Lanthanum Carbonate Delays Progression of Coronary Artery Calcification Compared With Calcium-Based Phosphate Binders in Patients on Hemodialysis

Ohtake, Takayasu; Kobayashi, Shuzo; Oka, Machiko; Furuya, Rei; Iwagami, Masao; Tsutsumi, Daimu; Mochida, Yasuhiro; Maesato, Kyoko; Ishioka, Kunihiro; Moriya, Hideshige; Hidaka, Sumi

doi:10.1177/1074248413486355

Cited by 40 publications

(41 citation statements)

References 34 publications

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“…The potential explanation for the mortality decrease associated with the use of non-calcium-based binders might be related to slowing vascular calcification. This is also supported by additional evidence which suggest that switching phosphate binder from calcium carbonate to lanthanum carbonate delayed the progression of calcium calcification in patients on HD 24 .…”

Section: The Control Of Hyperphosphatemia: Oral Phosphate-binding Drugssupporting

confidence: 70%

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Hyperphosphatemia and phosphate binders: effectiveness and safety

Kalaitzidis

Elisaf

2013

Current Medical Research and Opinion

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Section: The Control Of Hyperphosphatemia: Oral Phosphate-binding Drugssupporting

confidence: 70%

“…Lanthanum carbonate, which is a non-aluminum-and non-calcium-containing phosphorus binder, has confirmed long-term safety 24,25 . Its main excretion route is through the bile, and it is thought to be advantageous for patients with renal insufficiency.…”

Section: Safety and Tolerability Considerationsmentioning

confidence: 99%

Hyperphosphatemia and phosphate binders: effectiveness and safety

Kalaitzidis

Elisaf

2013

Current Medical Research and Opinion

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“…In recent years, the association between PTH and CAC has become a research hotspot. The results of previous studies suggested that PTH levels were not associated with the baseline CAC score (CACS), but with CAC progression (7)(8)(9)(10)(11). All of the patients included in these studies suffered from kidney failure with or without hemodialysis.…”

Section: Introductionmentioning

confidence: 92%

Correlation between serum parathyroid hormone levels and coronary artery calcification in patients without renal failure

et al. 2016

Biomedical Reports

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Abstract. The aim of the present study was to investigate the correlation between serum parathyroid hormone (PTH) levels and coronary artery calcification (CAC) in patients without renal failure, as well as to determine independent risk factors of CAC score (CACS). A total of 157 patients who underwent coronary computed tomography angiographic examination at the 101th Hospital of the People's Liberation Army between December 2013 and February 2015 were retrospectively evaluated. The correlation between PTH levels and CACS was determined using a Pearson correlation analysis. A receiver operating characteristic (ROC) curve was drawn to determine the best cutoff PTH level for prediction of CAC. The independent association between serum PTH levels and CAC was analyzed by using a logistic regression analysis model with the response variable Be binary class. The results revealed that PTH levels in patients in the CAC group were significantly higher than those of patients in the non-calcification group. PTH levels were positively correlated with CACS (r=0.288, P<0.001). The ROC curve suggested that a PTH level of ≥31.05 pg/ml was the best cut-off point for the prediction of CAC, with a sensitivity of 80.88%, specificity of 60.67% and an area under the curve of 0.761. After including predictive factors for CAC (gender, age, smoking status, diabetes, hypertension, hyperlipidemia, body mass index, glomerular filtration rate and calcium, phosphorus, calcium-phosphorus product, magnesium, PTH, total cholesterol, low-density lipoprotein cholesterol, triglyceride, high-density lipoprotein cholesterol and C-reactive protein levels), the odds ratio of the serum PTH levels regarding the prediction of CAC was 1.050 (95% confidence interval, 1.027-1.074; P<0.001). In conclusion, the present study suggested that serum PTH levels are correlated with CAC in patients without renal failure and may thus be used as a reliable predictor of CAC.

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“…We performed a prospective randomized interventional study that compared the effect of lanthanum carbonate and calcium carbonate on the progression of CAC (Fig. 6) [98]. Treatment with lanthanum carbonate was more effective compared to calcium carbonate in preventing the progression of CAC in patients on hemodialysis; regression by 6.4% was shown in the lanthanum-treated group vs. 41.2% progression in those receiving calcium carbonate.…”

Section: Phosphate Bindersmentioning

confidence: 99%

“…Several clinical trials expected the beneficial inhibitory effect of sevelamer hydrochloride on the [96,97]. There are several studies that compared the effect of lanthanum carbonate on vascular calcification with calcium-based phosphate binders [98][99][100][101]. We performed a prospective randomized interventional study that compared the effect of lanthanum carbonate and calcium carbonate on the progression of CAC (Fig.…”

Section: Phosphate Bindersmentioning

confidence: 99%

Impact of vascular calcification on cardiovascular mortality in hemodialysis patients: clinical significance, mechanisms and possible strategies for treatment

Ohtake

Kobayashi

2017

Ren Replace Ther

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Vascular calcification has now been recognized as a major problem in dialysis patients because of its strong influence on the prognosis. Along with the regulatory failure of calcification-inhibitory system, active phenotypic change of vascular smooth muscle cells (VSMCs) to osteoblast-like cells is also involved in the progression of vascular calcification. Delaying or improving the vascular calcification is thought to be very important to improve the cardiovascular mortality in dialysis patients. Several interventional trials against vascular calcification using non-calcium-containing phosphate binders, low-dose active vitamin D plus cinacalcet, modification of dialysate calcium concentration, and sodium thiosulfate have been done, and some trials including non-calcium-containing phosphate binders showed beneficial effect on delaying vascular calcification in dialysis patients. However, delaying or improving vascular calcification has not been clearly proved to result in improved cardiovascular event and/or mortality rate by prospective interventional randomized controlled trials in dialysis patients. Whether the improvement of vascular calcification could directly lead to the improvement of survival is an urgent issue of clinical trials in dialysis patients.

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Lanthanum Carbonate Delays Progression of Coronary Artery Calcification Compared With Calcium-Based Phosphate Binders in Patients on Hemodialysis

Abstract: This pilot study suggested that LC delayed progression of CAC in patients on HD compared with CC.

Cited by 40 publications

References 34 publications

Hyperphosphatemia and phosphate binders: effectiveness and safety

Hyperphosphatemia and phosphate binders: effectiveness and safety

Correlation between serum parathyroid hormone levels and coronary artery calcification in patients without renal failure

Impact of vascular calcification on cardiovascular mortality in hemodialysis patients: clinical significance, mechanisms and possible strategies for treatment

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