Lanthanum carbonate provides control of phosphorus levels in patients new to phosphate binder therapy and patients changed from other phosphate binders.
OBJECTIVE
This retrospective study examined whether patients in an outpatient clinical setting with chronic kidney disease (CKD) stage 5, and who were either new to phosphate binder treatment or were previously treated with other phosphate binders, received benefit from treatment with lanthanum carbonate (LC).


METHODS
This was a retrospective analysis of patient records.


METHODS
Patients were treated at the Western New York Dialysis Center, LLC (Orchard Park, NY).


METHODS
Patients (n = 33) were identified through records as having CKD stage 5 and currently receiving or about to begin dialysis treatment. Naive patients (n = 16) had serum phosphorus levels >5.5 mg/dL and did not have previous exposure to phosphate binder treatment. "Changed" patients (n = 17) were treated with sevelamer hydrochloride or calcium-based binders before changing treatment to LC.


METHODS
Patients received 500 to 1,500 mg LC thrice daily as needed, to achieve serum phosphorus levels ≤5.5 mg/dL.


RESULTS
Serum phosphorus control with LC was rapid (within 1 month) and sustained (after 6 months) in 81% of naive patients; serum albumin levels were maintained at 3.61 ± 0.28 g/dL over a period of 13.81 ± 8.4 months. Treatment with LC maintained serum phosphorus control after 10 to 12 months in 65% of patients in whom treatment was changed from other phosphate binders; serum albumin levels were maintained at 3.78 ± 0.35 g/dL after the change.


CONCLUSIONS
In this clinical setting, outpatients treated with LC maintained serum phosphorus control and serum albumin levels, suggesting that LC may be effective as an alternative to other phosphate binders or as first-line therapy for controlling serum phosphorus for ≤6 months in patients with CKD stage 5 beginning dialysis.
Noto
Linda
L
Western New York Dialysis Centers, LLC, Orchard Park, New York, USA. lpanda11@bluefrog.com
D000085:Acetates / Q000378:metabolism; D000368:Aged; D000369:Aged, 80 and over; D002119:Calcium Carbonate / Q000378:metabolism; D017610:Calcium Compounds / Q000378:metabolism; D002614:Chelating Agents / Q000627:therapeutic use*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D007811:Lanthanum / Q000008:administration & dosage*; D008875:Middle Aged; D009518:New York; D009752:Nutritional Status; D010710:Phosphates / Q000378:metabolism*; D010758:Phosphorus / Q000097:blood*; D011073:Polyamines / Q000627:therapeutic use; D006435:Renal Dialysis; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis; D000069603:Sevelamer; D016896:Treatment Outcome
D000085:Acetates; D017610:Calcium Compounds; D002614:Chelating Agents; D010710:Phosphates; D011073:Polyamines; D012709:Serum Albumin; D010758:Phosphorus; C119467:lanthanum carbonate; D007811:Lanthanum; D000069603:Sevelamer; D002119:Calcium Carbonate; C120662:calcium acetate