=O BVKZGUZCCUSVTD-UHFFFAOYSA-M 0.000 description 10
- 238000001631 haemodialysis Methods 0.000 description 10
- 230000000322 hemodialysis Effects 0.000 description 10
- 238000011282 treatment Methods 0.000 description 9
- WCUXLLCKKVVCTQ-UHFFFAOYSA-M Potassium chloride Chemical compound [Cl-].[K+] WCUXLLCKKVVCTQ-UHFFFAOYSA-M 0.000 description 8
- 239000012611 container material Substances 0.000 description 7
- 239000000843 powder Substances 0.000 description 7
- VTYYLEPIZMXCLO-UHFFFAOYSA-L Calcium carbonate Chemical compound [Ca+2].[O-]C([O-])=O VTYYLEPIZMXCLO-UHFFFAOYSA-L 0.000 description 6
- 238000010790 dilution Methods 0.000 description 5
- 239000012895 dilution Substances 0.000 description 5
- 239000003792 electrolyte Substances 0.000 description 5
- 238000001802 infusion Methods 0.000 description 5
- 239000007788 liquid Substances 0.000 description 5
- CURLTUGMZLYLDI-UHFFFAOYSA-N Carbon dioxide Chemical compound O=C=O CURLTUGMZLYLDI-UHFFFAOYSA-N 0.000 description 4
- 239000000872 buffer Substances 0.000 description 4
- 229960004106 citric acid Drugs 0.000 description 4
- 125000002791 glucosyl group Chemical group C1([C@H](O)[C@@H](O)[C@H](O)[C@H](O1)CO)* 0.000 description 4
- 239000008187 granular material Substances 0.000 description 4
- 238000002615 hemofiltration Methods 0.000 description 4
- 235000011147 magnesium chloride Nutrition 0.000 description 4
- 229910001629 magnesium chloride Inorganic materials 0.000 description 4
- 239000001103 potassium chloride Substances 0.000 description 4
- 235000011164 potassium chloride Nutrition 0.000 description 4
- PXRKCOCTEMYUEG-UHFFFAOYSA-N 5-aminoisoindole-1,3-dione Chemical compound NC1=CC=C2C(=O)NC(=O)C2=C1 PXRKCOCTEMYUEG-UHFFFAOYSA-N 0.000 description 3
- 229960004543 anhydrous citric acid Drugs 0.000 description 3
- 229910000019 calcium carbonate Inorganic materials 0.000 description 3
- JYYOBHFYCIDXHH-UHFFFAOYSA-N carbonic acid;hydrate Chemical compound O.OC(O)=O JYYOBHFYCIDXHH-UHFFFAOYSA-N 0.000 description 3
- 239000003795 chemical substances by application Substances 0.000 description 3
- 230000004087 circulation Effects 0.000 description 3
- 238000002425 crystallisation Methods 0.000 description 3
- 230000008025 crystallization Effects 0.000 description 3
- 230000007613 environmental effect Effects 0.000 description 3
- 230000006870 function Effects 0.000 description 3
- 238000011534 incubation Methods 0.000 description 3
- ZLNQQNXFFQJAID-UHFFFAOYSA-L magnesium carbonate Chemical compound [Mg+2].[O-]C([O-])=O ZLNQQNXFFQJAID-UHFFFAOYSA-L 0.000 description 3
- 239000001095 magnesium carbonate Substances 0.000 description 3
- 229910000021 magnesium carbonate Inorganic materials 0.000 description 3
- 238000001556 precipitation Methods 0.000 description 3
- 230000001225 therapeutic effect Effects 0.000 description 3
- 208000037157 Azotemia Diseases 0.000 description 2
- OYPRJOBELJOOCE-UHFFFAOYSA-N Calcium Chemical compound [Ca] OYPRJOBELJOOCE-UHFFFAOYSA-N 0.000 description 2
- BHPQYMZQTOCNFJ-UHFFFAOYSA-N Calcium cation Chemical compound [Ca+2] BHPQYMZQTOCNFJ-UHFFFAOYSA-N 0.000 description 2
- VEXZGXHMUGYJMC-UHFFFAOYSA-M Chloride anion Chemical compound [Cl-] VEXZGXHMUGYJMC-UHFFFAOYSA-M 0.000 description 2
- JLVVSXFLKOJNIY-UHFFFAOYSA-N Magnesium ion Chemical compound [Mg+2] JLVVSXFLKOJNIY-UHFFFAOYSA-N 0.000 description 2
- NPYPAHLBTDXSSS-UHFFFAOYSA-N Potassium ion Chemical compound [K+] NPYPAHLBTDXSSS-UHFFFAOYSA-N 0.000 description 2
- UIIMBOGNXHQVGW-UHFFFAOYSA-M Sodium bicarbonate Chemical compound [Na+].OC([O-])=O UIIMBOGNXHQVGW-UHFFFAOYSA-M 0.000 description 2
- 230000003064 anti-oxidating effect Effects 0.000 description 2
- 230000010100 anticoagulation Effects 0.000 description 2
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- 229910001424 calcium ion Inorganic materials 0.000 description 2
- 239000001569 carbon dioxide Substances 0.000 description 2
- 229910002092 carbon dioxide Inorganic materials 0.000 description 2
- BVKZGUZCCUSVTD-UHFFFAOYSA-N carbonic acid Chemical class OC(O)=O BVKZGUZCCUSVTD-UHFFFAOYSA-N 0.000 description 2
- 230000000052 comparative effect Effects 0.000 description 2
- 238000006073 displacement reaction Methods 0.000 description 2
- 238000005516 engineering process Methods 0.000 description 2
- 229910001425 magnesium ion Inorganic materials 0.000 description 2
- 210000004303 peritoneum Anatomy 0.000 description 2
- 229910001414 potassium ion Inorganic materials 0.000 description 2
- 230000007480 spreading Effects 0.000 description 2
- 238000012360 testing method Methods 0.000 description 2
- 208000009852 uremia Diseases 0.000 description 2
- 208000009304 Acute Kidney Injury Diseases 0.000 description 1
- DGAQECJNVWCQMB-PUAWFVPOSA-M Ilexoside XXIX Chemical compound C[C@@H]1CC[C@@]2(CC[C@@]3(C(=CC[C@H]4[C@]3(CC[C@@H]5[C@@]4(CC[C@@H](C5(C)C)OS(=O)(=O)[O-])C)C)[C@@H]2[C@]1(C)O)C)C(=O)O[C@H]6[C@@H]([C@H]([C@@H]([C@H](O6)CO)O)O)O.[Na+] DGAQECJNVWCQMB-PUAWFVPOSA-M 0.000 description 1
- 208000033626 Renal failure acute Diseases 0.000 description 1
- UIIMBOGNXHQVGW-DEQYMQKBSA-M Sodium bicarbonate-14C Chemical compound [Na+].O[14C]([O-])=O UIIMBOGNXHQVGW-DEQYMQKBSA-M 0.000 description 1
- FKNQFGJONOIPTF-UHFFFAOYSA-N Sodium cation Chemical compound [Na+] FKNQFGJONOIPTF-UHFFFAOYSA-N 0.000 description 1
- 210000000683 abdominal cavity Anatomy 0.000 description 1
- 239000003513 alkali Substances 0.000 description 1
- 239000007864 aqueous solution Substances 0.000 description 1
- 239000002585 base Substances 0.000 description 1
- 230000015572 biosynthetic process Effects 0.000 description 1
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- 238000002144 chemical decomposition reaction Methods 0.000 description 1
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- 239000003086 colorant Substances 0.000 description 1
- 150000001875 compounds Chemical class 0.000 description 1
- 239000002274 desiccant Substances 0.000 description 1
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- 238000002845 discoloration Methods 0.000 description 1
- 238000004090 dissolution Methods 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 239000000284 extract Substances 0.000 description 1
- 239000011888 foil Substances 0.000 description 1
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- 238000000338 in vitro Methods 0.000 description 1
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- 238000001764 infiltration Methods 0.000 description 1
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- 210000003734 kidney Anatomy 0.000 description 1
- 230000002045 lasting effect Effects 0.000 description 1
- 235000014666 liquid concentrate Nutrition 0.000 description 1
- DHRRIBDTHFBPNG-UHFFFAOYSA-L magnesium dichloride hexahydrate Chemical compound O.O.O.O.O.O.[Mg+2].[Cl-].[Cl-] DHRRIBDTHFBPNG-UHFFFAOYSA-L 0.000 description 1
- 230000005012 migration Effects 0.000 description 1
- 238000013508 migration Methods 0.000 description 1
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- 230000001988 toxicity Effects 0.000 description 1
- 231100000419 toxicity Toxicity 0.000 description 1
- 239000003053 toxin Substances 0.000 description 1
- 231100000765 toxin Toxicity 0.000 description 1
- 238000012546 transfer Methods 0.000 description 1
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Classifications
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Abstract
本发明涉及一种透析酸前体组合物,所述透析酸前体组合物用于制备透析酸浓缩溶液并用于与水和含碳酸氢盐的浓缩物混合以制成即用型透析溶液。所述透析酸前体组合物由包含氯化钠、至少一种干燥的酸和至少一种镁盐以及可选的钾盐、钙盐和葡萄糖的粉末成分组成。根据本发明,所述至少一种镁盐和所述可选的葡萄糖作为无水成分存在于所述透析酸前体组合物中。
Description
技术领域
本发明涉及一种透析酸前体组合物,所述透析酸前体组合物用于制备透析酸浓缩溶液并用于进一步与水和含碳酸氢盐的浓缩物混合以制成即用型透析溶液。本发明还涉及一种提供透析酸浓缩溶液的方法,所述透析酸浓缩溶液用于用水和含碳酸氢盐的浓缩物进行稀释从而产生即用型透析溶液。
背景技术
当人的肾功能失调时,会发展成尿毒症。透析对于尿毒症是完善的治疗技术。人工透析基本上代替了肾的功能。有两种不同类型的透析:血液透析和腹膜透析。
血液透析包括将血液从体内取出并在体外血液循环中清洁血液,然后使经净化的血液返回体内。体外血液循环包括含半透膜的透析机。半透膜具有血液侧和透析液侧,血液从半透膜的血液侧穿过半透膜到达半透膜的透析液侧,从而除去血液中的废物和过量液体。
血液透析可以以三种不同的治疗模式进行:血液透析、血液滤过和血液透析滤过。这三种治疗模式的共同点是患者通过血液管线与透析仪连接,透析仪持续地抽取患者的血液。然后使血液以流动方式在透析机内与半透膜的血液侧接触。
在血液透析中,使被称作透析溶液的水溶液以流动方式与膜反面(即透析液侧)接触。主要通过扩散来除去/控制废物(毒素)和溶质。通过对半透膜施加跨膜压力而除去过量液体。溶质和营养物会沿相反方向穿过半透膜从透析溶液中扩散到血液中。
在血液滤过中,没有透析溶液与半透膜的透析液侧接触。相反,仅对半透膜施加跨膜压力,从而使液体和废物穿过半透膜从血液中转移到其透析液侧(对流)。然后将液体和废物传输至排液装置。为了补偿一些除去的液体,将正确平衡的电解质/缓冲剂透析溶液(亦称为输注液或置换液)输注到体外血液循环中。该输注可以在透析机之前进行(前输注模式)或者在透析机之后进行(后输注模式)或者前后都进行。
血液透析滤过是血液透析和血液滤过的组合,是将废物与过量液体通过扩散和对流两种方式穿过半透性壁的输送合并到一起的治疗模式。因此,此时透析溶液以连续流动的方式与半透膜的透析液侧接触,且透析溶液(也称为输注液或置换液)用于以前输注模式、后输注模式或两种模式输注到体外血液循环中。
对于许多患者来说,血液透析进行3~5小时,每周三次。血液透析通常在透析中心进行,但是在家中透析也是可行的。在家中进行透析时,患者可以自由地更频繁的进行透析,还可以进行更长治疗时间的更温和的治疗,即,每次治疗4~8小时,每周5~7次治疗。可根据患者的不同需要来调节剂量和治疗时间。
对于患有急性肾功能不全的患者,根据患者状态而指示的治疗是历时最多数周的在全天大部分时间进行的连续治疗(即连续肾替代疗法(CRRT))或间歇肾替代疗法(IRRT)。此处,废物和过量液体从患者中的去除也是通过血液透析、血液滤过和血液透析滤过治疗模式中的任意一种或其组合来实现。
在腹膜透析治疗中,将高渗透析溶液输注至患者的腹腔中。在此种治疗中,溶质和水在患者腹膜的毛细血管中与所述高渗透析溶液进行交换。该方法的原理是因浓度梯度而转移的溶质的扩散以及跨腹膜的渗透差异所致的水迁移。
所有上述透析技术中所用的透析溶液均主要包含电解质(如钠、镁、钙、钾、酸/碱缓冲体系缓冲剂)和可选的葡萄糖或类似葡萄糖的化合物。透析溶液中的所有成分均经选择用来控制血液内的电解质水平和酸-碱平衡,并从血液中除去废物质。
如今,透析溶液从不同类型的浓缩物制得。可以是浓缩程度不同的液体浓缩物,其中酸/电解质部分与缓冲剂部分分离。其可以以袋中的1升~8升高度浓缩的体积来提供(供床边使用),或者以罐中的5升~20升更稀的浓缩体积来提供(仍供床边使用)。也可以将浓缩物以300升~1000升的体积制备在中心储箱中。
当使用碳酸氢盐作为透析溶液中的缓冲成分时,碳酸氢盐通常作为干燥的浓缩物提供,以用于即时制备含饱和碳酸氢盐的浓缩物。随后将含饱和碳酸氢盐的浓缩物与酸/电解质浓缩物混合,并进一步用纯水稀释,从而产生即时制备的透析溶液。
多年来,透析溶液的品质已得到改善,而且,可以得到用于进一步稀释并与其他成分混合以制成即用型透析溶液的浓缩前体组合物,由此降低了成本并改善了环境问题。
进一步限制成本并改善环境问题的一种方式是提供所有成分均干燥的透析前体组合物。然而,所有成分均为干燥成分增加了新的问题。
首先,干燥的酸和碳酸氢盐粉末不相容。存在少量湿气时,碳酸氢盐会分解产生二氧化碳。
第二,与碳酸氢盐混合的氯化镁和氯化钙会提供超过碳酸钙和/或碳酸镁的溶度积的区域,这在制备浓缩物或透析溶液的过程中添加水时会引起碳酸钙和/或碳酸镁的沉淀。
第三,即使将碳酸氢盐隔绝在单独的盒中,仍会遇到问题。例如,不同成分的结块和成团将导致其在制备即用型透析溶液时更难溶解甚至不可能溶解。
第四,如果存在葡萄糖,因存在葡萄糖的降解产物,前体会发生变色,随后即用型透析溶液也会变色,由于毒性和管理机构的规章(例如,欧洲药典)所设的限制,上述情况应当避免。
所有上述问题都是由干燥的前体组合物中湿气的存在引起的。
在现有技术中,已通过制备不同成分的颗粒并在各颗粒内形成成分不同的不同的层来解决该问题,如EP0567452或EP1714657所公开的。
然而,这仍会产生不同层之间的相互作用,并且为了制备即用型透析溶液而提供完全且适当地溶解的颗粒也是一件耗时工程。并且,难以确保颗粒中以及所制备的即用型透析溶液中的不同成分具有正确的组成和浓度。
发明内容
本发明的一个目的是提供一种显示出进一步改善的稳定性、有限的化学降解和延长的保存期限的透析前体组合物。
本发明的另一个目的是提供一种使成本进一步降低并且环境效益进一步改善的透析前体组合物。
本发明涉及一种透析酸前体组合物,所述透析酸前体组合物用于制备透析酸浓缩溶液并用于进一步与水和含碳酸氢盐的浓缩物混合以制成即用型透析溶液。所述透析酸前体组合物由粉末成分组成,所述粉末成分包含:氯化钠、至少一种干燥的酸和至少一种镁盐,以及可选的钾盐、钙盐和葡萄糖。根据本发明,所述至少一种镁盐和可选的所述葡萄糖(即,如果存在葡萄糖)作为无水成分存在于所述透析酸前体组合物中。并且,所述透析酸前体组合物密封在防潮容器中,所述防潮容器在38℃/90%RH下的水蒸汽透过率小于0.3g/m2/d。
本发明还涉及一种提供透析酸浓缩溶液的方法,所述透析酸浓缩溶液用于用水和含碳酸氢盐的浓缩物进行稀释以产生即用型透析溶液。根据本发明,该方法包括:
(a)提供透析前体组合物,所述透析前体组合物包含:氯化钠、至少一种干燥的酸和至少一种镁盐,可选的钾盐、钙盐和葡萄糖;其中,所述至少一种镁盐和可选的所述葡萄糖(即,如果存在葡萄糖)作为无水成分存在于所述透析酸前体组合物中,
(b)将所述透析前体组合物提供在密封的防潮容器中,所述防潮容器在38℃/90%RH下的水蒸汽透过率小于0.3g/m2/d,和
(c)将规定体积的水添加到所述容器中的所述透析前体组合物中并使其混合,从而将所述透析酸浓缩物提供为溶液形式。
本发明还涉及所述透析酸前体组合物在制备透析酸浓缩溶液中的应用。
最后,本发明涉及所述透析酸前体组合物在制备透析溶液中的应用。
根据下述描述和所附的权利要求,本发明的其他实施方式是显而易见的。
具体实施方式
制备了常规透析溶液的干燥粉末成分(例如氯化钾、氯化镁、氯化钙、葡萄糖、氯化钠、碳酸氢钠、干燥的酸(如柠檬酸、葡糖酸-δ-内酯)等)的多种不同组合和分区,并对其进行了强制稳定性研究。在1个月、4个月和10个月的储存期后研究了诸如结块、成团、变色和溶出度等问题。
经鉴定,正如所预期,由于二氧化碳的形成、碳酸钙的沉淀和碳酸镁的沉淀,需要将碳酸氢钠与其他成分分离。然而,当合并常规透析溶液的其余成分时,氯化镁所带的结晶水导致粉末组合物内的结块和成团问题以及葡萄糖(如果存在)的变色问题。通过将六水合氯化镁换为无水氯化镁或不含任何结晶水的另一种镁盐,粉末组合物保持稳定、自由流动且不发生变色。因此,为了确保得到稳定的组合物,储存所述组合物所用的容器材料应当是防潮的并且不允许等于或多于与氯化镁通常所带的结晶水量相等的量通过。这通过使用在38℃/90%RH下的水蒸汽透过率小于0.3g/m2/d的容器材料而得以实现。
在另一个实施方式中,所述容器材料在38℃/90%RH下的水蒸汽透过率小于0.2g/m2/d。
在另一个实施方式中,所述容器材料在38℃/90%RH下的水蒸汽透过率为0.05g/m2/d~0.3g/m2/d。
在另一个实施方式中,所述容器材料在38℃/90%RH下的水蒸汽透过率为0.05g/m2/d~0.2g/m2/d。
在另一个实施方式中,所述容器材料在38℃/90%RH下的水蒸汽透过率为0.1g/m2/d~0.3g/m2/d。
在再一个实施方式中,所述容器材料在38℃/90%RH下的水蒸汽透过率为0.1g/m2/d~0.2g/m2/d。
根据本发明,所述透析酸前体组合物由粉末成分组成,所述粉末成分包含氯化钠、至少一种干燥的酸和至少一种镁盐,以及可选的钾盐、钙盐和葡萄糖;其中,所述至少一种镁盐和所述可选的葡萄糖作为无水成分存在于防潮容器内的所述透析酸前体组合物中。
在本发明的其他一些实施方式中,所述至少一种干燥的酸选自由乳酸、柠檬酸、葡糖酸、葡糖酸-δ-内酯、N-乙酰基半胱氨酸和α-硫辛酸组成的组。因此,在所述透析酸前体组合物中可以使用几种干燥的酸的组合,并且,通过提供不同的干燥的酸的组合,可以提供除所述酸性功能之外的其他功能和作用,例如抗氧化作用(如用柠檬酸、葡糖酸、葡糖酸-δ-内酯、N-乙酰基半胱氨酸和α-硫辛酸时)和抗凝作用(如用柠檬酸时)等。
在再一个实施方式中,所述透析酸前体组合物中的所述至少一种镁盐选自由无水氯化镁、葡糖酸镁、柠檬酸镁(二柠檬酸三镁)、乳酸镁和α-酮戊二酸镁组成的组。此处也可以使用不同镁盐的组合以定制特定的附加特征,如来自葡糖酸镁的抗氧化作用,或者来自柠檬酸镁的抗凝作用,等等。
在一个实施方式中,所述透析酸前体组合物中的所述至少一种镁盐选自由葡糖酸镁、柠檬酸镁和乳酸镁组成的组。
在存在钙盐的另一些实施方式中,所述透析酸前体组合物中的所述钙盐是选自由二水合氯化钙、单水合氯化钙、无水氯化钙、葡糖酸钙、柠檬酸钙、乳酸钙和α-酮戊二酸钙组成的组中的至少一种。因此,此处也可以使用不同钙盐的组合。
在另一个实施方式中,所述钙盐是选自由无水氯化钙、葡糖酸钙、柠檬酸钙、乳酸钙和α-酮戊二酸钙组成的组中的至少一种。
在另一个实施方式中,所述钙盐是选自由葡糖酸钙、柠檬酸钙和乳酸钙组成的组中的至少一种。
在一个实施方式中,提供特定量的所述透析前体组合物,并将其配置成能够与规定体积的水在所述防潮容器中混合得到透析酸浓缩溶液。因此,将所述防潮容器设置成能够接受并调配最多至所述规定体积的溶液。
在一个实施方式中,所述规定体积可以是1升~8升。
在另一个实施方式中,所述规定体积可以是5升~20升。
在再一个实施方式中,所述规定体积可以是300升~1000升。
此外,在一个实施方式中,将所述透析酸浓缩溶液配置并提供为能够用水和碳酸氢盐浓缩物进行1:30~1:50的稀释。
本发明还涉及一种提供透析酸浓缩溶液的方法。所述透析酸浓缩溶液进一步计划用于与额外的水和碳酸氢盐浓缩物混合从而产生即用型透析溶液。根据本发明,所述方法包括:(a)提供透析前体组合物,所述透析前体组合物包含:氯化钠、至少一种干燥的酸和至少一种镁盐,可选的钾盐、钙盐和葡萄糖;其中,所述至少一种镁盐和可选的所述葡萄糖作为无水成分存在于所述透析酸前体组合物中,(b)将所述透析前体组合物提供在密封的防潮容器中,所述防潮容器在38℃/90%RH下的水蒸汽透过率小于0.3g/m2/d,和(c)将规定体积的水添加到所述容器中的所述透析前体组合物中并使其混合,从而将所述透析酸浓缩物提供为溶液形式。
在所述防潮容器中提供的氯化钠的量使得当规定体积的水已进入所述防潮容器中时在透析酸浓缩溶液中提供有浓度为2.55M~5.5M的氯化钠。
在所述防潮容器中提供的所述干燥的酸的量使得当规定体积的水已进入所述防潮容器中时在透析酸浓缩溶液中提供有浓度为60mEq/L~200mEq/L的H+(酸)。
此外,在所述防潮容器中提供的所述至少一种镁盐的量使得当规定体积的水已进入所述防潮容器时在透析酸浓缩溶液中提供有浓度为7.5mM~50mM的镁离子。
如果存在所述钙盐,则在所述防潮容器中提供的所述钙盐的量使得当规定体积的水已进入所述防潮容器时在透析酸浓缩溶液中提供有浓度为30mM~125mM的钙离子。
如果存在钾盐,则在所述防潮容器中提供的钾盐的量使得当规定体积的水已进入所述防潮容器时在透析酸浓缩溶液中提供有浓度为0~200mM的钾离子。
如果存在葡萄糖,则在所述防潮容器中提供的葡萄糖的量使得当规定体积的水已进入所述防潮容器时在透析酸浓缩溶液中提供的浓度为0~100g/L。
在一个实施方式中,所述干燥的透析酸前体组合物包含不同的成分,这些成分的量使得当所述干燥的透析酸前体组合物已与水和碳酸氢盐溶解并混合时其提供的即用型透析溶液包含约130mM~150mM的钠离子、约0~4mM的钾离子、约1mM~2.5mM的钙离子、约0.25mM~1mM的镁离子、约0~2%(g/l)的葡萄糖、约85mM~134mM的氯离子、约2mEq/L~4mEq/L的酸和约20mEq/L~40mEq/L的碳酸氢根离子。
因此,本发明提供一种含有干燥的透析酸前体组合物的预包装容器,所述干燥的透析酸前体组合物用于制备透析酸浓缩溶液并用于与水和含碳酸氢盐的浓缩物混合以制成即用型透析溶液,其中,所述透析酸前体组合物由包含氯化钠、至少一种干燥的酸和至少一种镁盐的粉末成分组成。可选的是,所述透析酸前体组合物还包含钾盐、钙盐和葡萄糖。根据本发明,所述至少一种镁盐作为无水成分存在于所述透析酸前体组合物中,并且将所述透析酸前体组合物密封在防潮容器中,所述防潮容器在38℃/90%RH下的水蒸汽透过率小于0.3g/m2/d。
通过在干燥的透析酸前体组合物中使用无水氯化镁粉末,该无水成分将在任何水被输送至袋中时充当干燥剂。
实施例
下述实施例确定了本发明的实施方式的各种透析酸前体组合物,所述实施例用于例举而非用于限制本发明。
在实施例1~5中,表格显示出了用于进行1:35稀释的透析酸前体组合物的内容物。每种透析酸浓缩溶液(下表中的DACS)的规定体积为5.714L,每种即用型透析溶液(下表中的RFUDS)的最终体积为200L。
实施例1:
实施例2:
实施例3:
实施例4:
实施例5:
在实施例6~10中,表格显示出了用于进行1:45稀释的干燥的酸前体组合物的内容物。每种透析酸浓缩溶液(下表中的DACS)的规定体积为5.33L,每种即用型透析溶液(下表中的RFUDS)的最终体积为240L。
实施例6:
实施例7:
实施例8:
实施例9:
实施例10:
测试
进行了测试以研究不同的干燥粉末组合物的稳定性,包括本发明的实施方式的两种干燥粉末组合物以及比较用干燥粉末组合物。评价了如结块、成团和变色等参数。
方法
将塑料膜接合成具有一个腔室的袋。
组合物1
将用来产生230升透析液所需的量的氯化钾、无水氯化镁、二水合氯化钙、无水葡萄糖、柠檬酸和氯化钠这些粉末成分填充到塑料袋中,这些塑料袋在38℃/90%RH下的水蒸汽透过率为0.11g/m2/d。将这些袋密封并分别在30℃、65%RH和40℃、75%RH下温育。
组合物2
将用来产生230升透析液所需的量的氯化钾、无水氯化镁、无水氯化钙、无水葡萄糖、柠檬酸和氯化钠这些粉末成分填充到塑料袋中,这些塑料袋在38℃/90%RH下的水蒸汽透过率为0.11g/m2/d。将这些袋密封并分别在30℃、65%RH和40℃、75%RH下温育。
比较组合物3
将用来产生230升透析液所需的量的氯化钾、无水氯化镁、脱水氯化钙、无水葡萄糖、柠檬酸和氯化钠这些粉末成分填充到塑料袋中,这些塑料袋在38℃/90%RH下的水蒸汽透过率为2.7g/m2/d。将这些袋密封并分别在30℃、65%RH和40℃、75%RH下温育。
结果
组合物1和组合物2证实能保持稳定至少6个月,而比较组合物3在不到一个月后就因形成棕色团块而失败。
应当理解对本文所述的实施方式的各种变化和修改对于本领域技术人员来说是显而易见的。可进行这些变化和修改而不背离本发明的要旨和范围且不减少其所具有的优势。因此意图将这些变化和修改包含在所附权利要求范围内。
Claims (10)
1.一种透析酸前体组合物,所述透析酸前体组合物用于制备透析酸浓缩溶液并用于与水和含碳酸氢盐的浓缩物混合以制成即用型透析溶液,其中,所述透析酸前体组合物由粉末成分组成,所述粉末成分包含:氯化钠、至少一种干燥的酸和至少一种镁盐,以及可选的钾盐、钙盐和葡萄糖;其中,所述至少一种镁盐和可选的所述葡萄糖作为无水成分存在于所述透析酸前体组合物中,且其中,所述透析酸前体组合物被密封在防潮容器中,所述防潮容器在38℃/90%RH下的水蒸汽透过率小于0.3g/m2/d。
2.如权利要求1所述的透析酸前体组合物,其中,所述至少一种干燥的酸选自由乳酸、柠檬酸、葡糖酸、葡糖酸-δ-内酯、N-乙酰基半胱氨酸和α-硫辛酸组成的组。
3.如权利要求1或权利要求2所述的透析酸前体组合物,其中,所述透析酸前体组合物中的所述至少一种镁盐选自由无水氯化镁、葡糖酸镁、柠檬酸镁、乳酸镁和α-酮戊二酸镁组成的组。
4.如权利要求1或2所述的透析酸前体组合物,其中,所述透析酸前体组合物中的所述钙盐是选自由二水合氯化钙、单水合氯化钙、无水氯化钙、葡糖酸钙、柠檬酸钙、乳酸钙和α-酮戊二酸钙组成的组中的至少一种。
5.如权利要求1或2所述的透析酸前体组合物,其中,所述防潮容器在38℃/90%RH下的水蒸汽透过率小于0.2g/m2/d。
6.如权利要求1或2所述的透析酸前体组合物,其中,所述防潮容器在38℃/90%RH下的水蒸汽透过率大于0.1g/m2/d。
7.如权利要求1或2所述的透析酸前体组合物,其中,所述透析酸前体组合物被配置成能够与规定体积的水在所述防潮容器中混合得到透析酸浓缩溶液。
8.一种提供透析酸浓缩溶液的方法,所述透析酸浓缩溶液用于用水和含碳酸氢盐的浓缩物进行稀释以产生即用型透析溶液,所述方法包括:
(a)提供透析前体组合物,所述透析前体组合物包含:氯化钠、至少一种干燥的酸和至少一种镁盐,可选的钾盐、钙盐和葡萄糖;其中,所述至少一种镁盐和可选的所述葡萄糖作为无水成分存在于所述透析酸前体组合物中,
(b)将所述透析前体组合物提供在密封的防潮容器中,所述防潮容器在38℃/90%RH下的水蒸汽透过率小于0.3g/m2/d,和
(c)将规定体积的水添加到所述容器中的所述透析前体组合物中并使其混合,从而将所述透析酸浓缩物提供为溶液形式。
9.权利要求1~7中任一项所述的透析酸前体组合物在制备透析酸浓缩溶液中的应用。
10.权利要求1~7中任一项所述的透析酸前体组合物在制备透析溶液、输注溶液、置换溶液、冲洗溶液或预充溶液中的应用。
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CA2803432A1 (en) | 2011-12-29 |
WO2011161055A1 (en) | 2011-12-29 |
BR112012033038B1 (pt) | 2019-10-08 |
EP2585076B1 (en) | 2015-03-04 |
KR101831007B1 (ko) | 2018-02-21 |
AU2011269108A1 (en) | 2013-02-07 |
TW201219040A (en) | 2012-05-16 |
ES2535867T3 (es) | 2015-05-18 |
AU2011269108B2 (en) | 2014-02-27 |
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