Effect of lanthanum carbonate vs. calcium carbonate on serum calcium in hemodialysis patients: a crossover study

Autor: Shouichi Fujimoto, Tatsunori Toida, Kazuhiro Yamada, Kazuo Kitamura, Yuji Sato, Keiichi Fukudome, Susumu Chiyotanda
Rok vydání: 2012
Předmět:
Male
medicine.medical_specialty
medicine.drug_class
medicine.medical_treatment
Acid Phosphatase
chemistry.chemical_element
Calcium
Gastroenterology
Bone remodeling
Calcium Carbonate
Hyperphosphatemia
Lanthanum
Renal Dialysis
Internal medicine
medicine
Vitamin D and neurology
Humans
Renal Insufficiency
Chronic
Vitamin D
Aged
Chelating Agents
Analysis of Variance
Chi-Square Distribution
Cross-Over Studies
business.industry
Tartrate-Resistant Acid Phosphatase
nutritional and metabolic diseases
Phosphorus
General Medicine
Middle Aged
medicine.disease
Alkaline Phosphatase
Crossover study
Phosphate binder
Fibroblast Growth Factors
Isoenzymes
Lanthanum carbonate
Fibroblast Growth Factor-23
Biochemistry
chemistry
Nephrology
Parathyroid Hormone
Hypercalcemia
Female
Hemodialysis
business
medicine.drug
Zdroj: Clinical nephrology. 78(3)
ISSN: 0301-0430
Popis: Background Lanthanum carbonate (LC) is a non-calcium-containing phosphate binder and shows a comparable effect with other phosphate binders on hyperphosphatemia in dialysis patients. LC also contributes to a reduced oral calcium load compared with calcium carbonate (CaC) treatment. However, no crossover studies which compare the influence on serum calcium level between treatments with LC and CaC in hemodialysis (HD) patients have been carried out. Methods After washout for 2 weeks, 50 patients on HD were randomized (1 : 1) to receive LC or CaC for 3 months. Thereafter, patients underwent a second 2-week washout period and were switched to the alternative binder for the next 3 months. Mineral and bone metabolism markers were measured with the changes of vitamin D doses. Results The serum phosphate level showed a similar decrease from baseline to 3 months in both groups. During the study periods, hypercalcemia was observed only in patients taking CaC. The dose of vitamin D analogue was increased more frequently in the patients of the LC group compared with LC group. The iPTH level showed a significant decrease in the CaC group, but not in the LC group. Serum levels of BAP, TRAP5b, and ALP were significantly elevated in the LC group, whereas the FGF-23 level showed a significant decrease. Conclusion LC effectively reduced the serum phosphate level (like CaC) and allowed the vitamin D analogue dosage to be increased without hypercalcemia in HD patients. LC is one of the useful phosphate binders without hypercalcemia. (UMIN-CTR registration number: UMIN000002331).
Databáze: OpenAIRE
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