WO2018079022A1 - Hemodialysis agent a - Google Patents

Hemodialysis agent a Download PDF

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Publication number
WO2018079022A1
WO2018079022A1 PCT/JP2017/029775 JP2017029775W WO2018079022A1 WO 2018079022 A1 WO2018079022 A1 WO 2018079022A1 JP 2017029775 W JP2017029775 W JP 2017029775W WO 2018079022 A1 WO2018079022 A1 WO 2018079022A1
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WO
WIPO (PCT)
Prior art keywords
hemodialysis
agent
fraction
acetic acid
solid
Prior art date
Application number
PCT/JP2017/029775
Other languages
French (fr)
Japanese (ja)
Inventor
由典 吉本
純也 菊石
博司 野口
Original Assignee
富田製薬株式会社
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from PCT/JP2017/007248 external-priority patent/WO2018078901A1/en
Application filed by 富田製薬株式会社 filed Critical 富田製薬株式会社
Priority to JP2018507053A priority Critical patent/JP6312957B1/en
Priority to CN201780064845.9A priority patent/CN109890370B/en
Publication of WO2018079022A1 publication Critical patent/WO2018079022A1/en

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/02Inorganic compounds
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/06Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/08Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing oxygen, e.g. ethers, acetals, ketones, quinones, aldehydes, peroxides
    • A61K47/12Carboxylic acids; Salts or anhydrides thereof
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/06Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/26Carbohydrates, e.g. sugar alcohols, amino sugars, nucleic acids, mono-, di- or oligo-saccharides; Derivatives thereof, e.g. polysorbates, sorbitan fatty acid esters or glycyrrhizin
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/08Solutions
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/20Pills, tablets, discs, rods
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P7/00Drugs for disorders of the blood or the extracellular fluid
    • A61P7/08Plasma substitutes; Perfusion solutions; Dialytics or haemodialytics; Drugs for electrolytic or acid-base disorders, e.g. hypovolemic shock

Definitions

  • the present invention relates to a hemodialysis agent A containing acetic acid and acetate and a method for producing the same. More specifically, the present invention includes acetic acid and acetate, can reduce acetic acid odor, and further suppresses solidification by storage, decomposition of glucose when coexisting with glucose, and increase in pH when dissolved in water.
  • the present invention relates to a solid A-dialysis agent having excellent storage stability and a method for producing the same. Furthermore, this invention relates to the agent for hemodialysis using the said A agent for hemodialysis.
  • Dialysis therapy for patients with renal failure is performed for the purpose of adjusting the concentration of electrolyte components in the blood, removing uremic substances, correcting acid-base balance, and the like.
  • the dialysis therapy generally performed is roughly classified into peritoneal dialysis and hemodialysis, and both methods use a dialysis solution.
  • the dialysate contains a plurality of components, but the components should be formulated at appropriate concentrations that have formulation stability, meet the purpose of treatment, and have less burden on the living body.
  • sodium lactate is generally used as an alkalizing agent in dialysate used for peritoneal dialysis, but sodium bicarbonate, sodium acetate, sodium citrate is used as dialysate for hemodialysis. From the viewpoints of difficulty in formulation, administration route, and biocompatibility, components suitable for each dialysis method are selected.
  • peritoneal dialysis has a slower dialysis efficiency than hemodialysis, has less burden on the heart and cells, and lowers renal function more slowly than hemodialysis.
  • hemodialysis is generally performed about 3 times a week for about 4 to 5 hours per dialysis, and water removal and waste removal in the body progress at a relatively high rate during dialysis treatment. Therefore, it often causes imbalance syndrome and hypotension.
  • glucose is used as the osmotic pressure adjusting substance
  • sodium ions (Na + ), calcium ions (Ca + ), and magnesium ions (Mg + ) are used as the cations
  • chloro ions are used as anions. Renal failure requiring nutritional management and / or blood glucose management characterized in that (Cl ⁇ ) and / or organic acid ions are included, and the water removal performance is adjusted by changing the type and concentration of the organic acid.
  • a peritoneal dialysis fluid for a patient is disclosed.
  • the solid hemodialysis agent was initially composed of three agents: A-1 containing an electrolyte and a pH regulator, A-2 consisting only of glucose, and B consisting of sodium bicarbonate.
  • A-1 containing an electrolyte and a pH regulator
  • A-2 consisting only of glucose
  • B consisting of sodium bicarbonate.
  • Many dialysis agents currently distributed in the country are two-part solid hemodialysis agents composed of an A agent and a B agent.
  • agent A contains sodium chloride, potassium chloride, calcium chloride, magnesium chloride, pH regulator (acid and optional buffer component), and glucose
  • agent B contains sodium bicarbonate.
  • the B agent is contraindicated in calcium chloride or magnesium chloride.
  • Patent Document 2 discloses an electrolyte component (other than sodium bicarbonate and sodium chloride) that makes it possible to change the bicarbonate ion concentration and the sodium ion concentration according to the patient's condition during dialysis treatment.
  • a three-drug hemodialysis agent comprising an A agent mainly containing, an S agent mainly containing sodium chloride, and a B agent mainly containing sodium bicarbonate has also been proposed.
  • bicarbonate dialysate used as a hemodialysis agent is formulated to have a composition and concentration as shown in Table 1 below when used as a dialysate in clinical practice.
  • the A-dialysis agent usually contains acetic acid as a pH regulator.
  • Acetic acid is metabolized in a short time because it is metabolized in a short time, and since the pH when dissolving the hemodialysis agent A is higher than that containing citric acid and hydrochloric acid, The impact when touching the machine is small. Therefore, hemodialysis agents containing acetic acid are prevalent in liquid preparations as well as solid preparations.
  • a general solid preparation for pharmaceuticals requires a special formulation technique different from a liquid preparation under the condition that at least a part of necessary solid components is maintained in a required amount uniformly and stably. If it is liquid, all components are dissolved and in a uniform state, so there is no problem with the uniformity of the component content, but it is not easy to create a state where the content is uniformly contained in the solid preparation.
  • Patent Document 3 discloses a dialysis agent and a method for producing the same that can improve the production efficiency while suppressing the problem that the amount of components contained in the granular material (granulated material) varies. Further, in Patent Document 4, if a specific cumulative pore volume ratio is set to 50% or less by granulation, a granulated product for agent A excellent in solubility, solidification suppression during storage, and the like can be obtained. It is disclosed.
  • the solid A-dialysis agent contains acetic acid as a pH regulator, acetic acid odor often becomes a problem.
  • acetic acid may react with other components to cause solidification.
  • Acetic acid is also a factor that promotes the degradation of glucose, which is widely and generally contained in the A-dialysis agent.
  • Patent Document 5 satisfies the A-dialysis agent used for the preparation of bicarbonate dialysate, which contains acetic acid and acetate, and the molar ratio of acetic acid: acetate is 1: 0.5-2. This makes it possible to prepare a bicarbonate dialysis solution so that the total acetate ion concentration is 2 mEq / L or more and less than 6 mEq / L, and in addition to excellent stability of components in the dialysis agent A, acetic acid It is disclosed that odor can be reduced.
  • Patent Document 6 discloses a solid dialysis agent A used for the preparation of bicarbonate dialysate, which contains glucose, acetic acid and acetate, and at least a part of acetic acid and acetate is alkali metal diacetate.
  • a bicarbonate dialysis solution having a total acetate ion concentration of 2 mEq / L or more and less than 6 mEq / L can be prepared.
  • the acetic acid odor can be reduced.
  • the object of the present invention is to reduce the odor of acetic acid, further suppress solidification by storage, degradation of glucose when coexisting with glucose, and pH increase when dissolved in water, and a solid state excellent in storage stability. It is to provide agent A for hemodialysis.
  • the inventors of the present invention as a solid A hemodialysis agent, contains only one of magnesium chloride and potassium chloride, and contains calcium chloride. It has been found that the coexistence of the first fraction composed of the product and the second fraction containing acetic acid and acetate can suppress the volatilization of acetic acid and reduce the odor of acetic acid. Furthermore, the solid A agent for hemodialysis is capable of suppressing solidification due to storage, suppressing pH increase when dissolved in water, and suppressing glucose degradation and coloring even when coexisting with glucose. It was also found that it has excellent storage stability.
  • the solid A agent for hemodialysis was dissolved in water by reducing the odor of acetic acid, suppressing solidification by storage, even when the first fraction and the second fraction were uniformly dispersed. It was found that the pH increase at the time, the decomposition of the glucose and the suppression of the coloring can be suppressed even when coexisting with glucose, and it has excellent storage stability.
  • the present invention has been completed by further studies based on this finding.
  • Item 1 A solid hemodialysis agent A containing a first fraction and a second fraction, The first fraction is a granulated product substantially containing only one of magnesium chloride and potassium chloride and containing calcium chloride; The solid A agent for hemodialysis, wherein the second fraction contains acetic acid and acetate.
  • Item 2. Item 2. The solid A agent for hemodialysis according to Item 1, wherein the first fraction contains magnesium chloride.
  • Item 3. Item 3.
  • Item 5. Item 5. The solid hemodialysis agent A according to any one of Items 1 to 4, comprising acetic acid and an alkali metal acetate as the acetic acid and acetate.
  • Item 6. Item 5. The solid hemodialysis agent A according to any one of Items 1 to 4, comprising an acetic acid and an alkali metal diacetate as the acetate.
  • Item 8. Item 8.
  • Item 9. Item 9. The solid hemodialysis agent A according to any one of Items 1 to 8, wherein the first fraction contains sodium chloride.
  • Item 10. Item 10. The solid hemodialysis agent A according to any one of Items 1 to 9, wherein the first fraction and / or the second fraction contains glucose.
  • Item 11. Item 11.
  • a solid hemodialysis agent A according to any one of Items 1 to 7, 10 and 11, which does not contain sodium chloride, S-agent for hemodialysis containing sodium chloride, B agent for hemodialysis containing sodium bicarbonate; A three-drug hemodialysis agent.
  • Item 14 A first step of preparing a granulated product substantially containing only one of magnesium chloride and potassium chloride and containing calcium chloride; and a granulated product obtained in the first step; and acetic acid and acetate.
  • a method for producing a solid hemodialysis agent A comprising a second step of obtaining a solid hemodialysis agent A.
  • the agent A for hemodialysis of the present invention can effectively suppress the volatilization of acetic acid and reduce the acetic acid odor. Furthermore, the agent A for hemodialysis of the present invention can suppress solidification by storage, decomposition of glucose when coexisting with glucose, and pH increase when dissolved in water, and has excellent storage stability. Have. Therefore, according to the hemodialysis agent A of the present invention, it is possible to improve the quality of the hemodialysis agent, improve the use environment in the medical field, and the like.
  • Solid A agent for hemodialysis hemodialysis A agent present invention the first fraction (first granular composition) and solid for hemodialysis A agent containing the second fraction (second composition)
  • the first fraction is a granulated material substantially containing only one of magnesium chloride and potassium chloride and containing calcium chloride
  • the second fraction contains acetic acid and acetate. It is characterized by.
  • the A fraction for hemodialysis so that the first fraction formed from the granulated product of the specific component and the second fraction containing the specific component coexist. It is possible to reduce the odor of acetic acid, suppress solidification by storage, suppress degradation of glucose when coexisting with glucose, and suppress an increase in pH when dissolved in water.
  • the hemodialysis agent A of the present invention will be described in detail.
  • the first fraction contained in the hemodialysis agent A of the present invention is a granulated product substantially containing only one of magnesium chloride and potassium chloride and containing calcium chloride.
  • the “granulated product” in the present invention refers to not only a state in which each component particle is agglomerated or reacted to mix multiple component particles in one particle, but also an aggregated state in which one particle is bonded.
  • Magnesium chloride is a substance that serves as a source of magnesium ions and chloride ions.
  • Magnesium chloride used as a raw material for producing the first fraction may be either a hydrate or an anhydride, but it is preferable that part or all of the magnesium chloride is in the form of a hydrate.
  • magnesium chloride hydrate is used, at least a part of the crystal water contained in the magnesium chloride hydrate is released by heating or heat generation during granulation, and serves as a binder, thereby efficiently using the electrolyte raw material. It becomes possible to granulate.
  • magnesium chloride hydrate examples include magnesium chloride dihydrate, magnesium chloride tetrahydrate, magnesium chloride hexahydrate, magnesium chloride octahydrate, magnesium chloride dodecahydrate, etc. 1 to 12 hydrates.
  • magnesium chloride hydrates magnesium chloride hexahydrate is preferable.
  • These magnesium chloride hydrates may be used alone or in combination of two or more.
  • Potassium chloride is a substance that is a source of potassium ions.
  • the first fraction only one of magnesium chloride and potassium chloride is substantially contained.
  • “substantially containing only one” means that one of potassium chloride and magnesium chloride is contained, and the other is not substantially contained. That is, magnesium chloride and potassium chloride do not substantially coexist in the same fraction. Therefore, the first fraction contains two aspects of the first aspect containing magnesium chloride and substantially free of potassium chloride, and the second aspect containing potassium chloride and substantially free of magnesium chloride. It is divided into.
  • the magnesium chloride content in the first fraction is such that the magnesium ion concentration of the hemodialysis solution prepared by the agent A for hemodialysis is 0.5 to 2.0 mEq. / L, preferably 0.75 to 1.5 mEq / L, may be set as appropriate in consideration of the content of other magnesium salts contained in the dialysis agent.
  • the first fraction Based on the anhydrous weight of magnesium chloride, 0.1 to 50 parts by weight, preferably 0.1 to 40 parts by weight, and more preferably 0.3 to 30 parts by weight per 100 parts by weight of the total amount.
  • anhydrous weight conversion of magnesium chloride means that when magnesium chloride is in the form of hydrate, the weight of anhydride is excluded except for the weight of crystal water (water molecules in the hydrate). It is a value obtained by converting to.
  • the first fraction is substantially free of potassium chloride.
  • substantially free of potassium chloride means that it is allowed to contain a small amount of potassium chloride as long as the effects of the present invention are not impaired.
  • Potassium chloride is 1 part by weight or less, preferably less than 0.3 part by weight, more preferably 0 part by weight per 100 parts by weight of the first fraction.
  • the potassium chloride content in the second fraction is such that the potassium ion concentration of the hemodialysis solution prepared by the agent A for hemodialysis is 0.5 to 3 mEq. / L may be appropriately set in consideration of the content of other potassium salts contained in the dialysis agent, for example, potassium chloride is 0.1 per 100 parts by weight of the total amount of the first fraction. 1 to 50 parts by weight, preferably 0.1 to 40 parts by weight, and more preferably 0.3 to 30 parts by weight.
  • the first fraction is substantially free of magnesium chloride.
  • substantially free of magnesium chloride means that it is allowed to contain a small amount of magnesium chloride as long as the effects of the present invention are not impaired.
  • Magnesium chloride is 1 part by weight or less, preferably less than 0.3 part by weight, more preferably 0 part by weight in terms of anhydride weight per 100 parts by weight of the first fraction.
  • Calcium chloride is a substance that is a source of calcium ions.
  • the calcium chloride used as the raw material for producing the first fraction may be either a hydrate or an anhydride, but it is preferable that a part or all of the calcium chloride is in the form of a hydrate.
  • calcium chloride hydrate is used, depending on the heating or exothermic conditions during granulation, at least a portion of the crystal water contained in the calcium chloride hydrate may be released and serve as a binder.
  • Specific examples of calcium chloride hydrates include 1 to 6 hydrates such as calcium chloride monohydrate, calcium chloride dihydrate, calcium chloride tetrahydrate, and calcium chloride hexahydrate. Can be mentioned. Among these calcium chloride hydrates, calcium chloride dihydrate is preferable. These calcium chloride hydrates may be used singly or in combination of two or more.
  • the calcium ion concentration of the hemodialysis solution prepared by the agent A for hemodialysis is 1.5 to 4.5 mEq / L, preferably 2.5 to 3.5 mEq / L.
  • L may be appropriately set in consideration of the content of other calcium salts contained in the dialysis agent, for example, the anhydrous weight of calcium chloride per 100 parts by weight of the first fraction. 0.1 to 70 parts by weight in terms of conversion, preferably 0.1 to 60 parts by weight, and more preferably 0.3 to 50 parts by weight.
  • calcium chloride anhydrous weight conversion means that when calcium chloride is in the form of hydrate, the weight of anhydride is excluded except for the weight of crystal water (water molecules in the hydrate). It is a value obtained by converting to.
  • the first fraction is granulated together with other components that are blended as necessary, and is in the form of a granulated product.
  • the particle diameter of the granulated material constituting the first fraction is not particularly limited.
  • the particle size passes through a 10 mesh (1700 ⁇ m opening) sieve with a Tyler standard sieve, but a 80 mesh (180 ⁇ m opening) sieve.
  • the proportion of particles that do not pass through is 90% by weight or more, preferably 93% by weight or more, and more preferably 95% by weight or more.
  • the water content of the first fraction is not particularly limited, but may be, for example, 3% by weight or less, preferably 2% by weight or less, and more preferably 1.5% by weight or less. When such moisture content is satisfied, it is possible to more effectively suppress acetic acid odor, solidification by storage, degradation of glucose when coexisting with glucose, and increase in pH when dissolved in water. become.
  • the water content of the first fraction is a value measured using a Karl Fischer moisture meter.
  • the second fraction is a fraction containing acetic acid and acetate.
  • all the components other than the granulated material constituting the first fraction are constituents of the second fraction.
  • the acetic acid used in the second fraction may be glacial acetic acid.
  • the acetate used in the second fraction is not particularly limited as long as it is acceptable as a component of the hemodialysis solution.
  • alkali metal acetates such as sodium acetate and potassium acetate; calcium acetate And alkaline earth metal acetates such as magnesium acetate.
  • These acetate salts may be anhydrous acetate salts.
  • alkali metal acetates are preferable, and sodium acetate is more preferable, from the viewpoints of safety and cost due to many years of use.
  • these acetates may be used individually by 1 type, and may be used in combination of 2 or more type.
  • acetic acid and acetate contained in the second fraction may be in the form of alkali metal diacetate.
  • Use of alkali metal diacetate reduces the odor of acetic acid, suppresses solidification by storage, suppresses degradation of glucose when coexisting with glucose, and suppresses increase in pH when dissolved in water. It becomes possible to plan.
  • the alkali metal diacetate is a complex (MH (C 2 H 3 O 2 ) 2 ; M represents an alkali metal atom) in which 1 mol of an alkali metal acetate and 1 mol of acetic acid are complexed.
  • alkali metal acetate from 1 mol of the metal salt, 1 mol of acetate (alkali metal acetate) and 1 mol of acetic acid are supplied.
  • alkali metal diacetate used in the present invention include sodium diacetate and potassium diacetate. These alkali metal diacetates may be used individually by 1 type, and may be used in combination of 2 or more type. Among the alkali metal diacetates, sodium diacetate is preferable.
  • acetic acid and acetate contained in the second fraction may be in the form of a higher-order acetate compound.
  • the higher order acetate compound is a compound formed by combining acetic acid (primary compound) and acetate (primary compound) with each other.
  • the molar ratio of acetic acid and acetate is not particularly limited and may be appropriately set based on the pH range to be applied to the hemodialysis solution.
  • acetic acid in the second fraction Mole ratio of acetate is preferably 1: 0.5 to 10, more preferably 1: 0.5 to 3.0, and particularly preferably 1: 0.7 to 2.0.
  • acetic acid and acetic acid salt include alkali metal diacetate
  • acetic acid and acetic acid salt derived from 1 mol of alkali metal diacetate are calculated as 1 mol of acetic acid and 1 mol of acetate, and the molar ratio is calculated.
  • acetic acid and a high-order acetate compound are included as the acetate, if the molar ratio of acetic acid: acetate in the high-order acetate compound is 1: X, it is derived from 1 mol of the higher-order acetate compound.
  • the molar ratio is calculated as 1 mol of acetic acid and X mol of acetate.
  • the acetate ion concentration of the hemodialysis solution prepared by the agent A for hemodialysis is 0.5 to 12 mEq / L, preferably 1.5 to 10 mEq / L, More preferably, it may be set appropriately so as to be 2 to 6 mEq / L.
  • the total amount of acetic acid and acetate is 1 to 100 parts by weight, preferably 5 to 80 parts per 100 parts by weight of the second fraction. Parts by weight, more preferably 5 to 25 parts by weight.
  • the second fraction may contain potassium chloride.
  • the content of other potassium salts contained in the hemodialysis agent is adjusted so that the potassium ion concentration of the hemodialysis solution is 0.5 to 3 mEq / L. What is necessary is just to set suitably in consideration of content etc.
  • the second fraction may contain magnesium chloride.
  • the magnesium ion concentration of the hemodialysis solution is 0.5 to 2.0 mEq / L, preferably 0.75 to 1.5 mEq / L.
  • the content of other magnesium salts contained in the agent A for hemodialysis may be appropriately set.
  • the second fraction may be in the form of a non-granulated product containing the above components and other components blended as necessary, and the second fraction is prepared together with other components blended as necessary. It may be in the form of granules. Further, the second fraction may be a combination of a non-granulated product and a granulated product.
  • the second fraction may be present in a state where the above components and other components blended as necessary are uniformly dispersed. Moreover, the said component and the other component mix
  • the agent A for hemodialysis of the present invention may contain sodium chloride as a sodium ion supply source.
  • sodium chloride may be contained in either the first fraction or the second fraction, and the first fraction and the second fraction. May be included in both minutes.
  • the content of sodium chloride in the hemodialysis solution prepared by hemodialysis agent A is 120 to 150 mEq / L, preferably 135 to 145 mEq. / L may be appropriately set in consideration of the content of other sodium salts contained in the dialysis agent.
  • the agent A for hemodialysis of the present invention may contain glucose for the purpose of maintaining the blood glucose level of the patient.
  • Glucose tends to be destabilized by contact with electrolytes such as calcium chloride and magnesium chloride, but in the agent A for hemodialysis according to the present invention, the first fraction is in the form of a granulated product. By coexisting with the fraction, glucose can be stably maintained even when glucose is contained.
  • glucose When glucose is included in the hemodialysis agent A of the present invention, glucose may be contained in either the first fraction or the second fraction, and both the first fraction and the second fraction. However, from the viewpoint of further improving the stability of glucose, it is preferably contained in the second fraction.
  • the content thereof is appropriately set according to the glucose concentration provided in the finally prepared hemodialysis solution.
  • the content of glucose in the hemodialysis agent A is such that the glucose concentration in the finally prepared dialysate is 0 to 2.5 g / L, preferably 1.0 to 2.0 g / L. What is necessary is just to set suitably.
  • the agent A for hemodialysis according to the present invention includes calcium ion, magnesium ion, sodium ion, potassium ion, chloride ion, citrate ion, lactate ion, gluconate ion, succinate as necessary.
  • Other organic acid salts and / or inorganic salts that serve as sources of acid ions, malate ions, and the like may be included. When these components are contained, they may be contained in any of the first fraction and the second fraction, and may be contained in both the first fraction and the second fraction.
  • Examples of the compound serving as a calcium ion supply source include calcium salts of organic acids such as calcium acetate, calcium lactate, calcium citrate, calcium gluconate, calcium succinate, and calcium malate. These calcium salts of organic acids may be used alone or in combination of two or more.
  • Examples of the compound serving as a supply source of magnesium ions include magnesium organic acid salts such as magnesium acetate, magnesium lactate, magnesium citrate, magnesium gluconate, magnesium succinate, and magnesium malate.
  • magnesium organic acid salts such as magnesium acetate, magnesium lactate, magnesium citrate, magnesium gluconate, magnesium succinate, and magnesium malate.
  • One of these organic acid salts of magnesium may be used alone, or two or more thereof may be used in combination.
  • Examples of the compound serving as a source of sodium ions include sodium organic acid salts such as sodium lactate, sodium citrate, sodium gluconate, sodium succinate, and sodium malate. These organic acid salts of sodium may be used alone or in combination of two or more.
  • Examples of the compound serving as a supply source of potassium ions include potassium organic acid salts such as potassium acetate, potassium lactate, potassium citrate, potassium gluconate, potassium succinate, and potassium malate. These organic acid salts of potassium may be used alone or in combination of two or more.
  • organic acid salts and / or inorganic acid salts may be appropriately selected according to the types of various ions to be contained in the finally prepared hemodialysis solution.
  • the content of these organic acid salts and / or inorganic salts is appropriately set according to each ion concentration provided in the hemodialysis solution to be finally prepared.
  • the content of the electrolyte component contained in the agent A for hemodialysis of the present invention may be appropriately set so that the finally prepared hemodialysis solution satisfies each ion concentration shown in Table 2 below. .
  • the hemodialysis agent A of the present invention contains acetic acid and acetate in the second fraction so that the prepared hemodialysis solution has an appropriate pH.
  • the dialysis agent A may further contain a pH adjusting agent other than acetic acid and acetate, if necessary.
  • the pH adjuster that can be used in the hemodialysis agent A of the present invention is not particularly limited as long as it is acceptable as a component of the dialysis solution.
  • liquid acids such as hydrochloric acid, lactic acid, and gluconic acid, Examples thereof include solid acids such as citric acid, succinic acid, fumaric acid, malic acid and glucono delta lactone, and sodium, potassium, calcium and magnesium salts thereof.
  • organic acids are preferably used.
  • a pH regulator may be used individually by 1 type, and may be used in combination of 2 or more type.
  • the pH regulator may be contained in any of the first fraction and the second fraction, Further, it may be contained in both the first fraction and the second fraction.
  • the pH of the hemodialysis solution to be finally prepared is 7.2 to 7.6, preferably May be appropriately set to be 7.2 to 7.5.
  • the hemodialysis agent A of the present invention is contained in a state in which the first fraction and the second fraction coexist.
  • the first fraction and the second fraction coexist in the contained container.
  • the first fraction and the second fraction are uniformly dispersed. Even in this state, the first fraction and the second fraction may be dispersed or distributed unevenly.
  • the water content of the hemodialysis agent A of the present invention is not particularly limited and is determined by the water content of the first fraction and the second fraction.
  • the hemodialysis agent A of the present invention contains sodium chloride.
  • the water content of the hemodialysis agent A is 5.0% by weight or less, preferably 2.0% by weight or less, and more preferably 1.5% by weight or less.
  • the water content of the hemodialysis agent A is a value measured using a Karl Fischer moisture meter.
  • the agent A for hemodialysis of the present invention is produced by preparing a granulated product constituting the first fraction and mixing the components contained in the second fraction with the granulated product.
  • examples of the method for producing the hemodialysis agent A of the present invention include a method including the following first step and second step.
  • First step A granulated product containing only one of magnesium chloride and potassium chloride and containing calcium chloride is prepared.
  • Second Step A solid hemodialysis agent A containing the granulated product obtained in the first step, acetic acid and acetate is obtained.
  • granulation may be performed using the components contained in the first fraction.
  • the granulation can be performed according to a method usually employed in the technical field.
  • the granulated product obtained in the first step may be subjected to post-treatment such as drying, cooling, and sieving as necessary.
  • post-treatment such as drying, cooling, and sieving as necessary.
  • the amount of water in the granulated product greatly depends on the total amount of water of crystallization of the raw material used, but as a guideline, when water is added and granulated in the first step, the same amount of water as the added water is removed.
  • the granulated product obtained in the first step (first fraction) and the components constituting the second fraction may be mixed or added.
  • the component constituting the second fraction may be added separately to the granulated product (first fraction) obtained in the first step, and the second fraction is constituted.
  • the mixture may be added after the components to be mixed are once mixed.
  • acetic acid and acetate are contained in the second fraction
  • acetic acid and acetate are once mixed, and then added or mixed to the granulated product obtained in the first step.
  • the stability can be improved more effectively.
  • the hemodialysis agent A of the present invention is provided by being housed in a packaging container.
  • a packaging container used for the packaging of A agent for hemodialysis For example, a flexible bag, a hard bottle, etc. are mentioned.
  • the packaging container include a silica vapor deposition laminate bag, an aluminum vapor deposition laminate bag, an aluminum oxide vapor deposition laminate bag, an aluminum laminate bag, and a polyethylene hard bottle.
  • a packaging bag (such as an aluminum laminate bag) using a metal foil such as an aluminum foil can reduce moisture permeability and more effectively suppress acetic acid volatilization.
  • the moisture permeability of these packaging containers is preferably 0.5 g / m 2 ⁇ 24 h (40 ° C., 90% RH) or less, and more preferably, from the viewpoint of more effectively reducing the odor of acetic acid. 2 g / m 2 ⁇ 24 h (40 ° C., 90% RH) or less.
  • the said moisture permeability is a value measured based on the measuring method prescribed
  • the packaging container for storing the hemodialysis agent A of the present invention may further contain a desiccant in order to effectively reduce the water content of the hemodialysis agent A.
  • a desiccant for example, a zeolite, magnesium sulfate, sodium sulfate, a silica gel, an alumina etc. are mentioned.
  • a desiccant is stored in a packaging container, a container in which these substances are blended with a part of plastic (for example, a polyethylene layer) constituting the container may be used, or a space in which the desiccant can be stored in the packaging container ( A separate room may be provided.
  • the desiccant may be contained in a non-woven fabric or the like so as not to be mixed into the hemodialysis agent A and contained in a packaging container.
  • Hemodialysis agent hemodialysis agent present invention the blood dialysis agent A, and contains a hemodialysis B agent containing sodium bicarbonate.
  • the B preparation for hemodialysis may contain glucose as necessary.
  • glucose included in the hemodialysis agent B
  • the content is such that the glucose concentration in the finally prepared hemodialysis solution is 0 to 2.5 g / L, preferably 1.0 to 1.5 g / L. What is necessary is just to set suitably so that it may become.
  • the B agent for hemodialysis does not contain electrolyte components other than sodium bicarbonate, and it is preferable that the component is substantially composed of sodium bicarbonate.
  • the hemodialysis agent B is preferably solid from the viewpoint of transportation and storage. Specific examples of the shape of the solid B agent for hemodialysis include powders and granules.
  • the amount of the hemodialysis agent B used may be appropriately set so that bicarbonate ion in the finally prepared hemodialysis solution is 20 to 40 mEq / L, preferably 25 to 35 mEq / L.
  • the hemodialysis agent of the present invention is a two-agent type comprising the hemodialysis agent A and the hemodialysis agent B containing sodium bicarbonate. It is used as a hemodialysis agent.
  • the hemodialysis agent of the present invention includes the hemodialysis agent A, hemodialysis agent S containing sodium chloride, and sodium bicarbonate. It is used as a three-drug hemodialysis agent comprising a B agent for hemodialysis. As described in Patent Document 2, the three-drug hemodialysis agent is prepared by adjusting the ratio of the addition amount of hemodialysis agent S and hemodialysis agent B during hemodialysis. Accordingly, it is possible to prepare a hemodialysis solution capable of maintaining a constant electrolyte concentration such as sodium, potassium, calcium, magnesium, etc. while freely changing the bicarbonate ion concentration even during hemodialysis.
  • the S-agent for hemodialysis may contain glucose as necessary.
  • glucose When glucose is contained in the S-agent for hemodialysis, the content thereof is such that the glucose concentration in the finally prepared hemodialysis solution is 0 to 2.5 g / L, preferably 1.0 to 1.5 g / L. What is necessary is just to set suitably so that it may become.
  • the S-agent for hemodialysis does not contain electrolyte components other than sodium chloride, and those containing substantially sodium chloride are preferred.
  • the S-agent for hemodialysis is preferably solid from the viewpoint of transportation and storage. Specific examples of the solid S-dialysis agent include powders and granules.
  • the amount of the S agent for hemodialysis is appropriately determined so that the hemodialysis solution finally prepared satisfies the sodium concentration shown in Table 1 in consideration of the amount of sodium salt in the agent A for hemodialysis. You only have to set it.
  • the hemodialysis agent of the present invention is used for preparing a bicarbonate hemodialysis solution. Specifically, when sodium chloride is not contained in the hemodialysis agent A, the hemodialysis agent B, and the hemodialysis agent A, the hemodialysis agent S is added with a predetermined amount of water ( Bicarbonate hemodialysate is prepared by mixing with and preferably diluting with purified water.
  • Test example 1 Production of solid A agent for hemodialysis Example 1 Weigh 928.8 g of sodium chloride, 28.2 g of calcium chloride dihydrate, and 18.0 g of magnesium chloride hexahydrate, put each in a separate plastic bag and seal it in a blow-type shelf dryer. And heated to 70 ° C. After heating, these raw materials and 18.0 g of purified water were put in one plastic bag and sealed, and after sufficiently mixing, they were again placed in a blow type shelf dryer and left at 70 ° C. for 20 minutes. Next, the entire contents of the plastic bag were spread uniformly on a stainless steel bat, placed in a 130 ° C. blown shelf dryer and dried for 2 hours. Since the granulated product was solidified by drying, it was pulverized with a spoon twice during drying, and after completion of drying, it was passed through a sieve having an opening of 2000 ⁇ m to produce a granulated product (first fraction).
  • Example 2 Weighing 928.8 g of sodium chloride, 25.3 g of potassium chloride, and 28.2 g of calcium chloride dihydrate, and placing each in a separate plastic bag and sealing it to 70 ° C. with a blow-type shelf dryer Warmed up. After heating, these raw materials and 18.0 g of purified water were put in one plastic bag and sealed, and after sufficiently mixing, they were again placed in a blow type shelf dryer and left at 70 ° C. for 20 minutes. Next, the entire contents of the plastic bag were spread uniformly on a stainless steel bat, placed in a 130 ° C. blown shelf dryer and dried for 2 hours. Since the granulated product was solidified by drying, it was pulverized with a spoon twice during drying, and after completion of drying, it was passed through a sieve having an opening of 2000 ⁇ m to produce a granulated product (first fraction).
  • Comparative Example 1 Weighing 928.8 g of sodium chloride, 25.3 g of potassium chloride, and 18.0 g of magnesium chloride hexahydrate, respectively, put each in a separate plastic bag, and sealed it in a fan-type shelf dryer at 70 ° C. Warmed up. After heating, these raw materials and 18.0 g of purified water were put in one plastic bag and sealed, and after sufficiently mixing, they were again placed in a blow type shelf dryer and left at 70 ° C. for 20 minutes. Next, the entire contents of the plastic bag were spread uniformly on a stainless steel bat, placed in a 130 ° C. blown shelf dryer and dried for 2 hours. Since the granulated product was solidified by drying, it was pulverized with a spoon twice during drying, and after completion of drying, it was passed through a sieve having an opening of 2000 ⁇ m to produce a granulated product (first fraction).
  • Comparative Example 2 Weighing 928.8 g of sodium chloride, 25.3 g of potassium chloride, 28.2 g of calcium chloride dihydrate, and 18.0 g of magnesium chloride hexahydrate, and placing each in a separate plastic bag and sealing, blow It heated to 70 degreeC with the type
  • a detector tube is set in a bag containing each hemodialysis agent A, and a certain amount of sample gas is passed through the detector tube for measuring acetic acid.
  • the volatile acetic acid concentration was measured by a manufacturer: GASTEC, model number: GV-100S.
  • the amount of 5-hydroxymethylfurfural (hereinafter referred to as 5-HMF), which is a degradation product of glucose, is determined by measuring the absorbance at the absorption wavelength (wavelength 284 nm) of 5-HMF using a spectrophotometer for the liquid filtered through a 0.2 ⁇ m filter. (Abs) was measured.
  • the increase in the concentration of volatile acetic acid was sufficiently suppressed even after 5 months of storage, and further, the solidification, coloring, the increase in pH when dissolved in water, and the decomposition of glucose were also sufficiently suppressed.
  • the water content of the granulated product (first fraction) used as a raw material for the hemodialysis agent A and the hemodialysis agent A was sufficiently low. .
  • Test example 2 Production of solid A agent for hemodialysis Example 3 1000 kg of sodium chloride, 33.4 kg of calcium chloride dihydrate, 22.3 kg of magnesium chloride hexahydrate, and an appropriate amount of purified water are placed in a Nauta mixer (manufacturer: Hosokawa Micron Corporation, model number: DBX-5000RW) and mixed for 30 minutes. A granulated product was obtained. Subsequently, the granulated material was continuously supplied to the vibrating sieve, and the discharged granulated material was continuously transferred. After continuous drying at a drying temperature of 155 ° C., the mixture was cooled to produce a granulated product (first fraction).
  • a Nauta mixer manufactured by Hosokawa Micron Corporation, model number: DBX-5000RW
  • Comparative Example 3 Sodium chloride 1000 kg, potassium chloride 28.9 kg, calcium chloride dihydrate 33.4 kg, magnesium chloride hexahydrate 22.3 kg and appropriate amount of purified water to Nauta mixer (manufacturer: Hosokawa Micron Corporation, model number: DBX-5000RW) The mixture was mixed for 30 minutes to obtain a granulated product. Subsequently, the granulated material was continuously supplied to the vibrating sieve, and the discharged granulated material was continuously transferred to a dryer. After continuous drying at a drying temperature of 155 ° C., the mixture was cooled to produce a granulated product (first fraction).
  • Test example 3 Production of solid A agent for hemodialysis
  • Example 4 486 kg of the granulated product used in Example 3 (first fraction), 12.4 kg of potassium chloride, 21.5 kg of a solid mixture of acetic acid and sodium acetate having a molar ratio of acetic acid: sodium acetate of 1: 1, and glucose 106 Place 4 kg in Nauta mixer (manufacturer: Hosokawa Micron Corporation, model number: DBX-5000RW), mix for 60 minutes, discharge, weigh 150.2 g, seal in moisture-proof packaging material containing aluminum laminate layer, and hemodialyze A preparation A was obtained.
  • Nauta mixer manufactured by Hosokawa Micron Corporation, model number: DBX-5000RW
  • Comparative Example 4 581 kg of granulated product (first fraction) used in Comparative Example 3, 25.7 kg of a solid mixture of acetic acid and sodium acetate, and 127.2 kg of glucose were added to a Nauta mixer (manufacturer: Hosokawa Micron Corporation, model number: DBX-5000RW). After mixing for 60 minutes and discharging, 150.2 g was weighed and sealed in a moisture-proof packaging material containing an aluminum laminate layer to obtain agent A for hemodialysis.
  • Results are shown in Tables 14-16.
  • a granulated product containing magnesium chloride, potassium chloride and calcium chloride (first fraction), and acetic acid and acetate (second fraction) were mixed (Comparative Example 4)
  • volatile acetic acid was stored after storage.
  • the increase in concentration, solidification, coloring, increase in pH when dissolved in water, and degradation of glucose were remarkable.
  • the granulated product containing magnesium chloride and calcium chloride (first fraction) and potassium chloride, acetic acid, and acetate (second fraction) are mixed (Example 4)
  • storage is performed. Even after that, the increase in the concentration of volatile acetic acid was sufficiently suppressed, and further, solidification, coloring, increase in pH when dissolved in water, and decomposition of glucose were also sufficiently suppressed.
  • Production example 1 Production of solid A agent for hemodialysis Example 5 Weighing 928.8 g of sodium chloride, 32.5 g of calcium chloride dihydrate, and 22.5 g of magnesium chloride hexahydrate, respectively, weighed each in a separate plastic bag, and sealed it in a blow-type shelf dryer At 70 ° C. After heating, these raw materials and 18.0 g of purified water were put in one plastic bag and sealed, and after sufficiently mixing, they were again placed in a blow type shelf dryer and left at 70 ° C. for 20 minutes. Next, the entire contents of the plastic bag were spread uniformly on a stainless steel bat, placed in a 130 ° C. blown shelf dryer and dried for 2 hours. Since the granulated product was solidified by drying, it was pulverized with a spoon twice during drying, and after completion of drying, it was passed through a sieve having an opening of 2000 ⁇ m to produce a granulated product (first fraction).
  • Example 6 Weighing 928.8 g of sodium chloride, 37.9 g of calcium chloride dihydrate, and 30.0 g of magnesium chloride hexahydrate, respectively, weighed each in a separate plastic bag, and sealed it in a blow-type shelf dryer At 70 ° C. After heating, these raw materials and 18.0 g of purified water were put in one plastic bag and sealed, and after sufficiently mixing, they were again placed in a blow type shelf dryer and left at 70 ° C. for 20 minutes. Next, the entire contents of the plastic bag were spread uniformly on a stainless steel bat, placed in a 130 ° C. blown shelf dryer and dried for 2 hours. Since the granulated product was solidified by drying, it was pulverized with a spoon twice during drying, and after completion of drying, it was passed through a sieve having an opening of 2000 ⁇ m to produce a granulated product (first fraction).

Abstract

The present invention addresses the problem of providing a hemodialysis solid agent A, in which acetic acid odor can be reduced, in which solidification due to storage, decomposition of glucose when made to coexist with glucose, and an increase in pH when dissolved in water can be suppressed, and which has excellent storage stability. The problem can be solved by a hemodialysis solid agent A which substantially contains only one among magnesium chloride and potassium chloride, and which includes a first fraction composed of granules containing calcium chloride and a second fraction containing acetic acid and acetate.

Description

血液透析用A剤Agent A for hemodialysis
 本発明は、酢酸及び酢酸塩を含む血液透析用A剤及びその製造方法に関する。より具体的には、本発明は、酢酸及び酢酸塩を含み、酢酸臭を低減でき、更に保存による固化、ブドウ糖を共存させた際のブドウ糖の分解、及び水に溶解した時のpH上昇を抑制可能で、保存安定性に優れた固体状の血液透析用A剤及びその製造方法に関する。更に、本発明は、当該血液透析用A剤を用いた血液透析用剤に関する。 The present invention relates to a hemodialysis agent A containing acetic acid and acetate and a method for producing the same. More specifically, the present invention includes acetic acid and acetate, can reduce acetic acid odor, and further suppresses solidification by storage, decomposition of glucose when coexisting with glucose, and increase in pH when dissolved in water. The present invention relates to a solid A-dialysis agent having excellent storage stability and a method for producing the same. Furthermore, this invention relates to the agent for hemodialysis using the said A agent for hemodialysis.
 腎不全患者を対象とした透析療法は、血中電解質成分濃度の調節、尿毒症性物質の除去、酸塩基平衡の是正等を目的として実施されている。一般的に行われる透析療法には、大別して腹膜透析と血液透析があり、どちらの方法も透析液を使用する。 Dialysis therapy for patients with renal failure is performed for the purpose of adjusting the concentration of electrolyte components in the blood, removing uremic substances, correcting acid-base balance, and the like. The dialysis therapy generally performed is roughly classified into peritoneal dialysis and hemodialysis, and both methods use a dialysis solution.
 透析液には複数の成分が含まれているが、製剤安定性を有し、治療の目的に合致し、且つ生体に対する負担の少ない成分が適切な濃度で配合されているべきである。例えば、腹膜透析に使用される透析液には、一般的に、主として乳酸ナトリウムがアルカリ化剤として使用されているが、血液透析に使用する透析液には重炭酸ナトリウムや酢酸ナトリウム、クエン酸ナトリウム等が含まれており、製剤化の難しさ、投与経路、生体適合性の観点から、それぞれの透析方法に合った成分が選定されている。 The dialysate contains a plurality of components, but the components should be formulated at appropriate concentrations that have formulation stability, meet the purpose of treatment, and have less burden on the living body. For example, sodium lactate is generally used as an alkalizing agent in dialysate used for peritoneal dialysis, but sodium bicarbonate, sodium acetate, sodium citrate is used as dialysate for hemodialysis. From the viewpoints of difficulty in formulation, administration route, and biocompatibility, components suitable for each dialysis method are selected.
 また、一般的に、腹膜透析は血液透析に比べ透析効率が緩徐であり、心臓や細胞への負担が少なく、且つ腎機能の低下が血液透析よりも緩やかになることが知られている。一方で、血液透析は週に3回程度、1回の透析につき4~5時間程度行うのが一般的であり、透析処置中に比較的速い速度で除水、体内の老廃物除去が進行するため、不均衡症候群や低血圧を引き起こすことが多い。 In general, it is known that peritoneal dialysis has a slower dialysis efficiency than hemodialysis, has less burden on the heart and cells, and lowers renal function more slowly than hemodialysis. On the other hand, hemodialysis is generally performed about 3 times a week for about 4 to 5 hours per dialysis, and water removal and waste removal in the body progress at a relatively high rate during dialysis treatment. Therefore, it often causes imbalance syndrome and hypotension.
 このような透析効率の違いからも、腹膜透析と血液透析に使用される透析液には処方上の差異がある。例えば、現在世界で市販されている多くの血液透析用剤にはカリウムが含まれており、国内ではカリウムの含有されていない血液透析用剤は販売されていない。血液透析は時間効率が良く、カリウムが含まれていない場合には急激なカリウムイオンの除去により、低カリウム血症を引き起こす危険があるため、致死的危険域を下回らない濃度の塩化カリウムを含有する必要があるからである。一方で、本来、腎不全患者にとってカリウムは十分に除去すべき電解質であるため、透析進行が緩徐な腹膜透析用剤にカリウムを含まないことは、合理的である。例えば、特許文献1では、浸透圧調整物質としてグルコース、カチオンとしてナトリウムイオン(Na+)、カルシウムイオン(Ca+)、マグネシウムイオン(Mg+)の各濃度が所定の範囲内で、アニオンとしてクロルイオン(Cl-)及び/又は有機酸イオンを含み、その有機酸の種類と濃度を変化させることで除水性能が調節されたことを特徴とする栄養管理及び/又は血糖管理を必要とする腎不全患者用の腹膜透析液が開示されている。 Due to the difference in dialysis efficiency, there is a difference in prescription between dialysates used for peritoneal dialysis and hemodialysis. For example, many hemodialysis agents currently marketed worldwide contain potassium, and no hemodialysis agent containing no potassium is sold in Japan. Hemodialysis is time efficient and contains potassium chloride at a concentration that does not fall below the lethal risk because there is a risk of hypokalemia due to rapid removal of potassium ions when potassium is not included It is necessary. On the other hand, since potassium is an electrolyte that should be sufficiently removed for patients with renal failure, it is reasonable not to include potassium in a peritoneal dialysis agent with a slow dialysis progression. For example, in Patent Document 1, glucose is used as the osmotic pressure adjusting substance, sodium ions (Na + ), calcium ions (Ca + ), and magnesium ions (Mg + ) are used as the cations, and chloro ions are used as anions. Renal failure requiring nutritional management and / or blood glucose management characterized in that (Cl ) and / or organic acid ions are included, and the water removal performance is adjusted by changing the type and concentration of the organic acid. A peritoneal dialysis fluid for a patient is disclosed.
 血液透析用剤が液状の場合、その嵩高さ故に輸送コストが高く、またそれに見合った保管スペースも必要なことから、近年国内では固体製剤の使用が主流となっている。固体製剤は、透析処置前に専用の装置等を用いて所定量の水に溶解して透析液を調製することから、大容量の透析液を運ぶ必要がなく、医療従事者の負担を減らすことができる。 When a hemodialysis agent is in liquid form, its bulky cost is high, and a storage space commensurate with it is required, so in recent years, the use of solid preparations has become the mainstream in Japan. Since solid preparations are prepared in a predetermined amount of water by using a special device before dialysis treatment to prepare dialysate, it is not necessary to carry a large volume of dialysate, reducing the burden on medical personnel. Can do.
 固体状の血液透析用剤は、当初は電解質及びpH調節剤を含むA-1剤と、ブドウ糖のみからなるA-2剤、炭酸水素ナトリウムからなるB剤の3剤で構成されていたが、現在国内で流通している多くの透析剤は、A剤とB剤から成る2剤型の固体状の血液透析用剤である。通常、A剤には塩化ナトリウム、塩化カリウム、塩化カルシウム、塩化マグネシウム、pH調節剤(酸および任意成分としてのバッファー成分)、及びブドウ糖が含まれており、B剤には炭酸水素ナトリウムが含まれている。また、不溶性塩の析出を防ぐため、B剤には塩化カルシウムや塩化マグネシウムの配合が禁忌とされている。また、例えば特許文献2には、透析処置中に、患者の病態に応じて、重炭酸イオン濃度やナトリウムイオン濃度を変化させることを可能とする、電解質成分(重炭酸ナトリウム及び塩化ナトリウム以外)を主として含むA剤、塩化ナトリウムを主として含むS剤、及び重炭酸ナトリウムを主として含むB剤からなる3剤型の血液透析用剤も提案されている。 The solid hemodialysis agent was initially composed of three agents: A-1 containing an electrolyte and a pH regulator, A-2 consisting only of glucose, and B consisting of sodium bicarbonate. Many dialysis agents currently distributed in the country are two-part solid hemodialysis agents composed of an A agent and a B agent. Usually, agent A contains sodium chloride, potassium chloride, calcium chloride, magnesium chloride, pH regulator (acid and optional buffer component), and glucose, and agent B contains sodium bicarbonate. ing. In order to prevent the precipitation of insoluble salts, the B agent is contraindicated in calcium chloride or magnesium chloride. In addition, for example, Patent Document 2 discloses an electrolyte component (other than sodium bicarbonate and sodium chloride) that makes it possible to change the bicarbonate ion concentration and the sodium ion concentration according to the patient's condition during dialysis treatment. A three-drug hemodialysis agent comprising an A agent mainly containing, an S agent mainly containing sodium chloride, and a B agent mainly containing sodium bicarbonate has also been proposed.
 今日では、血液透析用剤として使用されている重炭酸透析剤は、臨床において透析液として使用する際に以下の表1に示すような組成及び濃度となるように処方されている。
Figure JPOXMLDOC01-appb-T000001
Today, the bicarbonate dialysate used as a hemodialysis agent is formulated to have a composition and concentration as shown in Table 1 below when used as a dialysate in clinical practice.
Figure JPOXMLDOC01-appb-T000001
 血液透析用A剤には、通常、pH調節剤として酢酸が含まれている。酢酸は、短時間で代謝されるために生体への蓄積が少なく、血液透析用A剤を溶解した際のpHが、クエン酸や塩酸が含有されているものと比べて大きいことから、皮膚や機械に触れた時の影響が小さい。そのため、固体製剤のみならず、液状製剤にも酢酸を含む血液透析用剤が普及している。 The A-dialysis agent usually contains acetic acid as a pH regulator. Acetic acid is metabolized in a short time because it is metabolized in a short time, and since the pH when dissolving the hemodialysis agent A is higher than that containing citric acid and hydrochloric acid, The impact when touching the machine is small. Therefore, hemodialysis agents containing acetic acid are prevalent in liquid preparations as well as solid preparations.
 医薬品における一般的な固体製剤は、少なくとも一部分に、必要な成分が必要な量均一に、しかも安定的に維持されていることが条件となり、液状製剤とは異なる特別な製剤化技術を要する。液状であれば、全成分が溶けて均一な状態にあるため、成分含量均一性について問題となることはないが、固体製剤において含量が均一に含まれている状態を作り出すことは容易ではない。 A general solid preparation for pharmaceuticals requires a special formulation technique different from a liquid preparation under the condition that at least a part of necessary solid components is maintained in a required amount uniformly and stably. If it is liquid, all components are dissolved and in a uniform state, so there is no problem with the uniformity of the component content, but it is not easy to create a state where the content is uniformly contained in the solid preparation.
 固体状の血液透析用剤の場合、一般的には、含まれる電解質成分の一部、又は全部が混合あるいは造粒された状態に加工することにより、含量均一性の向上は勿論、他の多くの課題を解決している。例えば、特許文献3には、粒状物(造粒物)に含まれる成分量がバラつく不具合を抑えつつ、製造効率の向上を図ることができる透析用剤及びその製造方法が開示されている。また、特許文献4には、造粒により、ある特定の積算細孔容積の比を50%以下にすれば、溶解性や貯蔵時の固化抑制等が優れたA剤用造粒物が得られることが開示されている。 In the case of a solid hemodialysis agent, in general, it is possible to improve the content uniformity by processing into a state where a part or all of the electrolyte component contained is mixed or granulated. The problem is solved. For example, Patent Document 3 discloses a dialysis agent and a method for producing the same that can improve the production efficiency while suppressing the problem that the amount of components contained in the granular material (granulated material) varies. Further, in Patent Document 4, if a specific cumulative pore volume ratio is set to 50% or less by granulation, a granulated product for agent A excellent in solubility, solidification suppression during storage, and the like can be obtained. It is disclosed.
 また、近年、透析液中の総酢酸イオン含量が低いほど生理的に望ましく、6mEq/L未満または4mEq/L未満が望ましいとも学会等で報告されており、低い総酢酸イオン含量に設定できる血液透析用剤の開発が益々強く求められている。 In recent years, the lower the total acetate ion content in the dialysate is physiologically desirable, less than 6 mEq / L or less than 4 mEq / L has been reported by academic societies, etc. There is an increasing demand for the development of preparations.
 固体状の血液透析用A剤にpH調節剤として酢酸を含む場合、しばしば酢酸臭が問題となる。加えて、酢酸は他成分と反応し固化を生じさせることがある。また、酢酸は、血液透析用A剤に広く一般的に含まれているブドウ糖類の分解を促進させる要因ともなる。 When the solid A-dialysis agent contains acetic acid as a pH regulator, acetic acid odor often becomes a problem. In addition, acetic acid may react with other components to cause solidification. Acetic acid is also a factor that promotes the degradation of glucose, which is widely and generally contained in the A-dialysis agent.
 従来、血液透析用A剤に含まれる酢酸の揮発に起因する酢酸臭を低減させる手法について種々提案されている。例えば、特許文献5には、重炭酸透析液の調製に使用される透析用A剤において、酢酸及び酢酸塩を含有させ、且つ酢酸:酢酸塩のモル比が1:0.5~2を充足させることによって、総酢酸イオン濃度が2mEq/L以上6mEq/L未満となるように重炭酸透析液を調製可能になり、透析用A剤中の成分の安定性が優れていることに加え、酢酸臭を低減できることが開示されている。また、特許文献6には、重炭酸透析液の調製に使用される固体状の透析用A剤において、ブドウ糖、酢酸及び酢酸塩を含み、酢酸及び酢酸塩の少なくとも一部が二酢酸アルカリ金属塩であり、且つ酢酸:酢酸塩のモル比を1:0.5~2に設定することによって、総酢酸イオン濃度が2mEq/L以上6mEq/L未満となるような重炭酸透析液が調製可能となり、透析用A剤中の成分の安定性が優れていることに加え、酢酸臭を低減できる。このように、貯蔵時の固化抑制、酢酸臭の低減、ブドウ糖の劣化抑制等の不具合解消を実現できるよう、従来技術では既にいくつかの検討工夫がなされている。しかしながら、従来技術の課題解決手段は、製造方法に依る物性の違いを利用する方法や、含有する成分に制限を設ける等の対処法的な手法に止まり、造粒物とそれ以外の共存する成分について、含有される最適な形態または構成についての理解は未だ十分とは言えず、特に酢酸臭の低減手法については改善の余地がある。 Conventionally, various methods for reducing the odor of acetic acid caused by volatilization of acetic acid contained in the agent A for hemodialysis have been proposed. For example, Patent Document 5 satisfies the A-dialysis agent used for the preparation of bicarbonate dialysate, which contains acetic acid and acetate, and the molar ratio of acetic acid: acetate is 1: 0.5-2. This makes it possible to prepare a bicarbonate dialysis solution so that the total acetate ion concentration is 2 mEq / L or more and less than 6 mEq / L, and in addition to excellent stability of components in the dialysis agent A, acetic acid It is disclosed that odor can be reduced. Patent Document 6 discloses a solid dialysis agent A used for the preparation of bicarbonate dialysate, which contains glucose, acetic acid and acetate, and at least a part of acetic acid and acetate is alkali metal diacetate. In addition, by setting the molar ratio of acetic acid: acetate to 1: 0.5 to 2, a bicarbonate dialysis solution having a total acetate ion concentration of 2 mEq / L or more and less than 6 mEq / L can be prepared. In addition to the excellent stability of the components in the dialysis agent A, the acetic acid odor can be reduced. As described above, some studies have been already made in the prior art so as to realize problems such as solidification suppression during storage, reduction of acetic acid odor, and glucose degradation suppression. However, the problem solving means of the prior art is limited to a method using a difference in physical properties depending on the manufacturing method and a coping method such as limiting the components contained, and the granulated product and other coexisting components However, there is still room for improvement in the method for reducing the odor of acetic acid.
特開2001-190662号公報Japanese Patent Laid-Open No. 2001-190662 特許第5099464号公報Japanese Patent No. 5099464 特開2012-105964号公報JP 2012-105964 A 特開2016-209485号公報JP-A-2016-209485 特許第5376480号公報Japanese Patent No. 5376480 特許第5517321号公報Japanese Patent No. 5517321
 本発明の目的は、酢酸臭を低減でき、更に保存による固化、ブドウ糖を共存させた際のブドウ糖の分解、及び水に溶解した時のpH上昇を抑制でき、保存安定性に優れた固体状の血液透析用A剤を提供することである。 The object of the present invention is to reduce the odor of acetic acid, further suppress solidification by storage, degradation of glucose when coexisting with glucose, and pH increase when dissolved in water, and a solid state excellent in storage stability. It is to provide agent A for hemodialysis.
 本発明者等は、前記課題を解決すべく鋭意検討を行ったところ、固体状の血液透析用A剤として、塩化マグネシウム及び塩化カリウムの一方のみを実質的に含み、且つ塩化カルシウムを含む造粒物で構成された第1画分と、酢酸及び酢酸塩を含む第2画分とを共存させることによって、酢酸の揮発を抑制し、酢酸臭を低減できることを見出した。更に、前記固体状の血液透析用A剤は、保存による固化の抑制、水に溶解した時のpH上昇の抑制、ブドウ糖と共存させてもブドウ糖の分解や着色の抑制等が可能になっており、優れた保存安定性を有していることをも見出した。特に、前記固体状の血液透析用A剤は、前記第1画分と前記第2画分が均一に分散した状態であっても、酢酸臭の低減、保存による固化の抑制、水に溶解した時のpH上昇の抑制、ブドウ糖と共存させてもブドウ糖の分解や着色の抑制等が可能になっており、優れた保存安定性を有していることを見出した。本発明は、かかる知見に基づいて、更に検討を重ねることにより完成したものである。 As a result of intensive studies to solve the above-mentioned problems, the inventors of the present invention, as a solid A hemodialysis agent, contains only one of magnesium chloride and potassium chloride, and contains calcium chloride. It has been found that the coexistence of the first fraction composed of the product and the second fraction containing acetic acid and acetate can suppress the volatilization of acetic acid and reduce the odor of acetic acid. Furthermore, the solid A agent for hemodialysis is capable of suppressing solidification due to storage, suppressing pH increase when dissolved in water, and suppressing glucose degradation and coloring even when coexisting with glucose. It was also found that it has excellent storage stability. In particular, the solid A agent for hemodialysis was dissolved in water by reducing the odor of acetic acid, suppressing solidification by storage, even when the first fraction and the second fraction were uniformly dispersed. It was found that the pH increase at the time, the decomposition of the glucose and the suppression of the coloring can be suppressed even when coexisting with glucose, and it has excellent storage stability. The present invention has been completed by further studies based on this finding.
 即ち、本発明は、下記に掲げる態様の発明を提供する。
項1. 第1画分と第2画分を含む固体状の血液透析用A剤であって、
 前記第1画分が、塩化マグネシウム及び塩化カリウムの一方のみを実質的に含み、且つ塩化カルシウムを含む造粒物であり、
 前記第2画分が、酢酸及び酢酸塩を含む、固体状の血液透析用A剤。
項2. 前記第1画分が塩化マグネシウムを含む、項1に記載の固体状の血液透析用A剤。
項3. 前記第1画分が塩化マグネシウムを含み、前記第2画分が塩化カリウムを含む、項1又は2に記載の固体状の血液透析用A剤。
項4. 前記第1画分が塩化カリウムを含み、前記第2画分が塩化マグネシウムを含む、項1に記載の固体状の血液透析用A剤。
項5. 前記酢酸及び酢酸塩として酢酸及び酢酸アルカリ金属塩を含む、項1~4のいずれかに記載の固体状の血液透析用A剤。
項6. 前記酢酸及び酢酸塩として二酢酸アルカリ金属塩を含む、項1~4のいずれかに記載の固体状の血液透析用A剤。
項7. 前記酢酸及び酢酸塩として高次酢酸塩化合物を含む、項1~4のいずれかに記載の固体状の血液透析用A剤。
項8. 前記第1画分及び/又は前記第2画分が塩化ナトリウムを含む、項1~7のいずれかに記載の固体状の血液透析用A剤。
項9. 前記第1画分が塩化ナトリウムを含む、項1~8のいずれかに記載の固体状の血液透析用A剤。
項10. 前記第1画分及び/又は前記第2画分がブドウ糖を含む、項1~9のいずれかに記載の固体状の血液透析用A剤。
項11. 前記第2画分がブドウ糖を含む、項1~10のいずれかに記載の固体状の血液透析用A剤。
項12. 項1~11のいずれかに記載の固体状の血液透析用A剤、及び重炭酸ナトリウムを含む血液透析用B剤を含む、2剤型の血液透析用剤。
項13. 塩化ナトリウムを含まない、項1~7、10及び11のいずれかに示す固体状の血液透析用A剤と、
 塩化ナトリウムを含む血液透析用S剤と、
 重炭酸ナトリウムを含む血液透析用B剤と、
を含む、3剤型の血液透析用剤。
項14. 塩化マグネシウム及び塩化カリウムの一方のみを実質的に含み、且つ塩化カルシウムを含む造粒物を調製する第1工程、及び
 前記第1工程で得られた造粒物と、酢酸及び酢酸塩とを含む固体状の血液透析用A剤を得る第2工程
を含む、固体状の血液透析用A剤の製造方法。
That is, this invention provides the invention of the aspect hung up below.
Item 1. A solid hemodialysis agent A containing a first fraction and a second fraction,
The first fraction is a granulated product substantially containing only one of magnesium chloride and potassium chloride and containing calcium chloride;
The solid A agent for hemodialysis, wherein the second fraction contains acetic acid and acetate.
Item 2. Item 2. The solid A agent for hemodialysis according to Item 1, wherein the first fraction contains magnesium chloride.
Item 3. Item 3. The solid hemodialysis agent A according to Item 1 or 2, wherein the first fraction contains magnesium chloride and the second fraction contains potassium chloride.
Item 4. Item 2. The solid hemodialysis agent A according to Item 1, wherein the first fraction contains potassium chloride and the second fraction contains magnesium chloride.
Item 5. Item 5. The solid hemodialysis agent A according to any one of Items 1 to 4, comprising acetic acid and an alkali metal acetate as the acetic acid and acetate.
Item 6. Item 5. The solid hemodialysis agent A according to any one of Items 1 to 4, comprising an acetic acid and an alkali metal diacetate as the acetate.
Item 7. Item 5. The solid hemodialysis agent A according to any one of Items 1 to 4, comprising a higher-order acetate compound as the acetic acid and acetate.
Item 8. Item 8. The solid hemodialysis agent A according to any one of Items 1 to 7, wherein the first fraction and / or the second fraction contains sodium chloride.
Item 9. Item 9. The solid hemodialysis agent A according to any one of Items 1 to 8, wherein the first fraction contains sodium chloride.
Item 10. Item 10. The solid hemodialysis agent A according to any one of Items 1 to 9, wherein the first fraction and / or the second fraction contains glucose.
Item 11. Item 11. The solid hemodialysis agent A according to any one of Items 1 to 10, wherein the second fraction contains glucose.
Item 12. Item 12. A two-agent hemodialysis agent comprising the solid hemodialysis agent A according to any one of items 1 to 11 and a hemodialysis agent B containing sodium bicarbonate.
Item 13. A solid hemodialysis agent A according to any one of Items 1 to 7, 10 and 11, which does not contain sodium chloride,
S-agent for hemodialysis containing sodium chloride,
B agent for hemodialysis containing sodium bicarbonate;
A three-drug hemodialysis agent.
Item 14. A first step of preparing a granulated product substantially containing only one of magnesium chloride and potassium chloride and containing calcium chloride; and a granulated product obtained in the first step; and acetic acid and acetate. A method for producing a solid hemodialysis agent A, comprising a second step of obtaining a solid hemodialysis agent A.
 本発明の血液透析用A剤は、酢酸の揮発を効果的に抑制でき、酢酸臭が低減されている。更に、本発明の血液透析用A剤は、保存による固化、ブドウ糖を共存させた際のブドウ糖の分解、及び水に溶解した時のpH上昇を抑制可能になっており、優れた保存安定性を有している。従って、本発明の血液透析用A剤によれば、血液透析用剤の品質の向上、医療現場での使用環境の改善等を図ることが可能になる。 The agent A for hemodialysis of the present invention can effectively suppress the volatilization of acetic acid and reduce the acetic acid odor. Furthermore, the agent A for hemodialysis of the present invention can suppress solidification by storage, decomposition of glucose when coexisting with glucose, and pH increase when dissolved in water, and has excellent storage stability. Have. Therefore, according to the hemodialysis agent A of the present invention, it is possible to improve the quality of the hemodialysis agent, improve the use environment in the medical field, and the like.
1.固体状の血液透析用A剤
 本発明の血液透析用A剤は、第1画分(第1顆粒組成物)と第2画分(第2組成物)を含む固体状の血液透析用A剤であって、前記第1画分が、塩化マグネシウム及び塩化カリウムの一方のみを実質的に含み、且つ塩化カルシウムを含む造粒物であり、前記第2画分が、酢酸及び酢酸塩を含むことを特徴とする。このように、血液透析用A剤において、特定成分の造粒物で形成された第1画分と、特定成分を含む第2画分とを共存させた状態になるように製剤化することによって、酢酸臭の低減、保存による固化の抑制、ブドウ糖を共存させた際のブドウ糖の分解抑制、及び水に溶解した時のpH上昇の抑制が可能になる。以下、本発明の血液透析用A剤について詳述する。
1. Solid A agent for hemodialysis hemodialysis A agent present invention, the first fraction (first granular composition) and solid for hemodialysis A agent containing the second fraction (second composition) Wherein the first fraction is a granulated material substantially containing only one of magnesium chloride and potassium chloride and containing calcium chloride, and the second fraction contains acetic acid and acetate. It is characterized by. In this way, by formulating the A fraction for hemodialysis so that the first fraction formed from the granulated product of the specific component and the second fraction containing the specific component coexist. It is possible to reduce the odor of acetic acid, suppress solidification by storage, suppress degradation of glucose when coexisting with glucose, and suppress an increase in pH when dissolved in water. Hereinafter, the hemodialysis agent A of the present invention will be described in detail.
<第1画分>
 本発明の血液透析用A剤に含まれる第1画分は、塩化マグネシウム及び塩化カリウムの一方のみを実質的に含み、且つ塩化カルシウムを含む造粒物である。本発明における「造粒物」とは、各成分粒子を凝集又は反応させ、1粒子中に多成分粒子が混在した状態だけではなく、1粒子同士が結合した凝集塊状態を指す。
<First fraction>
The first fraction contained in the hemodialysis agent A of the present invention is a granulated product substantially containing only one of magnesium chloride and potassium chloride and containing calcium chloride. The “granulated product” in the present invention refers to not only a state in which each component particle is agglomerated or reacted to mix multiple component particles in one particle, but also an aggregated state in which one particle is bonded.
 塩化マグネシウムは、マグネシウムイオン及び塩化物イオンの供給源となる物質である。第1画分の製造原料として使用される塩化マグネシウムは、水和物又は無水物のいずれを使用してもよいが、塩化マグネシウムの一部又は全てが水和物の形態であることが好ましい。塩化マグネシウムの水和物を使用すると、造粒時の加熱または発熱によって塩化マグネシウムの水和物に含まれる結晶水の少なくとも一部が離脱してバインダーとしての役割を果たし、電解質原料を効率的に造粒させることが可能になる。塩化マグネシウムの水和物としては、具体的には、塩化マグネシウム二水和物、塩化マグネシウム四水和物、塩化マグネシウム六水和物、塩化マグネシウム八水和物、塩化マグネシウム十二水和物等の1~12水和物が挙げられる。これらの塩化マグネシウムの水和物の中でも、好ましくは塩化マグネシウム六水和物が挙げられる。これらの塩化マグネシウムの水和物は、1種単独で使用してもよく、また2種以上を組み合わせて使用してもよい。 Magnesium chloride is a substance that serves as a source of magnesium ions and chloride ions. Magnesium chloride used as a raw material for producing the first fraction may be either a hydrate or an anhydride, but it is preferable that part or all of the magnesium chloride is in the form of a hydrate. When magnesium chloride hydrate is used, at least a part of the crystal water contained in the magnesium chloride hydrate is released by heating or heat generation during granulation, and serves as a binder, thereby efficiently using the electrolyte raw material. It becomes possible to granulate. Specific examples of magnesium chloride hydrate include magnesium chloride dihydrate, magnesium chloride tetrahydrate, magnesium chloride hexahydrate, magnesium chloride octahydrate, magnesium chloride dodecahydrate, etc. 1 to 12 hydrates. Among these magnesium chloride hydrates, magnesium chloride hexahydrate is preferable. These magnesium chloride hydrates may be used alone or in combination of two or more.
 塩化カリウムは、カリウムイオンの供給源となる物質である。 Potassium chloride is a substance that is a source of potassium ions.
 第1画分では、塩化マグネシウム及び塩化カリウムの一方のみを実質的に含有させる。ここで、「一方のみを実質的に含有させる」とは、塩化カリウム及び塩化マグネシウムの内、一方を含有し、他方は実質的に含有しないことを指す。即ち、塩化マグネシウム及び塩化カリウムが同一画分に実質的に共存しないことである。従って、第1画分は、塩化マグネシウムを含有し、且つ塩化カリウムを実質的に含まない第1態様と、塩化カリウムを含有し、且つ塩化マグネシウムを実質的に含まない第2態様の2つの態様に分けられる。 In the first fraction, only one of magnesium chloride and potassium chloride is substantially contained. Here, “substantially containing only one” means that one of potassium chloride and magnesium chloride is contained, and the other is not substantially contained. That is, magnesium chloride and potassium chloride do not substantially coexist in the same fraction. Therefore, the first fraction contains two aspects of the first aspect containing magnesium chloride and substantially free of potassium chloride, and the second aspect containing potassium chloride and substantially free of magnesium chloride. It is divided into.
 第1画分が前記第1態様である場合、第1画分における塩化マグネシウムの含有量については、血液透析用A剤によって調製される血液透析液のマグネシウムイオン濃度が0.5~2.0mEq/L、好ましくは0.75~1.5mEq/Lとなるように、透析用剤に含まれる他のマグネシウム塩の含有量等を勘案して適宜設定すればよいが、例えば、第1画分の総量100重量部当たり、塩化マグネシウムの無水物重量換算で0.1~50重量部、好ましくは0.1~40重量部、更に好ましくは0.3~30重量部が挙げられる。本発明において、「塩化マグネシウムの無水物重量換算」とは、塩化マグネシウムが水和物の形態の場合には、結晶水(水和物中の水分子)の重量を除いて、無水物の重量に換算して求められる値である。 When the first fraction is the first aspect, the magnesium chloride content in the first fraction is such that the magnesium ion concentration of the hemodialysis solution prepared by the agent A for hemodialysis is 0.5 to 2.0 mEq. / L, preferably 0.75 to 1.5 mEq / L, may be set as appropriate in consideration of the content of other magnesium salts contained in the dialysis agent. For example, the first fraction Based on the anhydrous weight of magnesium chloride, 0.1 to 50 parts by weight, preferably 0.1 to 40 parts by weight, and more preferably 0.3 to 30 parts by weight per 100 parts by weight of the total amount. In the present invention, "anhydrous weight conversion of magnesium chloride" means that when magnesium chloride is in the form of hydrate, the weight of anhydride is excluded except for the weight of crystal water (water molecules in the hydrate). It is a value obtained by converting to.
 第1画分が前記第1態様である場合、第1画分は、塩化カリウムを実質的に含まない。ここで、「塩化カリウムを実質的に含まない」とは、本発明の効果を損なわない範囲であれば、少量の塩化カリウムを含有することが許容されることを意味し、具体的には、第1画分の総量100重量部当たり、塩化カリウムが1重量部以下、好ましくは0.3重量部未満、更に好ましくは0重量部が挙げられる。 When the first fraction is the first aspect, the first fraction is substantially free of potassium chloride. Here, “substantially free of potassium chloride” means that it is allowed to contain a small amount of potassium chloride as long as the effects of the present invention are not impaired. Specifically, Potassium chloride is 1 part by weight or less, preferably less than 0.3 part by weight, more preferably 0 part by weight per 100 parts by weight of the first fraction.
 また、第1画分が前記第2態様である場合、第2画分における塩化カリウムの含有量については、血液透析用A剤によって調製される血液透析液のカリウムイオン濃度が0.5~3mEq/Lとなるように、透析用剤に含まれる他のカリウム塩の含有量等を勘案して適宜設定すればよいが、例えば、第1画分の総量100重量部当たり、塩化カリウムが0.1~50重量部、好ましくは0.1~40重量部、更に好ましくは0.3~30重量部が挙げられる。 Further, when the first fraction is the second aspect, the potassium chloride content in the second fraction is such that the potassium ion concentration of the hemodialysis solution prepared by the agent A for hemodialysis is 0.5 to 3 mEq. / L may be appropriately set in consideration of the content of other potassium salts contained in the dialysis agent, for example, potassium chloride is 0.1 per 100 parts by weight of the total amount of the first fraction. 1 to 50 parts by weight, preferably 0.1 to 40 parts by weight, and more preferably 0.3 to 30 parts by weight.
 第1画分が前記第2態様である場合、第1画分は、塩化マグネシウムを実質的に含まない。ここで、「塩化マグネシウムを実質的に含まない」とは、本発明の効果を損なわない範囲であれば、少量の塩化マグネシウムを含有することが許容されることを意味し、具体的には、第1画分の総量100重量部当たり、塩化マグネシウムが無水物重量換算で1重量部以下、好ましくは0.3重量部未満、更に好ましくは0重量部が挙げられる。 When the first fraction is the second aspect, the first fraction is substantially free of magnesium chloride. Here, “substantially free of magnesium chloride” means that it is allowed to contain a small amount of magnesium chloride as long as the effects of the present invention are not impaired. Specifically, Magnesium chloride is 1 part by weight or less, preferably less than 0.3 part by weight, more preferably 0 part by weight in terms of anhydride weight per 100 parts by weight of the first fraction.
 塩化カルシウムは、カルシウムイオンの供給源となる物質である。第1画分の製造原料として使用される塩化カルシウムは、水和物又は無水物のいずれを使用してもよいが、塩化カルシウムの一部又は全てが水和物の形態であることが好ましい。塩化カルシウムの水和物を使用すると、造粒時の加熱または発熱条件によっては、塩化カルシウムの水和物に含まれる結晶水の少なくとも一部が離脱してバインダーとしての役割を果たすこともある。塩化カルシウムの水和物としては、具体的には、塩化カルシウム一水和物、塩化カルシウム二水和物、塩化カルシウム四水和物、塩化カルシウム六水和物等の1~6水和物が挙げられる。これらの塩化カルシウムの水和物の中でも、好ましくは塩化カルシウム二水和物が挙げられる。これらの塩化カルシウムの水和物は、1種単独で使用してもよく、また2種以上を組み合わせて使用してもよい。 Calcium chloride is a substance that is a source of calcium ions. The calcium chloride used as the raw material for producing the first fraction may be either a hydrate or an anhydride, but it is preferable that a part or all of the calcium chloride is in the form of a hydrate. When calcium chloride hydrate is used, depending on the heating or exothermic conditions during granulation, at least a portion of the crystal water contained in the calcium chloride hydrate may be released and serve as a binder. Specific examples of calcium chloride hydrates include 1 to 6 hydrates such as calcium chloride monohydrate, calcium chloride dihydrate, calcium chloride tetrahydrate, and calcium chloride hexahydrate. Can be mentioned. Among these calcium chloride hydrates, calcium chloride dihydrate is preferable. These calcium chloride hydrates may be used singly or in combination of two or more.
 第1画分における塩化カルシウムの含有量については、血液透析用A剤によって調製される血液透析液のカルシウムイオン濃度が1.5~4.5mEq/L、好ましくは2.5~3.5mEq/Lとなるように、透析用剤に含まれる他のカルシウム塩の含有量等を勘案して適宜設定すればよいが、例えば、第1画分の総量100重量部当たり、塩化カルシウムの無水物重量換算で0.1~70重量部、好ましくは0.1~60重量部、更に好ましくは0.3~50重量部が挙げられる。本発明において、「塩化カルシウムの無水物重量換算」とは、塩化カルシウムが水和物の形態の場合には、結晶水(水和物中の水分子)の重量を除いて、無水物の重量に換算して求められる値である。 Regarding the content of calcium chloride in the first fraction, the calcium ion concentration of the hemodialysis solution prepared by the agent A for hemodialysis is 1.5 to 4.5 mEq / L, preferably 2.5 to 3.5 mEq / L. L may be appropriately set in consideration of the content of other calcium salts contained in the dialysis agent, for example, the anhydrous weight of calcium chloride per 100 parts by weight of the first fraction. 0.1 to 70 parts by weight in terms of conversion, preferably 0.1 to 60 parts by weight, and more preferably 0.3 to 50 parts by weight. In the present invention, “calcium chloride anhydrous weight conversion” means that when calcium chloride is in the form of hydrate, the weight of anhydride is excluded except for the weight of crystal water (water molecules in the hydrate). It is a value obtained by converting to.
 第1画分は、前記成分が必要に応じて配合される他の成分と共に造粒されて、造粒物の形態になっている。第1画分を構成する造粒物の粒子径については、特に制限されないが、例えば、Tyler標準篩で10メッシュ(目開き1700μm)の篩を通過するが、80メッシュ(目開き180μm)の篩を通過しない粒子の割合が90重量%以上、好ましくは93重量%以上、更に好ましくは95重量%以上が挙げられる。 The first fraction is granulated together with other components that are blended as necessary, and is in the form of a granulated product. The particle diameter of the granulated material constituting the first fraction is not particularly limited. For example, the particle size passes through a 10 mesh (1700 μm opening) sieve with a Tyler standard sieve, but a 80 mesh (180 μm opening) sieve. The proportion of particles that do not pass through is 90% by weight or more, preferably 93% by weight or more, and more preferably 95% by weight or more.
 第1画分の水分含量については、特に制限されないが、例えば、3重量%以下、好ましくは2重量%以下、更に好ましくは1.5重量%以下が挙げられる。このような水分含量を満たしている場合、酢酸臭、保存による固化、ブドウ糖を共存させた際のブドウ糖の分解、及び水に溶解した時のpH上昇を、より一層効果的に抑制することが可能になる。本発明において、第1画分の水分含量は、カールフィッシャー水分計を用いて測定される値である。 The water content of the first fraction is not particularly limited, but may be, for example, 3% by weight or less, preferably 2% by weight or less, and more preferably 1.5% by weight or less. When such moisture content is satisfied, it is possible to more effectively suppress acetic acid odor, solidification by storage, degradation of glucose when coexisting with glucose, and increase in pH when dissolved in water. become. In the present invention, the water content of the first fraction is a value measured using a Karl Fischer moisture meter.
<第2画分>
 第2画分は、酢酸及び酢酸塩を含む画分である。本発明の血液透析用A剤において、前記第1画分を構成する造粒物以外の含有成分は全て第2画分の構成成分となる。
<Second fraction>
The second fraction is a fraction containing acetic acid and acetate. In the agent A for hemodialysis according to the present invention, all the components other than the granulated material constituting the first fraction are constituents of the second fraction.
 第2画分で使用される酢酸は氷酢酸であってもよい。また、第2画分で使用される酢酸塩としては、血液透析液の成分として許容されるものである限り、特に制限されないが、例えば、酢酸ナトリウム、酢酸カリウム等の酢酸アルカリ金属塩;酢酸カルシウム、酢酸マグネシウム等の酢酸アルカリ土類金属塩が挙げられる。これらの酢酸塩は無水酢酸塩であってもよい。これらの酢酸塩の中でも、長年の使用実績による安全性、コストの観点から、好ましくは酢酸アルカリ金属塩、更に好ましくは酢酸ナトリウムが挙げられる。また、これらの酢酸塩は、1種単独で使用してもよく、また2種以上を組み合わせて使用してもよい。 The acetic acid used in the second fraction may be glacial acetic acid. The acetate used in the second fraction is not particularly limited as long as it is acceptable as a component of the hemodialysis solution. For example, alkali metal acetates such as sodium acetate and potassium acetate; calcium acetate And alkaline earth metal acetates such as magnesium acetate. These acetate salts may be anhydrous acetate salts. Among these acetates, alkali metal acetates are preferable, and sodium acetate is more preferable, from the viewpoints of safety and cost due to many years of use. Moreover, these acetates may be used individually by 1 type, and may be used in combination of 2 or more type.
 また、第2画分に含まれる酢酸及び酢酸塩の少なくとも一部が、二酢酸アルカリ金属塩の形態であってもよい。二酢酸アルカリ金属塩を使用することによって酢酸臭の低減、保存による固化の抑制、ブドウ糖を共存させた際のブドウ糖の分解抑制、及び水に溶解した時のpH上昇の抑制をより一層効果的に図ることが可能になる。二酢酸アルカリ金属塩とは、酢酸アルカリ金属塩1モルと酢酸1モルが複合化した複合体(MH(C2322;Mはアルカリ金属原子を示す)であり、二酢酸アルカリ金属塩1モルからは、酢酸塩(酢酸アルカリ金属塩)1モルと酢酸1モルが供給されることになる。本発明で使用される二酢酸アルカリ金属塩としては、具体的には、二酢酸ナトリウム、二酢酸カリウム等が挙げられる。これらの二酢酸アルカリ金属塩は、1種単独で使用してもよく、また2種以上を組み合わせて使用してもよい。二酢酸アルカリ金属塩の中でも、好ましくは二酢酸ナトリウムが挙げられる。 Further, at least part of acetic acid and acetate contained in the second fraction may be in the form of alkali metal diacetate. Use of alkali metal diacetate reduces the odor of acetic acid, suppresses solidification by storage, suppresses degradation of glucose when coexisting with glucose, and suppresses increase in pH when dissolved in water. It becomes possible to plan. The alkali metal diacetate is a complex (MH (C 2 H 3 O 2 ) 2 ; M represents an alkali metal atom) in which 1 mol of an alkali metal acetate and 1 mol of acetic acid are complexed. From 1 mol of the metal salt, 1 mol of acetate (alkali metal acetate) and 1 mol of acetic acid are supplied. Specific examples of the alkali metal diacetate used in the present invention include sodium diacetate and potassium diacetate. These alkali metal diacetates may be used individually by 1 type, and may be used in combination of 2 or more type. Among the alkali metal diacetates, sodium diacetate is preferable.
 また、第2画分に含まれる酢酸及び酢酸塩の少なくとも一部が、高次酢酸塩化合物の形態であってもよい。高次酢酸塩化合物とは、酢酸(一次化合物)と酢酸塩(一次化合物)が互いに結合して生成された化合物である。二酢酸アルカリ金属塩を使用することによって、酢酸臭の低減、保存による固化の抑制、ブドウ糖を共存させた際のブドウ糖の分解抑制、及び水に溶解した時のpH上昇の抑制をより一層効果的に図ることが可能になる。 Further, at least a part of acetic acid and acetate contained in the second fraction may be in the form of a higher-order acetate compound. The higher order acetate compound is a compound formed by combining acetic acid (primary compound) and acetate (primary compound) with each other. By using alkali metal diacetate, it is more effective to reduce acetic acid odor, suppress solidification by storage, suppress degradation of glucose when coexisting with glucose, and suppress increase in pH when dissolved in water. It becomes possible to aim at.
 第2画分において、酢酸及び酢酸塩のモル比については、特に制限されず、血液透析液に付与すべきpHの範囲等に基づいて適宜設定すればよいが、例えば、第2画分における酢酸:酢酸塩のモル比として、好ましくは1:0.5~10、更に好ましくは1:0.5~3.0、特に好ましくは1:0.7~2.0が挙げられる。ここで、酢酸及び酢酸塩として二酢酸アルカリ金属塩を含む場合には、二酢酸アルカリ金属塩1モルに由来する酢酸及び酢酸塩は、酢酸1モルと酢酸塩1モルとして前記モル比は算出される。また、酢酸及び酢酸塩として高次酢酸塩化合物を含む場合には、当該高次酢酸塩化合物における酢酸:酢酸塩のモル比が1:Xであれば、当該高次酢酸塩化合物1モルに由来する酢酸及び酢酸塩は、酢酸1モル、酢酸塩Xモルとして前記モル比は算出される。 In the second fraction, the molar ratio of acetic acid and acetate is not particularly limited and may be appropriately set based on the pH range to be applied to the hemodialysis solution. For example, acetic acid in the second fraction : Mole ratio of acetate is preferably 1: 0.5 to 10, more preferably 1: 0.5 to 3.0, and particularly preferably 1: 0.7 to 2.0. Here, when acetic acid and acetic acid salt include alkali metal diacetate, acetic acid and acetic acid salt derived from 1 mol of alkali metal diacetate are calculated as 1 mol of acetic acid and 1 mol of acetate, and the molar ratio is calculated. The When acetic acid and a high-order acetate compound are included as the acetate, if the molar ratio of acetic acid: acetate in the high-order acetate compound is 1: X, it is derived from 1 mol of the higher-order acetate compound. As for acetic acid and acetate, the molar ratio is calculated as 1 mol of acetic acid and X mol of acetate.
 第2画分における酢酸と酢酸塩の含有量については、血液透析用A剤によって調製される血液透析液の酢酸イオン濃度が0.5~12mEq/L、好ましくは1.5~10mEq/L、更に好ましくは2~6mEq/Lとなるように適宜設定すればよいが、例えば、第2画分の総量100重量部当たり、酢酸と酢酸塩の総量が1~100重量部、好ましくは5~80重量部、更に好ましくは5~25重量部が挙げられる。 Regarding the contents of acetic acid and acetate in the second fraction, the acetate ion concentration of the hemodialysis solution prepared by the agent A for hemodialysis is 0.5 to 12 mEq / L, preferably 1.5 to 10 mEq / L, More preferably, it may be set appropriately so as to be 2 to 6 mEq / L. For example, the total amount of acetic acid and acetate is 1 to 100 parts by weight, preferably 5 to 80 parts per 100 parts by weight of the second fraction. Parts by weight, more preferably 5 to 25 parts by weight.
 また、前記第1画分が第1態様(即ち、塩化カリウムを実質的に含まない態様)である場合、第2画分には、塩化カリウムが含まれていてもよい。第2画分に塩化カリウムを含有させる場合、その含有量については、血液透析液のカリウムイオン濃度が0.5~3mEq/Lとなるように、血液透析用剤に含まれる他のカリウム塩の含有量等を勘案して適宜設定すればよい。 In addition, when the first fraction is in the first aspect (that is, an aspect substantially not containing potassium chloride), the second fraction may contain potassium chloride. When potassium chloride is contained in the second fraction, the content of other potassium salts contained in the hemodialysis agent is adjusted so that the potassium ion concentration of the hemodialysis solution is 0.5 to 3 mEq / L. What is necessary is just to set suitably in consideration of content etc.
 また、前記第1画分が第2態様(即ち、塩化マグネシウムを実質的に含まない態様)である場合、第2画分には、塩化マグネシウムが含まれていてもよい。第2画分に塩化マグネシウムを含有させる場合、その含有量については、血液透析液のマグネシウムイオン濃度が0.5~2.0mEq/L、好ましくは0.75~1.5mEq/Lとなるように、血液透析用A剤に含まれる他のマグネシウム塩の含有量等を勘案して適宜設定すればよい。 In addition, when the first fraction is in the second aspect (that is, an aspect that does not substantially contain magnesium chloride), the second fraction may contain magnesium chloride. When magnesium chloride is added to the second fraction, the magnesium ion concentration of the hemodialysis solution is 0.5 to 2.0 mEq / L, preferably 0.75 to 1.5 mEq / L. In addition, the content of other magnesium salts contained in the agent A for hemodialysis may be appropriately set.
 第2画分は、前記成分と必要に応じて配合される他の成分とを含む非造粒物の形態であってもよく、また前記成分が必要に応じて配合される他の成分と共に造粒物の形態になっていてもよい。更に、第2画分は、非造粒物と造粒物との組み合わせであってもよい。 The second fraction may be in the form of a non-granulated product containing the above components and other components blended as necessary, and the second fraction is prepared together with other components blended as necessary. It may be in the form of granules. Further, the second fraction may be a combination of a non-granulated product and a granulated product.
 本発明の血液透析用A剤が収容されている容器内で、第2画分は、前記成分と必要に応じて配合される他の成分が均一に分散している状態で存在してもよく、また前記成分と必要に応じて配合される他の成分が不均一に分散又は分布している状態で存在してもよい。 In the container containing the hemodialysis agent A of the present invention, the second fraction may be present in a state where the above components and other components blended as necessary are uniformly dispersed. Moreover, the said component and the other component mix | blended as needed may exist in the state disperse | distributed or distributed unevenly.
<塩化ナトリウム>
 本発明の血液透析用A剤には、ナトリウムイオンの供給源として、塩化ナトリウムを含んでいてもよい。本発明の血液透析用A剤に塩化ナトリウムを含有させる場合、塩化ナトリウムは、第1画分又は第2画分のいずれか一方に含まれていてもよく、また第1画分及び第2画分の双方に含まれていてもよい。
<Sodium chloride>
The agent A for hemodialysis of the present invention may contain sodium chloride as a sodium ion supply source. When sodium chloride is contained in the hemodialysis agent A of the present invention, sodium chloride may be contained in either the first fraction or the second fraction, and the first fraction and the second fraction. May be included in both minutes.
 本発明の血液透析用A剤に塩化ナトリウムを含有させる場合、その含有量については、血液透析用A剤によって調製される血液透析液のナトリウムイオン濃度が120~150mEq/L、好ましくは135~145mEq/Lとなるように、透析用剤に含まれる他のナトリウム塩の含有量等を勘案して適宜設定すればよい。 When sodium chloride is contained in the hemodialysis agent A of the present invention, the content of sodium chloride in the hemodialysis solution prepared by hemodialysis agent A is 120 to 150 mEq / L, preferably 135 to 145 mEq. / L may be appropriately set in consideration of the content of other sodium salts contained in the dialysis agent.
<ブドウ糖>
 本発明の血液透析用A剤には、患者の血糖値の維持の目的で、ブドウ糖を含んでいてもよい。ブドウ糖は、塩化カルシウム、塩化マグネシウム等の電解質との接触によって不安定化される傾向があるが、本発明の血液透析用A剤では、前記第1画分が造粒物の形態で前記第2画分と共存していることにより、ブドウ糖を含有させても、ブドウ糖を安定に維持することができる。
<Glucose>
The agent A for hemodialysis of the present invention may contain glucose for the purpose of maintaining the blood glucose level of the patient. Glucose tends to be destabilized by contact with electrolytes such as calcium chloride and magnesium chloride, but in the agent A for hemodialysis according to the present invention, the first fraction is in the form of a granulated product. By coexisting with the fraction, glucose can be stably maintained even when glucose is contained.
 本発明の血液透析用A剤にブドウ糖を含有させる場合、ブドウ糖は、第1画分及び第2画分のいずれかに含まれていてもよく、また第1画分及び第2画分の双方に含まれていてもよいが、ブドウ糖の安定性をより一層向上させるという観点から、第2画分に含まれていることが好ましい。 When glucose is included in the hemodialysis agent A of the present invention, glucose may be contained in either the first fraction or the second fraction, and both the first fraction and the second fraction. However, from the viewpoint of further improving the stability of glucose, it is preferably contained in the second fraction.
 本発明の血液透析用A剤にブドウ糖を含有させる場合、その含有量については、最終的に調製される血液透析液に備えさせるブドウ糖濃度に応じて適宜設定される。具体的には、血液透析用A剤におけるブドウ糖の含有量は、最終的に調製される透析液におけるブドウ糖濃度が0~2.5g/L、好ましくは1.0~2.0g/Lとなるように適宜設定すればよい。 In the case of containing glucose in the hemodialysis agent A of the present invention, the content thereof is appropriately set according to the glucose concentration provided in the finally prepared hemodialysis solution. Specifically, the content of glucose in the hemodialysis agent A is such that the glucose concentration in the finally prepared dialysate is 0 to 2.5 g / L, preferably 1.0 to 2.0 g / L. What is necessary is just to set suitably.
<その他の成分>
 本発明の血液透析用A剤には、前述する成分以外に、必要に応じて、カルシウムイオン、マグネシウムイオン、ナトリウムイオン、カリウムイオン、塩化物イオン、クエン酸イオン、乳酸イオン、グルコン酸イオン、コハク酸イオン、リンゴ酸イオン等の供給源となる他の有機酸塩及び/又は無機塩が含まれていてもよい。これらの成分を含有させる場合、第1画分及び第2画分のいずれに含まれていてもよく、また第1画分及び第2画分の双方に含まれていてもよい。
<Other ingredients>
In addition to the components described above, the agent A for hemodialysis according to the present invention includes calcium ion, magnesium ion, sodium ion, potassium ion, chloride ion, citrate ion, lactate ion, gluconate ion, succinate as necessary. Other organic acid salts and / or inorganic salts that serve as sources of acid ions, malate ions, and the like may be included. When these components are contained, they may be contained in any of the first fraction and the second fraction, and may be contained in both the first fraction and the second fraction.
 カルシウムイオンの供給源となる化合物としては、例えば、酢酸カルシウム、乳酸カルシウム、クエン酸カルシウム、グルコン酸カルシウム、コハク酸カルシウム、リンゴ酸カルシウム等の有機酸のカルシウム塩が挙げられる。これらの有機酸のカルシウム塩は、1種を単独で使用してもよく、2種以上を組み合わせて使用してもよい。 Examples of the compound serving as a calcium ion supply source include calcium salts of organic acids such as calcium acetate, calcium lactate, calcium citrate, calcium gluconate, calcium succinate, and calcium malate. These calcium salts of organic acids may be used alone or in combination of two or more.
 マグネシウムイオンの供給源となる化合物としては、例えば、酢酸マグネシウム、乳酸マグネシウム、クエン酸マグネシウム、グルコン酸マグネシウム、コハク酸マグネシウム、リンゴ酸マグネシウム等のマグネシウムの有機酸塩が挙げられる。これらのマグネシウムの有機酸塩は、1種を単独で使用してもよく、2種以上を組み合わせて使用してもよい。 Examples of the compound serving as a supply source of magnesium ions include magnesium organic acid salts such as magnesium acetate, magnesium lactate, magnesium citrate, magnesium gluconate, magnesium succinate, and magnesium malate. One of these organic acid salts of magnesium may be used alone, or two or more thereof may be used in combination.
 ナトリウムイオンの供給源となる化合物としては、例えば、乳酸ナトリウム、クエン酸ナトリウム、グルコン酸ナトリウム、コハク酸ナトリウム、リンゴ酸ナトリウム等のナトリウムの有機酸塩が挙げられる。これらのナトリウムの有機酸塩は、1種を単独で使用してもよく、2種以上を組み合わせて使用してもよい。 Examples of the compound serving as a source of sodium ions include sodium organic acid salts such as sodium lactate, sodium citrate, sodium gluconate, sodium succinate, and sodium malate. These organic acid salts of sodium may be used alone or in combination of two or more.
 カリウムイオンの供給源となる化合物としては、例えば、酢酸カリウム、乳酸カリウム、クエン酸カリウム、グルコン酸カリウム、コハク酸カリウム、リンゴ酸カリウム等のカリウムの有機酸塩が挙げられる。これらのカリウムの有機酸塩は、1種を単独で使用してもよく、2種以上を組み合わせて使用してもよい。 Examples of the compound serving as a supply source of potassium ions include potassium organic acid salts such as potassium acetate, potassium lactate, potassium citrate, potassium gluconate, potassium succinate, and potassium malate. These organic acid salts of potassium may be used alone or in combination of two or more.
 これらの有機酸塩及び/又は無機酸塩については、最終的に調製される血液透析液に含有させるべき各種イオンの種類に応じて適宜選択すればよい。 These organic acid salts and / or inorganic acid salts may be appropriately selected according to the types of various ions to be contained in the finally prepared hemodialysis solution.
 本発明の血液透析用A剤において、これらの有機酸塩及び/又は無機塩の含有量については、最終的に調製される血液透析液に備えさせる各イオン濃度に応じて適宜設定される。具体的には、本発明の血液透析用A剤に含まれる電解質成分の含有量は、最終的に調製される血液透析液が下記表2に示す各イオン濃度を満たすよう、適宜設定すればよい。 In the hemodialysis agent A of the present invention, the content of these organic acid salts and / or inorganic salts is appropriately set according to each ion concentration provided in the hemodialysis solution to be finally prepared. Specifically, the content of the electrolyte component contained in the agent A for hemodialysis of the present invention may be appropriately set so that the finally prepared hemodialysis solution satisfies each ion concentration shown in Table 2 below. .
Figure JPOXMLDOC01-appb-T000002
Figure JPOXMLDOC01-appb-T000002
 本発明の血液透析用A剤には、第2画分に酢酸及び酢酸塩を含有することにより、調製される血液透析液に適切なpHを備えさせることができているが、本発明の血液透析用A剤には、更に必要に応じて、酢酸及び酢酸塩以外のpH調節剤を含んでいてもよい。本発明の血液透析用A剤に使用可能なpH調節剤としては、透析液の成分として許容されるものである限り、特に制限されないが、例えば、塩酸、乳酸、グルコン酸等の液状の酸、クエン酸、コハク酸、フマル酸、リンゴ酸、グルコノデルタラクトン等の固形状の酸、及びこれらのナトリウム、カリウム、カルシウム、マグネシウム塩等が挙げられる。これらのpH調節剤の中でも、有機酸が好適に使用される。pH調節剤は、1種単独で使用してもよく、また2種以上を組み合わせて使用してもよい。 The hemodialysis agent A of the present invention contains acetic acid and acetate in the second fraction so that the prepared hemodialysis solution has an appropriate pH. The dialysis agent A may further contain a pH adjusting agent other than acetic acid and acetate, if necessary. The pH adjuster that can be used in the hemodialysis agent A of the present invention is not particularly limited as long as it is acceptable as a component of the dialysis solution. For example, liquid acids such as hydrochloric acid, lactic acid, and gluconic acid, Examples thereof include solid acids such as citric acid, succinic acid, fumaric acid, malic acid and glucono delta lactone, and sodium, potassium, calcium and magnesium salts thereof. Among these pH regulators, organic acids are preferably used. A pH regulator may be used individually by 1 type, and may be used in combination of 2 or more type.
 また、本発明の血液透析用A剤に、酢酸及び酢酸塩以外のpH調節剤を含有させる場合、pH調節剤は、第1画分及び第2画分のいずれに含まれていてもよく、また第1画分及び第2画分の双方に含まれていてもよい。 In addition, when the A agent for hemodialysis of the present invention contains a pH regulator other than acetic acid and acetate, the pH regulator may be contained in any of the first fraction and the second fraction, Further, it may be contained in both the first fraction and the second fraction.
 本発明の血液透析用A剤に酢酸及び酢酸塩以外のpH調節剤を含有させる場合、その含有量については、最終的に調製される血液透析液のpHが7.2~7.6、好ましくは7.2~7.5となるように適宜設定すればよい。 In the case where the hemodialysis agent A of the present invention contains a pH adjusting agent other than acetic acid and acetate, the pH of the hemodialysis solution to be finally prepared is 7.2 to 7.6, preferably May be appropriately set to be 7.2 to 7.5.
<第1画分と第2画分の含有態様>
 本発明の血液透析用A剤は、第1画分と第2画分が共存した状態で含まれる。本発明の血液透析用A剤は、収容されている容器内で第1画分と第2画分が共存していればよく、例えば、第1画分と第2画分が均一に分散している状態であっても、第1画分と第2画分が不均一に分散又は分布していてもよい。
<Contained aspect of the first fraction and the second fraction>
The hemodialysis agent A of the present invention is contained in a state in which the first fraction and the second fraction coexist. In the hemodialysis agent A of the present invention, it is sufficient that the first fraction and the second fraction coexist in the contained container. For example, the first fraction and the second fraction are uniformly dispersed. Even in this state, the first fraction and the second fraction may be dispersed or distributed unevenly.
<血液透析用A剤の水分含量>
 本発明の血液透析用A剤の水分含量については、特に制限されず、第1画分と第2画分が有する水分含量によって定まるが、例えば、本発明の血液透析用A剤が塩化ナトリウムを含む場合であれば、当該血液透析用A剤の水分含量として、5.0重量%以下、好ましくは2.0重量%以下、更に好ましくは1.5重量%以下が挙げられる。本発明の血液透析用A剤が、このような水分含量を満たしている場合、酢酸臭、保存による固化、ブドウ糖を共存させた際のブドウ糖の分解、及び水に溶解した時のpH上昇を、より一層効果的に抑制することが可能になる。本発明において、血液透析用A剤の水分含量は、カールフィッシャー水分計を用いて測定される値である。
<Water content of agent A for hemodialysis>
The water content of the hemodialysis agent A of the present invention is not particularly limited and is determined by the water content of the first fraction and the second fraction. For example, the hemodialysis agent A of the present invention contains sodium chloride. If included, the water content of the hemodialysis agent A is 5.0% by weight or less, preferably 2.0% by weight or less, and more preferably 1.5% by weight or less. When the hemodialysis agent A of the present invention satisfies such a moisture content, acetic acid odor, solidification by storage, decomposition of glucose when glucose is allowed to coexist, and pH increase when dissolved in water, It becomes possible to suppress more effectively. In the present invention, the water content of the hemodialysis agent A is a value measured using a Karl Fischer moisture meter.
<製造方法>
 本発明の血液透析用A剤は、第1画分を構成する造粒物を調製し、当該造粒物に第2画分に含まれる成分を混合することによって製造される。具体的には、本発明の血液透析用A剤の製造方法としては、下記第1工程及び第2工程を含む方法が挙げられる。
第1工程:塩化マグネシウム及び塩化カリウムの一方のみを実質的に含み、且つ塩化カルシウムを含む造粒物を調製する。
第2工程: 前記第1工程で得られた造粒物と、酢酸及び酢酸塩とを含む固体状の血液透析用A剤を得る。
<Manufacturing method>
The agent A for hemodialysis of the present invention is produced by preparing a granulated product constituting the first fraction and mixing the components contained in the second fraction with the granulated product. Specifically, examples of the method for producing the hemodialysis agent A of the present invention include a method including the following first step and second step.
First step: A granulated product containing only one of magnesium chloride and potassium chloride and containing calcium chloride is prepared.
Second Step: A solid hemodialysis agent A containing the granulated product obtained in the first step, acetic acid and acetate is obtained.
 前記第1工程では、第1画分に含まれる成分を用いて造粒を行えばよい。造粒は、当該技術分野において通常採用されている手法に従って行うことができる。 In the first step, granulation may be performed using the components contained in the first fraction. The granulation can be performed according to a method usually employed in the technical field.
 前記第1工程で得られた造粒物は、必要に応じて、乾燥や冷却、篩過などの後処理に供しても良い。特に乾燥を行う場合、製剤安定性や流動性を考慮して、十分に水分を除去することが好ましい。造粒物中の水分量は、使用する原料の全結晶水量に大きく依存するが、目安として、前記第1工程で水を加えて造粒した場合は、加えた水と同量の水を除去し、更に、使用する原料が元々保持していた全結晶水100重量部当たり、80重量部~20重量部、更に好ましくは80~40重量部、特に好ましくは75~50重量部の結晶水を除去するように乾燥することが好ましい。原料が分解しない温度範囲内で、当該造粒物を十分に乾燥することにより、酢酸臭の低減、固化の抑制、及びブドウ糖が含まれる場合にはその安定性の向上をより一層効果的に図ることが可能になる。 The granulated product obtained in the first step may be subjected to post-treatment such as drying, cooling, and sieving as necessary. In particular, when drying is performed, it is preferable to sufficiently remove moisture in consideration of formulation stability and fluidity. The amount of water in the granulated product greatly depends on the total amount of water of crystallization of the raw material used, but as a guideline, when water is added and granulated in the first step, the same amount of water as the added water is removed. Further, 80 parts by weight to 20 parts by weight, more preferably 80 to 40 parts by weight, and particularly preferably 75 to 50 parts by weight of crystallization water per 100 parts by weight of the total crystallization water originally retained by the raw material used. Drying to remove is preferred. By sufficiently drying the granulated material within a temperature range in which the raw material is not decomposed, reduction of acetic acid odor, suppression of solidification, and improvement of stability when glucose is contained are more effectively achieved. It becomes possible.
 前記第2工程では、第1工程で得られた造粒物(第1画分)と、第2画分を構成する成分とを混合又は添加すればよい。前記第2工程では、第1工程で得られた造粒物(第1画分)に対して、第2画分を構成する成分を別々に添加してもよく、また第2画分を構成する成分を一旦混合した後に当該混合物を添加してもよい。第2画分において、酢酸と酢酸塩を含有させる場合には、前記第2工程において、酢酸と酢酸塩を一旦混合した後に、第1工程で得られた造粒物に添加又は混合することにより、酢酸臭の低減、固化の抑制、及びブドウ糖が含まれる場合にはその安定性の向上をより一層効果的に図ることが可能になる。 In the second step, the granulated product obtained in the first step (first fraction) and the components constituting the second fraction may be mixed or added. In the second step, the component constituting the second fraction may be added separately to the granulated product (first fraction) obtained in the first step, and the second fraction is constituted. The mixture may be added after the components to be mixed are once mixed. When acetic acid and acetate are contained in the second fraction, in the second step, acetic acid and acetate are once mixed, and then added or mixed to the granulated product obtained in the first step. When the acetic acid odor is reduced, solidification is suppressed, and glucose is contained, the stability can be improved more effectively.
<血液透析用A剤の包装態様>
 本発明の血液透析用A剤は、包装容器に収容して提供される。血液透析用A剤の包装に使用される包装容器としては、特に制限されないが、例えば、フレキシブルバッグやハードボトル等が挙げられる。当該包装容器として、具体的には、シリカ蒸着ラミネート袋やアルミ蒸着ラミネート袋、酸化アルミ蒸着ラミネート袋、アルミラミネート袋、ポリエチレン製ハードボトル等が挙げられる。とりわけ、アルミニウム箔等の金属箔が用いられている包装袋(アルミラミネート袋等)は、透湿度を低くでき、酢酸が揮発するのをより効果的に抑制できる。また、これらの包装容器の透湿度については、酢酸臭をより一層有効に低減させるという観点から、好ましくは0.5g/m2・24h(40℃、90%RH)以下、更に好ましくは0.2g/m2・24h(40℃、90%RH)以下が挙げられる。当該透湿度は、JISZ0208防湿包装材料の透湿度試験方法(カップ法)に規定の測定方法に準拠して測定される値である。
<Packaging aspect of agent A for hemodialysis>
The hemodialysis agent A of the present invention is provided by being housed in a packaging container. Although it does not restrict | limit especially as a packaging container used for the packaging of A agent for hemodialysis, For example, a flexible bag, a hard bottle, etc. are mentioned. Specific examples of the packaging container include a silica vapor deposition laminate bag, an aluminum vapor deposition laminate bag, an aluminum oxide vapor deposition laminate bag, an aluminum laminate bag, and a polyethylene hard bottle. In particular, a packaging bag (such as an aluminum laminate bag) using a metal foil such as an aluminum foil can reduce moisture permeability and more effectively suppress acetic acid volatilization. Further, the moisture permeability of these packaging containers is preferably 0.5 g / m 2 · 24 h (40 ° C., 90% RH) or less, and more preferably, from the viewpoint of more effectively reducing the odor of acetic acid. 2 g / m 2 · 24 h (40 ° C., 90% RH) or less. The said moisture permeability is a value measured based on the measuring method prescribed | regulated to the moisture permeability test method (cup method) of a JISZ0208 moisture-proof packaging material.
 更に、本発明の血液透析用A剤を収容する包装容器には、当該血液透析用A剤の水分含量を効果的に低減させるために、更に乾燥剤が含まれていてもよい。乾燥剤としては、特に制限されないが、例えば、ゼオライト、硫酸マグネシウム、硫酸ナトリウム、シリカゲル、アルミナ等が挙げられる。包装容器に乾燥剤を収容する場合、これら物質が容器を構成するプラスチックの一部(例えば、ポリエチレン層)に配合された容器を用いてもよいし、包装容器内に乾燥剤を収納できるスペース(別室)を設けてもよい。また乾燥剤を不織布等に入れた状態で、血液透析用A剤に混入しないようにして包装容器に収容してもよい。 Furthermore, the packaging container for storing the hemodialysis agent A of the present invention may further contain a desiccant in order to effectively reduce the water content of the hemodialysis agent A. Although it does not restrict | limit especially as a desiccant, For example, a zeolite, magnesium sulfate, sodium sulfate, a silica gel, an alumina etc. are mentioned. When a desiccant is stored in a packaging container, a container in which these substances are blended with a part of plastic (for example, a polyethylene layer) constituting the container may be used, or a space in which the desiccant can be stored in the packaging container ( A separate room may be provided. Alternatively, the desiccant may be contained in a non-woven fabric or the like so as not to be mixed into the hemodialysis agent A and contained in a packaging container.
2.血液透析用剤
 本発明の血液透析用剤は、前記血液透析用A剤、及び重炭酸ナトリウムを含む血液透析用B剤を含有する。
2. Hemodialysis agent hemodialysis agent present invention, the blood dialysis agent A, and contains a hemodialysis B agent containing sodium bicarbonate.
 前記血液透析用B剤には、必要に応じてブドウ糖が含まれていてもよい。前記血液透析用B剤にブドウ糖を含有させる場合、その含有量は、最終的に調製される血液透析液におけるブドウ糖濃度が0~2.5g/L、好ましくは1.0~1.5g/Lとなるように適宜設定すればよい。但し、前記血液透析用B剤は、重炭酸ナトリウム以外の電解質成分が含まれていないことが望ましく、含有成分が実質的に重炭酸ナトリウムからなるものが好適である。前記血液透析用B剤は、輸送や保管の観点から固形状であることが望ましい。また、固形状の血液透析用B剤の形状としては、具体的には粉末剤、顆粒剤等が挙げられる。 The B preparation for hemodialysis may contain glucose as necessary. When glucose is included in the hemodialysis agent B, the content is such that the glucose concentration in the finally prepared hemodialysis solution is 0 to 2.5 g / L, preferably 1.0 to 1.5 g / L. What is necessary is just to set suitably so that it may become. However, it is desirable that the B agent for hemodialysis does not contain electrolyte components other than sodium bicarbonate, and it is preferable that the component is substantially composed of sodium bicarbonate. The hemodialysis agent B is preferably solid from the viewpoint of transportation and storage. Specific examples of the shape of the solid B agent for hemodialysis include powders and granules.
 前記血液透析用B剤の使用量は、最終的に調製される血液透析液中の重炭酸イオンが20~40mEq/L、好ましくは25~35mEq/Lとなるように適宜設定すればよい。 The amount of the hemodialysis agent B used may be appropriately set so that bicarbonate ion in the finally prepared hemodialysis solution is 20 to 40 mEq / L, preferably 25 to 35 mEq / L.
 前記血液透析用A剤に塩化ナトリウムが含まれている場合には、本発明の血液透析用剤は、前記血液透析用A剤、及び重炭酸ナトリウムを含む血液透析用B剤からなる2剤型の血液透析用剤として使用される。 In the case where sodium chloride is contained in the hemodialysis agent A, the hemodialysis agent of the present invention is a two-agent type comprising the hemodialysis agent A and the hemodialysis agent B containing sodium bicarbonate. It is used as a hemodialysis agent.
 また、前記血液透析用A剤に塩化ナトリウムが含まれていない場合には、本発明の血液透析用剤は、前記血液透析用A剤、塩化ナトリウムを含む血液透析用S剤、及び重炭酸ナトリウムを含む血液透析用B剤からなる3剤型の血液透析用剤として使用される。当該3剤型の血液透析用剤は、特許文献2に記載されているように、血液透析時に血液透析用S剤と血液透析用B剤の添加量の比率を調節することによって、患者の病態に応じて、血液透析中でも重炭酸イオン濃度を自在に変化させつつ、ナトリウム、カリウム、カルシウム、マグネシウム等の電解質濃度を一定に維持できる血液透析液を調製することが可能になる。 In addition, when sodium chloride is not contained in the hemodialysis agent A, the hemodialysis agent of the present invention includes the hemodialysis agent A, hemodialysis agent S containing sodium chloride, and sodium bicarbonate. It is used as a three-drug hemodialysis agent comprising a B agent for hemodialysis. As described in Patent Document 2, the three-drug hemodialysis agent is prepared by adjusting the ratio of the addition amount of hemodialysis agent S and hemodialysis agent B during hemodialysis. Accordingly, it is possible to prepare a hemodialysis solution capable of maintaining a constant electrolyte concentration such as sodium, potassium, calcium, magnesium, etc. while freely changing the bicarbonate ion concentration even during hemodialysis.
 前記血液透析用S剤には、必要に応じてブドウ糖が含まれていてもよい。前記血液透析用S剤にブドウ糖を含有させる場合、その含有量は、最終的に調製される血液透析液におけるブドウ糖濃度が0~2.5g/L、好ましくは1.0~1.5g/Lとなるように適宜設定すればよい。但し、前記血液透析用S剤は、塩化ナトリウム以外の電解質成分が含まれていないことが望ましく、含有成分が実質的に塩化ナトリウムからなるものが好適である。前記血液透析用S剤は、輸送や保管の観点から固形状であることが望ましい。また、固形状の血液透析用S剤の形状としては、具体的には粉末剤、顆粒剤等が挙げられる。 The S-agent for hemodialysis may contain glucose as necessary. When glucose is contained in the S-agent for hemodialysis, the content thereof is such that the glucose concentration in the finally prepared hemodialysis solution is 0 to 2.5 g / L, preferably 1.0 to 1.5 g / L. What is necessary is just to set suitably so that it may become. However, it is desirable that the S-agent for hemodialysis does not contain electrolyte components other than sodium chloride, and those containing substantially sodium chloride are preferred. The S-agent for hemodialysis is preferably solid from the viewpoint of transportation and storage. Specific examples of the solid S-dialysis agent include powders and granules.
 前記血液透析用S剤の使用量は、前記血液透析用A剤中のナトリウム塩の量等を勘案し、最終的に調製される血液透析液が前記表1に示すナトリウム濃度を満たすように適宜設定すればよい。 The amount of the S agent for hemodialysis is appropriately determined so that the hemodialysis solution finally prepared satisfies the sodium concentration shown in Table 1 in consideration of the amount of sodium salt in the agent A for hemodialysis. You only have to set it.
 本発明の血液透析用剤は、重炭酸血液透析液を調製するために使用される。具体的には、前記血液透析用A剤、前記血液透析用B剤、及び前記血液透析用A剤に塩化ナトリウムが含まれていない場合には前記血液透析用S剤を、所定量の水(好ましくは精製水)に混合し希釈させることによって、重炭酸血液透析液が調製される。 The hemodialysis agent of the present invention is used for preparing a bicarbonate hemodialysis solution. Specifically, when sodium chloride is not contained in the hemodialysis agent A, the hemodialysis agent B, and the hemodialysis agent A, the hemodialysis agent S is added with a predetermined amount of water ( Bicarbonate hemodialysate is prepared by mixing with and preferably diluting with purified water.
 以下、実施例を挙げて本発明を具体的に説明する。但し、本発明は以下の実施例に限定して解釈されるものではない。 Hereinafter, the present invention will be specifically described with reference to examples. However, the present invention is not construed as being limited to the following examples.
試験例1
1.固体状の血液透析用A剤の作製
実施例1
 塩化ナトリウム928.8g、塩化カルシウム二水和物28.2g、塩化マグネシウム六水和物18.0gをそれぞれ計量し、それぞれを別々のポリ袋に入れ密閉した状態で、送風式棚段乾燥機にて70℃に加温した。加温後、それら原料と、精製水18.0gを一つのポリ袋内に入れ密封し、十分に混合後、再度送風式棚段乾燥機に入れ70℃で20分間静置した。次に、ポリ袋の内容物全てをステンレス製のバットに均一になるよう敷きつめ、130℃の送風式棚段乾燥機に入れ、2時間乾燥した。造粒物が乾燥により固化するため、乾燥中に2度、スプーンで粉砕し、乾燥終了後、目開き2000μmの篩を通過させ、造粒物(第1画分)を作製した。
Test example 1
1. Production of solid A agent for hemodialysis
Example 1
Weigh 928.8 g of sodium chloride, 28.2 g of calcium chloride dihydrate, and 18.0 g of magnesium chloride hexahydrate, put each in a separate plastic bag and seal it in a blow-type shelf dryer. And heated to 70 ° C. After heating, these raw materials and 18.0 g of purified water were put in one plastic bag and sealed, and after sufficiently mixing, they were again placed in a blow type shelf dryer and left at 70 ° C. for 20 minutes. Next, the entire contents of the plastic bag were spread uniformly on a stainless steel bat, placed in a 130 ° C. blown shelf dryer and dried for 2 hours. Since the granulated product was solidified by drying, it was pulverized with a spoon twice during drying, and after completion of drying, it was passed through a sieve having an opening of 2000 μm to produce a granulated product (first fraction).
 得られた造粒物(第1画分)118.70g、酢酸:酢酸ナトリウムのモル比が1:1の酢酸と酢酸ナトリウムの固体状混合物(第2画分)5.27g、ブドウ糖(第2画分)26.25gを計量し、ポリ袋内で十分に混合した後、アルミラミネート層を含む遮湿性包材に入れて密封し、固体状の血液透析用A剤を得た。 118.70 g of the obtained granulated product (first fraction), 5.27 g of a solid mixture of acetic acid and sodium acetate having a molar ratio of acetic acid: sodium acetate of 1: 1 (second fraction), glucose (second Fraction) 26.25 g was weighed and thoroughly mixed in a plastic bag, and then sealed in a moisture-proof packaging material containing an aluminum laminate layer to obtain a solid A agent for hemodialysis.
実施例2
 塩化ナトリウム928.8g、塩化カリウム25.3g、塩化カルシウム二水和物28.2gをそれぞれ計量し、それぞれを別々のポリ袋に入れ密閉した状態で、送風式棚段乾燥機にて70℃に加温した。加温後、それら原料と、精製水18.0gを一つのポリ袋内に入れ密封し、十分に混合後、再度送風式棚段乾燥機に入れ70℃で20分間静置した。次に、ポリ袋の内容物全てをステンレス製のバットに均一になるよう敷きつめ、130℃の送風式棚段乾燥機に入れ、2時間乾燥した。造粒物が乾燥により固化するため、乾燥中に2度、スプーンで粉砕し、乾燥終了後、目開き2000μmの篩を通過させ、造粒物(第1画分)を作製した。
Example 2
Weighing 928.8 g of sodium chloride, 25.3 g of potassium chloride, and 28.2 g of calcium chloride dihydrate, and placing each in a separate plastic bag and sealing it to 70 ° C. with a blow-type shelf dryer Warmed up. After heating, these raw materials and 18.0 g of purified water were put in one plastic bag and sealed, and after sufficiently mixing, they were again placed in a blow type shelf dryer and left at 70 ° C. for 20 minutes. Next, the entire contents of the plastic bag were spread uniformly on a stainless steel bat, placed in a 130 ° C. blown shelf dryer and dried for 2 hours. Since the granulated product was solidified by drying, it was pulverized with a spoon twice during drying, and after completion of drying, it was passed through a sieve having an opening of 2000 μm to produce a granulated product (first fraction).
 得られた造粒物(第1画分)118.70g、酢酸:酢酸ナトリウムのモル比が1:1の酢酸と酢酸ナトリウムの固体状混合物(第2画分)5.27g、ブドウ糖(第2画分)26.25gを計量し、ポリ袋内で十分に混合した後、アルミラミネート層を含む遮湿性包材に入れて密封し、固体状の血液透析用A剤を得た。 118.70 g of the obtained granulated product (first fraction), 5.27 g of a solid mixture of acetic acid and sodium acetate having a molar ratio of acetic acid: sodium acetate of 1: 1 (second fraction), glucose (second Fraction) 26.25 g was weighed and thoroughly mixed in a plastic bag, and then sealed in a moisture-proof packaging material containing an aluminum laminate layer to obtain a solid A agent for hemodialysis.
比較例1
 塩化ナトリウム928.8g、塩化カリウム25.3g、塩化マグネシウム六水和物18.0gをそれぞれ計量し、それぞれを別々のポリ袋に入れ密閉した状態で、送風式棚段乾燥機にて70℃に加温した。加温後、それら原料と、精製水18.0gを一つのポリ袋内に入れ密封し、十分に混合後、再度送風式棚段乾燥機に入れ70℃で20分間静置した。次に、ポリ袋の内容物全てをステンレス製のバットに均一になるよう敷きつめ、130℃の送風式棚段乾燥機に入れ、2時間乾燥した。造粒物が乾燥により固化するため、乾燥中に2度、スプーンで粉砕し、乾燥終了後、目開き2000μmの篩を通過させ、造粒物(第1画分)を作製した。
Comparative Example 1
Weighing 928.8 g of sodium chloride, 25.3 g of potassium chloride, and 18.0 g of magnesium chloride hexahydrate, respectively, put each in a separate plastic bag, and sealed it in a fan-type shelf dryer at 70 ° C. Warmed up. After heating, these raw materials and 18.0 g of purified water were put in one plastic bag and sealed, and after sufficiently mixing, they were again placed in a blow type shelf dryer and left at 70 ° C. for 20 minutes. Next, the entire contents of the plastic bag were spread uniformly on a stainless steel bat, placed in a 130 ° C. blown shelf dryer and dried for 2 hours. Since the granulated product was solidified by drying, it was pulverized with a spoon twice during drying, and after completion of drying, it was passed through a sieve having an opening of 2000 μm to produce a granulated product (first fraction).
 得られた造粒物(第1画分)118.70g、酢酸:酢酸ナトリウムのモル比が1:1の酢酸と酢酸ナトリウムの固体状混合物(第2画分)5.27g、ブドウ糖(第2画分)26.25gを計量し、ポリ袋内で十分に混合した後、アルミラミネート層を含む遮湿性包材に入れて密封し、固体状の血液透析用A剤を得た。 118.70 g of the obtained granulated product (first fraction), 5.27 g of a solid mixture of acetic acid and sodium acetate having a molar ratio of acetic acid: sodium acetate of 1: 1 (second fraction), glucose (second Fraction) 26.25 g was weighed and thoroughly mixed in a plastic bag, and then sealed in a moisture-proof packaging material containing an aluminum laminate layer to obtain a solid A agent for hemodialysis.
比較例2
 塩化ナトリウム928.8g、塩化カリウム25.3g、塩化カルシウム二水和物28.2g、塩化マグネシウム六水和物18.0gをそれぞれ計量し、それぞれを別々のポリ袋に入れ密閉した状態で、送風式棚段乾燥機にて70℃に加温した。加温後、それら原料と、精製水18.0gを一つのポリ袋内に入れ密封し、十分に混合後、再度送風式棚段乾燥機に入れ70℃で20分間静置した。次に、ポリ袋の内容物全てをステンレス製のバットに均一になるよう敷きつめ、130℃の送風式棚段乾燥機に入れ、2時間乾燥した。造粒物が乾燥により固化するため、乾燥中に2度、スプーンで粉砕し、乾燥終了後、目開き2000μmの篩を通過させ、造粒物(第1画分)を作製した。
Comparative Example 2
Weighing 928.8 g of sodium chloride, 25.3 g of potassium chloride, 28.2 g of calcium chloride dihydrate, and 18.0 g of magnesium chloride hexahydrate, and placing each in a separate plastic bag and sealing, blow It heated to 70 degreeC with the type | formula shelf dryer. After heating, these raw materials and 18.0 g of purified water were put in one plastic bag and sealed, and after sufficiently mixing, they were again placed in a blow type shelf dryer and left at 70 ° C. for 20 minutes. Next, the entire contents of the plastic bag were spread uniformly on a stainless steel bat, placed in a 130 ° C. blown shelf dryer and dried for 2 hours. Since the granulated product was solidified by drying, it was pulverized with a spoon twice during drying, and after completion of drying, it was passed through a sieve having an opening of 2000 μm to produce a granulated product (first fraction).
 得られた造粒物(第1画分)118.70g、酢酸:酢酸ナトリウムのモル比が1:1の酢酸と酢酸ナトリウムの固体状混合物(第2画分)5.27g、ブドウ糖(第2画分)26.25gを計量し、ポリ袋内で十分に混合した後、アルミラミネート層を含む遮湿性包材に入れて密封し、固体状の血液透析用A剤を得た。 118.70 g of the obtained granulated product (first fraction), 5.27 g of a solid mixture of acetic acid and sodium acetate having a molar ratio of acetic acid: sodium acetate of 1: 1 (second fraction), glucose (second Fraction) 26.25 g was weighed and thoroughly mixed in a plastic bag, and then sealed in a moisture-proof packaging material containing an aluminum laminate layer to obtain a solid A agent for hemodialysis.
2.血液透析用A剤の評価
 各血液透析用A剤を、40℃/75%RHで保存した際の開始時及び保存1ヵ月、2ヵ月、3ヵ月、5ヵ月後の揮発酢酸濃度の測定、固化と着色の確認、35倍濃縮A液とした時のpH及び5-HMF量の測定を、以下に示す方法で行った。また、各血液透析用A剤の原料として使用した造粒物(第1画分)、及び各血液透析用A剤の水分含量を以下に示す方法で測定した。
2. Evaluation of hemodialysis agent A Measurement and solidification of volatile acetic acid concentration at the start of each hemodialysis agent A when stored at 40 ° C / 75% RH and after 1 month, 2 months, 3 months, and 5 months Confirmation of coloration and measurement of pH and 5-HMF amount when 35-fold concentrated solution A was obtained were carried out by the following methods. Moreover, the granulated material (1st fraction) used as a raw material of each A dialysis agent and the water content of each A dialysis agent were measured by the method shown below.
(1)揮発酢酸濃度の測定
 各血液透析用A剤を収容した袋内に検知管をセットし、一定量の試料気体を酢酸測定用の検知管に通気させて、検知管式気体測定器(製造元:GASTEC、型番:GV-100S)で揮発酢酸濃度を測定した。
(1) Measurement of volatile acetic acid concentration A detector tube is set in a bag containing each hemodialysis agent A, and a certain amount of sample gas is passed through the detector tube for measuring acetic acid. The volatile acetic acid concentration was measured by a manufacturer: GASTEC, model number: GV-100S.
(2)固化と着色の確認
 各血液透析用A剤を収容した袋内を目視で確認し、固化と着色の有無を確認した。固化とは、内容物の変化により、流動性が失われ湿気を帯びたような状態のことを指す。
(2) Confirmation of solidification and coloring The inside of the bag which accommodated each agent A for hemodialysis was confirmed visually, and the presence or absence of solidification and coloring was confirmed. Solidification refers to a state in which the fluidity is lost due to changes in the contents, resulting in moisture.
(3)pH及び5-HMFの測定
 各血液透析用A剤を精製水に溶解し、最終的に調製される透析液中の各成分濃度の35倍に濃縮した水溶液の状態にして、35倍濃縮A液を調製した。具体的には、各血液透析用A剤全量を、精製水に溶かし、500mLとすることにより、35倍濃縮A液を調製した。各35倍濃縮A液について、pHはpHメーター(製造元:堀場製作所、型番:F-73)を用いて液温25℃で測定した。ブドウ糖の分解物である5-ヒドロキシメチルフルフラール(以下5-HMFと記載)量は、0.2μmフィルターでろ過した液について分光光度計を用いて、5-HMFの吸収波長(波長284nm)の吸光度(Abs)を測定した。
(3) Measurement of pH and 5-HMF Each A-dialysis agent for hemodialysis is dissolved in purified water, and the solution is concentrated 35 times the concentration of each component in the dialysate to be finally prepared. Concentrated solution A was prepared. Specifically, a 35-fold concentrated A solution was prepared by dissolving the total amount of each A-dialysis hemodialysis agent in purified water to 500 mL. About each 35 times concentrated A liquid, pH was measured at the liquid temperature of 25 degreeC using the pH meter (manufacturer: Horiba, model number: F-73). The amount of 5-hydroxymethylfurfural (hereinafter referred to as 5-HMF), which is a degradation product of glucose, is determined by measuring the absorbance at the absorption wavelength (wavelength 284 nm) of 5-HMF using a spectrophotometer for the liquid filtered through a 0.2 μm filter. (Abs) was measured.
(4)水分含量の測定
 各血液透析用A剤の原料として使用した造粒物(第1画分)、及び製造直後の各血液透析用A剤について、カールフィッシャー水分計(製造元:平沼産業、型番:AQV-2200)を用いて水分含量を測定した。
(4) Measurement of water content About the granulated product (first fraction) used as a raw material for each hemodialysis agent A and each hemodialysis agent A immediately after production, Karl Fischer moisture meter (manufacturer: Hiranuma Sangyo, The water content was measured using a model number: AQV-2200).
 結果を表3~8に示す。この結果、塩化マグネシウム及び塩化カリウムを含む造粒物(第1画分)と、酢酸及び酢酸塩(第2画分)とを混合した場合(比較例1及び2)では、保存期間の経過に伴って、揮発酢酸濃度の上昇、固化、着色、ブドウ糖の分解が顕著になっていた。これに対して、塩化マグネシウム又は塩化カリウムの一方のみと塩化カルシウムを含む造粒物(第1画分)と、酢酸及び酢酸塩(第2画分)とを混合した場合(実施例1及び2)では、保存5カ月後でも、揮発酢酸濃度の上昇を十分に抑制できており、更に、固化、着色、水に溶解した際のpHの上昇、ブドウ糖の分解も十分に抑制できていた。なお、いずれの実施例及び比較例でも、血液透析用A剤の原料として使用した造粒物(第1画分)、及び血液透析用A剤の水分含量は、十分に低い値になっていた。 The results are shown in Tables 3-8. As a result, when the granulated product containing magnesium chloride and potassium chloride (first fraction) and acetic acid and acetate (second fraction) were mixed (Comparative Examples 1 and 2), the storage period passed. Along with this, the increase in the concentration of volatile acetic acid, solidification, coloring, and decomposition of glucose were remarkable. On the other hand, when the granulated material (first fraction) containing only one of magnesium chloride or potassium chloride and calcium chloride is mixed with acetic acid and acetate (second fraction) (Examples 1 and 2). ), The increase in the concentration of volatile acetic acid was sufficiently suppressed even after 5 months of storage, and further, the solidification, coloring, the increase in pH when dissolved in water, and the decomposition of glucose were also sufficiently suppressed. In any of the examples and comparative examples, the water content of the granulated product (first fraction) used as a raw material for the hemodialysis agent A and the hemodialysis agent A was sufficiently low. .
Figure JPOXMLDOC01-appb-T000003
Figure JPOXMLDOC01-appb-T000003
Figure JPOXMLDOC01-appb-T000004
Figure JPOXMLDOC01-appb-T000004
Figure JPOXMLDOC01-appb-T000005
Figure JPOXMLDOC01-appb-T000005
Figure JPOXMLDOC01-appb-T000006
Figure JPOXMLDOC01-appb-T000006
Figure JPOXMLDOC01-appb-T000007
Figure JPOXMLDOC01-appb-T000007
Figure JPOXMLDOC01-appb-T000008
Figure JPOXMLDOC01-appb-T000008
試験例2
1.固体状の血液透析用A剤の作製
実施例3
 塩化ナトリウム1000kg、塩化カルシウム二水和物33.4kg、塩化マグネシウム六水和物22.3kg、及び精製水適量をナウタミキサ(製造元:ホソカワミクロン株式会社、型番:DBX-5000RW)に入れ30分混合し、造粒物を得た。次いで、その造粒物を振動篩に連続的に供給し、排出された造粒物を連続的に移送した。乾燥温度155℃の条件で連続乾燥後、冷却し、造粒物(第1画分)を作製した。
Test example 2
1. Production of solid A agent for hemodialysis
Example 3
1000 kg of sodium chloride, 33.4 kg of calcium chloride dihydrate, 22.3 kg of magnesium chloride hexahydrate, and an appropriate amount of purified water are placed in a Nauta mixer (manufacturer: Hosokawa Micron Corporation, model number: DBX-5000RW) and mixed for 30 minutes. A granulated product was obtained. Subsequently, the granulated material was continuously supplied to the vibrating sieve, and the discharged granulated material was continuously transferred. After continuous drying at a drying temperature of 155 ° C., the mixture was cooled to produce a granulated product (first fraction).
 得られた造粒物(第1画分)115.70g、酢酸:酢酸ナトリウムのモル比1:1の酢酸と酢酸ナトリウムの固体状混合物(第2画分)5.27g、塩化カリウム(第2画分)3.0gを計量し、ポリ袋内で十分に混合した後、アルミラミネート層を含む遮湿性包材に入れて密封し、固体状の血液透析用A剤を得た。 The resulting granulated product (first fraction) 115.70 g, acetic acid: sodium acetate molar ratio 1: 1 solid mixture of acetic acid and sodium acetate (second fraction) 5.27 g, potassium chloride (second fraction) Fractions) 3.0 g was weighed and thoroughly mixed in a plastic bag, and then sealed in a moisture-proof packaging material containing an aluminum laminate layer to obtain a solid A agent for hemodialysis.
比較例3
 塩化ナトリウム1000kg、塩化カリウム28.9kg、塩化カルシウム二水和物33.4kg、塩化マグネシウム六水和物22.3kg、及び精製水適量をナウタミキサ(製造元:ホソカワミクロン株式会社、型番:DBX-5000RW)に入れ30分混合し、造粒物を得た。次いで、その造粒物を振動篩に連続的に供給し、排出された造粒物を連続的に乾燥機に移送した。乾燥温度155℃の条件で連続乾燥後、冷却し、造粒物(第1画分)を作製した。
Comparative Example 3
Sodium chloride 1000 kg, potassium chloride 28.9 kg, calcium chloride dihydrate 33.4 kg, magnesium chloride hexahydrate 22.3 kg and appropriate amount of purified water to Nauta mixer (manufacturer: Hosokawa Micron Corporation, model number: DBX-5000RW) The mixture was mixed for 30 minutes to obtain a granulated product. Subsequently, the granulated material was continuously supplied to the vibrating sieve, and the discharged granulated material was continuously transferred to a dryer. After continuous drying at a drying temperature of 155 ° C., the mixture was cooled to produce a granulated product (first fraction).
 得られた造粒物(第1画分)118.70g、酢酸:酢酸ナトリウムのモル比が1:1の酢酸と酢酸ナトリウムの固体状混合物(第2画分)5.27gを計量し、ポリ袋内で混合した後、アルミラミネート層を含む遮湿性包材に入れて密封し、固体状の血液透析用A剤を得た。 118.70 g of the obtained granulated product (first fraction), 5.27 g of a solid mixture of acetic acid and sodium acetate (second fraction) having a molar ratio of acetic acid: sodium acetate of 1: 1 (second fraction) were weighed. After mixing in the bag, the mixture was sealed in a moisture-proof packaging material containing an aluminum laminate layer to obtain a solid hemodialysis agent A.
2.血液透析用A剤の評価
(1)造粒物(第1画分)の含量測定
 実施例3と比較例3で使用した造粒物(第1画分)を、それぞれ115.72g、118.72g計量し、水で溶解して全量を500mLとし、それぞれの造粒物濃縮液を得た。これら造粒物濃縮液について液体イオンクロマトグラフィーにて各主要成分の含量測定を行った。
2. Evaluation of Hemodialysis Agent A (1) Content Measurement of Granulated Product (First Fraction) The granulated product (first fraction) used in Example 3 and Comparative Example 3 was 115.72 g and 118. 72 g was weighed and dissolved in water to make a total volume of 500 mL, and each granulated concentrate was obtained. The contents of each major component were measured by liquid ion chromatography for these granulated concentrates.
 結果を表9に示す。この結果、実施例3と比較例3で作製した造粒物(第1画分)には、意図していた通りの電解質含量であることが確認された。 The results are shown in Table 9. As a result, it was confirmed that the granulated product (first fraction) produced in Example 3 and Comparative Example 3 had the electrolyte content as intended.
Figure JPOXMLDOC01-appb-T000009
Figure JPOXMLDOC01-appb-T000009
(2)揮発酢酸濃度の測定、固化と着色の確認、pH、及び水分含量の測定
 実施例3及び比較例3の血液透析用A剤それぞれについて、40℃/75%RHで保存した際の開始時及び保存1ヵ月の測定結果と、50℃(湿度管理なし)で5日保存後の揮発酢酸濃度の測定、固化と着色の確認、35倍濃縮A液とした時のpH及び5-HMF量の測定を行った。また、各血液透析用A剤の原料として使用した造粒物(第1画分)、及び製造直後の各血液透析用A剤の水分含量の測定を行った。具体的な測定条件は、前記試験例1と同様である。
(2) Measurement of concentration of volatile acetic acid, confirmation of solidification and coloration, measurement of pH and water content Start of each A-agent for hemodialysis of Example 3 and Comparative Example 3 when stored at 40 ° C./75% RH Measurement result of 1 hour and storage, measurement of volatile acetic acid concentration after 5 days storage at 50 ° C (no humidity control), confirmation of solidification and coloring, pH and 5-HMF amount when used as 35-fold concentrated solution A Was measured. Moreover, the water content of each granulated product (first fraction) used as a raw material for each hemodialysis agent A and each hemodialysis agent A immediately after production was measured. Specific measurement conditions are the same as in Test Example 1.
 結果を表10~13に示す。この結果、塩化マグネシウム、塩化カリウム及び塩化カルシウムを含む造粒物(第1画分)と、酢酸及び酢酸塩(第2画分)を混合した場合(比較例3)では、保存後に、揮発酢酸濃度の上昇、固化、着色が顕著になっていた。これに対して、塩化マグネシウム及び塩化カルシウムを含む造粒物(第1画分)と、塩化カリウム、酢酸及び酢酸塩(第2画分)とを混合した場合(実施例3)では、保存後でも、揮発酢酸濃度の上昇を十分に抑制できており、更に、固化、着色、水に溶解した際のpHの上昇も十分に抑制できていた。また、実施例3及び比較例4のいずれでも、血液透析用A剤の原料として使用した造粒物(第1画分)、及び血液透析用A剤の水分含量は、十分に低い値になっていた。 Results are shown in Tables 10-13. As a result, when a granulated product containing magnesium chloride, potassium chloride and calcium chloride (first fraction), and acetic acid and acetate (second fraction) were mixed (Comparative Example 3), after storage, volatile acetic acid was used. The increase in concentration, solidification, and coloration were remarkable. On the other hand, in the case where a granulated product containing magnesium chloride and calcium chloride (first fraction) and potassium chloride, acetic acid and acetate (second fraction) are mixed (Example 3), after storage However, the increase in the concentration of volatile acetic acid can be sufficiently suppressed, and further, the increase in pH when solidified, colored, or dissolved in water can be sufficiently suppressed. In both Example 3 and Comparative Example 4, the water content of the granulated product (first fraction) used as a raw material for hemodialysis agent A and the hemodialysis agent A is sufficiently low. It was.
Figure JPOXMLDOC01-appb-T000010
Figure JPOXMLDOC01-appb-T000010
Figure JPOXMLDOC01-appb-T000011
Figure JPOXMLDOC01-appb-T000011
Figure JPOXMLDOC01-appb-T000012
Figure JPOXMLDOC01-appb-T000012
Figure JPOXMLDOC01-appb-T000013
Figure JPOXMLDOC01-appb-T000013
試験例3
1.固体状の血液透析用A剤の作製
実施例4
 実施例3で使用した造粒物(第1画分)486kg、塩化カリウム12.4kg、酢酸:酢酸ナトリウムのモル比が1:1の酢酸と酢酸ナトリウムの固体状混合物21.5kg、及びブドウ糖106.4kgをナウタミキサ(製造元:ホソカワミクロン株式会社、型番:DBX-5000RW)に入れ60分混合後、排出し、150.2gを計量し、アルミラミネート層を含む遮湿性包材に入れ密封し、血液透析用A剤を得た。
Test example 3
1. Production of solid A agent for hemodialysis
Example 4
486 kg of the granulated product used in Example 3 (first fraction), 12.4 kg of potassium chloride, 21.5 kg of a solid mixture of acetic acid and sodium acetate having a molar ratio of acetic acid: sodium acetate of 1: 1, and glucose 106 Place 4 kg in Nauta mixer (manufacturer: Hosokawa Micron Corporation, model number: DBX-5000RW), mix for 60 minutes, discharge, weigh 150.2 g, seal in moisture-proof packaging material containing aluminum laminate layer, and hemodialyze A preparation A was obtained.
比較例4
 比較例3で使用した造粒物(第1画分)581kg、酢酸と酢酸ナトリウムの固体状混合物25.7kg、及びブドウ糖127.2kgをナウタミキサ(製造元:ホソカワミクロン株式会社、型番:DBX-5000RW)に入れ60分混合後し排出後、150.2gを計量し、アルミラミネート層を含む遮湿性包材に入れ密封し、血液透析用A剤を得た。
Comparative Example 4
581 kg of granulated product (first fraction) used in Comparative Example 3, 25.7 kg of a solid mixture of acetic acid and sodium acetate, and 127.2 kg of glucose were added to a Nauta mixer (manufacturer: Hosokawa Micron Corporation, model number: DBX-5000RW). After mixing for 60 minutes and discharging, 150.2 g was weighed and sealed in a moisture-proof packaging material containing an aluminum laminate layer to obtain agent A for hemodialysis.
2.血液透析用A剤の評価
 実施例4及び比較例4の血液透析用A剤それぞれについて、40℃/75%RHで保存した際の開始時及び保存1ヵ月の測定結果と、50℃(湿度管理なし)で5日保存後の揮発酢酸濃度の測定、固化と着色の確認、35倍濃縮A液とした時のpH及び5-HMF量の測定を行った。具体的な測定条件は、前記試験例1と同様である。
2. Evaluation of hemodialysis agent A For each of hemodialysis agent A of Example 4 and Comparative Example 4, the measurement results at the start and storage of one month when stored at 40 ° C / 75% RH, and 50 ° C (humidity control) None), the concentration of volatile acetic acid after storage for 5 days, confirmation of solidification and coloring, and the pH and the amount of 5-HMF when a 35-fold concentrated solution A was obtained were measured. Specific measurement conditions are the same as in Test Example 1.
 結果を表14~16に示す。この結果、塩化マグネシウム、塩化カリウム及び塩化カルシウムを含む造粒物(第1画分)と、酢酸及び酢酸塩(第2画分)を混合した場合(比較例4)では、保存後に、揮発酢酸濃度の上昇、固化、着色、水に溶解した際のpHの上昇、ブドウ糖の分解が顕著になっていた。これに対して、塩化マグネシウム及び塩化カルシウムを含む造粒物(第1画分)と、塩化カリウム、酢酸、及び酢酸塩(第2画分)とを混合した場合(実施例4)では、保存後でも、揮発酢酸濃度の上昇を十分に抑制できており、更に、固化、着色、水に溶解した際のpHの上昇、及びブドウ糖の分解も十分に抑制できていた。 Results are shown in Tables 14-16. As a result, when a granulated product containing magnesium chloride, potassium chloride and calcium chloride (first fraction), and acetic acid and acetate (second fraction) were mixed (Comparative Example 4), volatile acetic acid was stored after storage. The increase in concentration, solidification, coloring, increase in pH when dissolved in water, and degradation of glucose were remarkable. On the other hand, when the granulated product containing magnesium chloride and calcium chloride (first fraction) and potassium chloride, acetic acid, and acetate (second fraction) are mixed (Example 4), storage is performed. Even after that, the increase in the concentration of volatile acetic acid was sufficiently suppressed, and further, solidification, coloring, increase in pH when dissolved in water, and decomposition of glucose were also sufficiently suppressed.
Figure JPOXMLDOC01-appb-T000014
Figure JPOXMLDOC01-appb-T000014
Figure JPOXMLDOC01-appb-T000015
Figure JPOXMLDOC01-appb-T000015
Figure JPOXMLDOC01-appb-T000016
Figure JPOXMLDOC01-appb-T000016
製造例
1.固体状の血液透析用A剤の作製
実施例5
 塩化ナトリウム928.8g、塩化カルシウム二水和物32.5g、及び塩化マグネシウム六水和物22.5gをそれぞれ計量し、それぞれを別々のポリ袋に入れ密閉した状態で、送風式棚段乾燥機にて70℃に加温した。加温後、それら原料と、精製水18.0gを一つのポリ袋内に入れ密封し、十分に混合後、再度送風式棚段乾燥機に入れ70℃で20分間静置した。次に、ポリ袋の内容物全てをステンレス製のバットに均一になるよう敷きつめ、130℃の送風式棚段乾燥機に入れ、2時間乾燥した。造粒物が乾燥により固化するため、乾燥中に2度、スプーンで粉砕し、乾燥終了後、目開き2000μmの篩を通過させ、造粒物(第1画分)を作製した。
Production example
1. Production of solid A agent for hemodialysis
Example 5
Weighing 928.8 g of sodium chloride, 32.5 g of calcium chloride dihydrate, and 22.5 g of magnesium chloride hexahydrate, respectively, weighed each in a separate plastic bag, and sealed it in a blow-type shelf dryer At 70 ° C. After heating, these raw materials and 18.0 g of purified water were put in one plastic bag and sealed, and after sufficiently mixing, they were again placed in a blow type shelf dryer and left at 70 ° C. for 20 minutes. Next, the entire contents of the plastic bag were spread uniformly on a stainless steel bat, placed in a 130 ° C. blown shelf dryer and dried for 2 hours. Since the granulated product was solidified by drying, it was pulverized with a spoon twice during drying, and after completion of drying, it was passed through a sieve having an opening of 2000 μm to produce a granulated product (first fraction).
 得られた造粒物(第1画分)118.70g、塩化カリウム27.5g、酢酸:酢酸ナトリウムのモル比が1:1の酢酸と酢酸ナトリウムの固体状混合物(第2画分)5.27g、及びブドウ糖(第2画分)26.25gを計量し、ポリ袋内で十分に混合した後、アルミラミネート層を含む遮湿性包材に入れて密封し、固体状の血液透析用A剤を得た。 4. The resulting granulated product (first fraction) 118.70 g, potassium chloride 27.5 g, acetic acid: sodium acetate molar ratio 1: 1, solid mixture of acetic acid and sodium acetate (second fraction) 27 g and glucose (second fraction) 26.25 g are weighed and mixed thoroughly in a plastic bag, then sealed in a moisture-proof packaging material containing an aluminum laminate layer, and a solid A agent for hemodialysis Got.
実施例6
 塩化ナトリウム928.8g、塩化カルシウム二水和物37.9g、及び塩化マグネシウム六水和物30.0gをそれぞれ計量し、それぞれを別々のポリ袋に入れ密閉した状態で、送風式棚段乾燥機にて70℃に加温した。加温後、それら原料と、精製水18.0gを一つのポリ袋内に入れ密封し、十分に混合後、再度送風式棚段乾燥機に入れ70℃で20分間静置した。次に、ポリ袋の内容物全てをステンレス製のバットに均一になるよう敷きつめ、130℃の送風式棚段乾燥機に入れ、2時間乾燥した。造粒物が乾燥により固化するため、乾燥中に2度、スプーンで粉砕し、乾燥終了後、目開き2000μmの篩を通過させ、造粒物(第1画分)を作製した。
Example 6
Weighing 928.8 g of sodium chloride, 37.9 g of calcium chloride dihydrate, and 30.0 g of magnesium chloride hexahydrate, respectively, weighed each in a separate plastic bag, and sealed it in a blow-type shelf dryer At 70 ° C. After heating, these raw materials and 18.0 g of purified water were put in one plastic bag and sealed, and after sufficiently mixing, they were again placed in a blow type shelf dryer and left at 70 ° C. for 20 minutes. Next, the entire contents of the plastic bag were spread uniformly on a stainless steel bat, placed in a 130 ° C. blown shelf dryer and dried for 2 hours. Since the granulated product was solidified by drying, it was pulverized with a spoon twice during drying, and after completion of drying, it was passed through a sieve having an opening of 2000 μm to produce a granulated product (first fraction).
 得られた造粒物(第1画分)118.70g、塩化カリウム33.0g、酢酸:酢酸ナトリウムのモル比が1:1の酢酸と酢酸ナトリウムの固体状混合物(第2画分)5.27g、及びブドウ糖(第2画分)26.25gを計量し、ポリ袋内で十分に混合した後、アルミラミネート層を含む遮湿性包材に入れて密封し、固体状の血液透析用A剤を得た。 4. The obtained granulated product (first fraction) 118.70 g, potassium chloride 33.0 g, acetic acid: sodium acetate molar ratio 1: 1, solid mixture of acetic acid and sodium acetate (second fraction) 27 g and glucose (second fraction) 26.25 g are weighed and mixed thoroughly in a plastic bag, then sealed in a moisture-proof packaging material containing an aluminum laminate layer, and a solid A agent for hemodialysis Got.

Claims (14)

  1.  第1画分と第2画分を含む固体状の血液透析用A剤であって、
     前記第1画分が、塩化マグネシウム及び塩化カリウムの一方のみを実質的に含み、且つ塩化カルシウムを含む造粒物であり、
     前記第2画分が、酢酸及び酢酸塩を含む、固体状の血液透析用A剤。
    A solid hemodialysis agent A containing a first fraction and a second fraction,
    The first fraction is a granulated product substantially containing only one of magnesium chloride and potassium chloride and containing calcium chloride;
    The solid A agent for hemodialysis, wherein the second fraction contains acetic acid and acetate.
  2.  前記第1画分が塩化マグネシウムを含む、請求項1に記載の固体状の血液透析用A剤。 The solid A agent for hemodialysis according to claim 1, wherein the first fraction contains magnesium chloride.
  3.  前記第1画分が塩化マグネシウムを含み、前記第2画分が塩化カリウムを含む、請求項1又は2に記載の固体状の血液透析用A剤。 The solid A agent for hemodialysis according to claim 1 or 2, wherein the first fraction contains magnesium chloride and the second fraction contains potassium chloride.
  4.  前記第1画分が塩化カリウムを含み、前記第2画分が塩化マグネシウムを含む、請求項1に記載の固体状の血液透析用A剤。 The solid hemodialysis agent A according to claim 1, wherein the first fraction contains potassium chloride and the second fraction contains magnesium chloride.
  5.  前記酢酸及び酢酸塩として酢酸及び酢酸アルカリ金属塩を含む、請求項1~4のいずれかに記載の固体状の血液透析用A剤。 The solid hemodialysis agent A according to any one of claims 1 to 4, comprising acetic acid and an alkali metal acetate as the acetic acid and acetate.
  6.  前記酢酸及び酢酸塩として二酢酸アルカリ金属塩を含む、請求項1~4のいずれかに記載の固体状の血液透析用A剤。 The solid hemodialysis agent A according to any one of claims 1 to 4, comprising an alkali metal diacetate as the acetic acid and the acetate.
  7.  前記酢酸及び酢酸塩として高次酢酸塩化合物を含む、請求項1~4のいずれかに記載の固体状の血液透析用A剤。 The solid hemodialysis agent A according to any one of claims 1 to 4, comprising a higher-order acetate compound as the acetic acid and acetate.
  8.  前記第1画分及び/又は前記第2画分が塩化ナトリウムを含む、請求項1~7のいずれかに記載の固体状の血液透析用A剤。 The solid A agent for hemodialysis according to any one of claims 1 to 7, wherein the first fraction and / or the second fraction contains sodium chloride.
  9.  前記第1画分が塩化ナトリウムを含む、請求項1~8のいずれかに記載の固体状の血液透析用A剤。 The solid A agent for hemodialysis according to any one of claims 1 to 8, wherein the first fraction contains sodium chloride.
  10.  前記第1画分及び/又は前記第2画分がブドウ糖を含む、請求項1~9のいずれかに記載の固体状の血液透析用A剤。 10. The solid hemodialysis agent A according to claim 1, wherein the first fraction and / or the second fraction contains glucose.
  11.  前記第2画分がブドウ糖を含む、請求項1~10のいずれかに記載の固体状の血液透析用A剤。 The solid A agent for hemodialysis according to any one of claims 1 to 10, wherein the second fraction contains glucose.
  12.  請求項1~11のいずれかに記載の固体状の血液透析用A剤、及び重炭酸ナトリウムを含む血液透析用B剤を含む、2剤型の血液透析用剤。 A two-agent type hemodialysis agent comprising the solid hemodialysis agent A according to any one of claims 1 to 11 and a hemodialysis agent B containing sodium bicarbonate.
  13.  塩化ナトリウムを含まない、請求項1~7、10及び11のいずれかに示す固体状の血液透析用A剤と、
     塩化ナトリウムを含む血液透析用S剤と、
     重炭酸ナトリウムを含む血液透析用B剤と、
    を含む、3剤型の血液透析用剤。
    A solid hemodialysis agent A according to any one of claims 1 to 7, 10 and 11, which does not contain sodium chloride,
    S-agent for hemodialysis containing sodium chloride,
    B agent for hemodialysis containing sodium bicarbonate;
    A three-drug hemodialysis agent.
  14.  塩化マグネシウム及び塩化カリウムの一方のみを実質的に含み、且つ塩化カルシウムを含む造粒物を調製する第1工程、及び
     前記第1工程で得られた造粒物と、酢酸及び酢酸塩とを含む固体状の血液透析用A剤を得る第2工程
    を含む、固体状の血液透析用A剤の製造方法。
    A first step of preparing a granulated product substantially containing only one of magnesium chloride and potassium chloride and containing calcium chloride; and a granulated product obtained in the first step; and acetic acid and acetate. A method for producing a solid hemodialysis agent A, comprising a second step of obtaining a solid hemodialysis agent A.
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CN109890370A (en) 2019-06-14

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