PURPOSE: We conducted this review to assess the relative efficacy and safety of lanthanum carbonate versus calcium-based phosphate binders in chronic kidney disease.
METHODS: We systematically searched PubMed, EMBASE, the Cochrane Controlled Trial Register of Controlled Trials and Chinese Biological Medical Database for randomized controlled trials comparing lanthanum carbonate with calcium-based phosphate binders in adult patients with chronic kidney disease. Study quality was assessed using the criteria outlined in the Cochrane Handbook for Systematic Reviews of intervention. Meta-analysis was conducted by reviewer manager software, version 5.3.
RESULTS: Eleven trials with 1,501 participants were included. Lanthanum carbonate appeared to be associated with a significant reduction in progression of vascular calcification and a beneficial effect on bone outcomes without aluminum-like toxicity. Lanthanum carbonate achieved similar proportions of phosphate-controlled patients (RR 0.63, 95 % CI 0.27-1.44) with lower incidence of hypercalcemia (RR 0.13, 95 % CI 0.05-0.35) in comparison with calcium-based phosphate binders. Lanthanum carbonate was associated with significantly lower serum calcium, similar serum Ca × P product and higher serum iPTH compared with calcium salts in patients with chronic kidney disease.
CONCLUSION: Lanthanum carbonate could delay the progression of vascular calcification and benefit chronic kidney disease patients on bone outcomes. Lanthanum carbonate could achieve similar proportion of phosphate-controlled patients as calcium-based phosphate binders with lower incidence of hypercalcemia.
Written by:
Zhai CJ, Yang XW, Sun J, Wang R. Are you the author?
Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, 250021, China.
Reference: Int Urol Nephrol. 2014 Nov 16. Epub ahead of print.
doi: 10.1007/s11255-014-0876-x
PubMed Abstract
PMID: 25399356