Safety and Effectiveness of Lanthanum Carbonate for Hyperphosphatemia in Chronic Kidney Disease (CKD) Patients: a Meta-analysis

Overview

Journal Ren Fail

Publisher Informa Healthcare

Date 2021 Oct 4

PMID 34602015

Citations 1

Authors

Lijuan Zhao

An Liu

Guoshuang Xu

Affiliations

Soon will be listed here.

Abstract

Objective: The aim of this study was to determine the efficacy and safety of lanthanum carbonate (LC) versus calcium salts, non-LC phosphate binders (PBs), sevelamer, or placebo in patients with chronic kidney disease (CKD).

Materials And Methods: A literature search on PubMed, Embase, and Cochrane Library databases was conducted up to 18 June 2021. Data acquisition and quality assessment were performed by two reviewers. Meta-analysis was performed to evaluate the serum biochemical parameters, adverse events, and patient-level outcomes of LC, non-LC PBs, and sevelamer for hyperphosphatemia in patients with CKD. Heterogeneity across studies was assessed utilizing the statistic and -test, and a random effect model was selected to calculate the pooled effect size.

Results: A total of 26 randomized, controlled trials and 3 observational studies were included. Compared to the other groups, better control effect of serum phosphorus (RR = 2.68, < 0.001), reduction in serum phosphorus (95%CI = -1.93, -0.99; < 0.001), Ca × P (95%CI = -13.89, -2.99; = 0.002), serum intact parathyroid hormone levels (95%CI = -181.17, -3.96, = 0.041) were found in LC group. Besides, reduced risk of various adverse effects, such as hypotension, abdominal pain, diarrhea, dyspepsia, and a score of coronary artery calcification were identified with LC in comparison to calcium salt, non-LC PBs, or placebo group. Significantly lower risk in mortality with LC treatment vs. non-LC PBs was observed, while no significant difference was identified between LC and calcium salt groups.

Conclusion: LC might be an alternative treatment for hyperphosphatemia in patients with CKD considering its comprehensive curative effect.

Citing Articles

Effects of the novel sodium-dependent phosphate cotransporter 2b inhibitor DZ1462 on hyperphosphatemia in chronic kidney disease.

Lu X, Yu L, Guo Q, Zhang L, Jiang S Am J Transl Res. 2024; 16(3):768-780.

PMID: 38586086 PMC: 10994808. DOI: 10.62347/UGTW5471.

References

Scaria P, Gangadhar R, Pisharody R . Effect of lanthanum carbonate and calcium acetate in the treatment of hyperphosphatemia in patients of chronic kidney disease. Indian J Pharmacol. 2010; 41(4):187-91. PMC: 2875739. DOI: 10.4103/0253-7613.56074. View

Joy M, Finn W . Randomized, double-blind, placebo-controlled, dose-titration, phase III study assessing the efficacy and tolerability of lanthanum carbonate: a new phosphate binder for the treatment of hyperphosphatemia. Am J Kidney Dis. 2003; 42(1):96-107. DOI: 10.1016/s0272-6386(03)00554-7. View

Xu J, Zhang Y, Yu X, Liu Z, Wang L, Chen J . Lanthanum carbonate for the treatment of hyperphosphatemia in CKD 5D: multicenter, double blind, randomized, controlled trial in mainland China. BMC Nephrol. 2013; 14:29. PMC: 3570485. DOI: 10.1186/1471-2369-14-29. View

Zhang C, Wang S, Zhao S, Zhang X . Effect of lanthanum carbonate on coronary artery calcification and bone mineral density in maintenance hemodialysis patients with diabetes complicated with adynamic bone disease: A prospective pilot study. Medicine (Baltimore). 2017; 96(45):e8664. PMC: 5690800. DOI: 10.1097/MD.0000000000008664. View

Jamal S, Vandermeer B, Raggi P, Mendelssohn D, Chatterley T, Dorgan M . Effect of calcium-based versus non-calcium-based phosphate binders on mortality in patients with chronic kidney disease: an updated systematic review and meta-analysis. Lancet. 2013; 382(9900):1268-77. DOI: 10.1016/S0140-6736(13)60897-1. View

Sprague S, Abboud H, Qiu P, Dauphin M, Zhang P, Finn W . Lanthanum carbonate reduces phosphorus burden in patients with CKD stages 3 and 4: a randomized trial. Clin J Am Soc Nephrol. 2008; 4(1):178-85. PMC: 2615694. DOI: 10.2215/CJN.02830608. View

Lee Y, Choi H, Shin S, Lee H . Effect of lanthanum carbonate on phosphate control in continuous ambulatory peritoneal dialysis patients in Korea: a randomized prospective study. Clin Nephrol. 2012; 79(2):136-42. DOI: 10.5414/CN107362. View

Hutchison A, Maes B, Vanwalleghem J, Asmus G, Mohamed E, Schmieder R . Efficacy, tolerability, and safety of lanthanum carbonate in hyperphosphatemia: a 6-month, randomized, comparative trial versus calcium carbonate. Nephron Clin Pract. 2005; 100(1):c8-19. DOI: 10.1159/000084653. View

Minakuchi H, Yoshida T, Kaburagi N, Fujino T, Endo S, Takemitsu T . Proton pump inhibitors may hinder hypophosphatemic effect of lanthanum carbonate, but not of ferric citrate hydrate or sucroferric oxyhydroxide, in hemodialysis patients. Ren Fail. 2020; 42(1):799-806. PMC: 7472469. DOI: 10.1080/0886022X.2020.1803085. View

10.

Shang D, Xie Q, Ge X, Yan H, Tian J, Kuang D . Hyperphosphatemia as an independent risk factor for coronary artery calcification progression in peritoneal dialysis patients. BMC Nephrol. 2015; 16:107. PMC: 4506628. DOI: 10.1186/s12882-015-0103-8. View

11.

Cozzolino M, Mazzaferro S, Brandenburg V . The treatment of hyperphosphataemia in CKD: calcium-based or calcium-free phosphate binders?. Nephrol Dial Transplant. 2010; 26(2):402-7. DOI: 10.1093/ndt/gfq691. View

12.

Stang A . Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010; 25(9):603-5. DOI: 10.1007/s10654-010-9491-z. View

13.

Sturtevant J, Hawley C, Reiger K, Johnson D, Campbell S, Burke J . Efficacy and side-effect profile of sevelamer hydrochloride used in combination with conventional phosphate binders. Nephrology (Carlton). 2005; 9(6):406-13. DOI: 10.1111/j.1440-1797.2004.00338.x. View

14.

Spasovski G, Sikole A, Gelev S, Masin-Spasovska J, Freemont T, Webster I . Evolution of bone and plasma concentration of lanthanum in dialysis patients before, during 1 year of treatment with lanthanum carbonate and after 2 years of follow-up. Nephrol Dial Transplant. 2006; 21(8):2217-24. DOI: 10.1093/ndt/gfl146. View

15.

Komaba H, Kakuta T, Suzuki H, Hida M, Suga T, Fukagawa M . Survival advantage of lanthanum carbonate for hemodialysis patients with uncontrolled hyperphosphatemia. Nephrol Dial Transplant. 2014; 30(1):107-14. DOI: 10.1093/ndt/gfu335. View

16.

Asmus H, Braun J, Krause R, Brunkhorst R, Holzer H, Schulz W . Two year comparison of sevelamer and calcium carbonate effects on cardiovascular calcification and bone density. Nephrol Dial Transplant. 2005; 20(8):1653-61. DOI: 10.1093/ndt/gfh894. View

17.

Bervoets A, Behets G, Schryvers D, Roels F, Yang Z, Verberckmoes S . Hepatocellular transport and gastrointestinal absorption of lanthanum in chronic renal failure. Kidney Int. 2008; 75(4):389-98. DOI: 10.1038/ki.2008.571. View

18.

Wilson R, Zhang P, Smyth M, Pratt R . Assessment of survival in a 2-year comparative study of lanthanum carbonate versus standard therapy. Curr Med Res Opin. 2009; 25(12):3021-8. DOI: 10.1185/03007990903399398. View

19.

Damment S, Pennick M . Clinical pharmacokinetics of the phosphate binder lanthanum carbonate. Clin Pharmacokinet. 2008; 47(9):553-63. DOI: 10.2165/00003088-200847090-00001. View

20.

Prajapati V, Galani V, Shah P . A comparative study of phosphate binders in patients with end stage kidney disease undergoing hemodialysis. Saudi J Kidney Dis Transpl. 2014; 25(3):530-8. DOI: 10.4103/1319-2442.132167. View