title: Effect of lanthanum carbonate vs. calcium carbonate on serum calcium in hemodialysis patients: a crossover study.
abstract: 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.
  
  
  CONCLUSIONS
  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).
authors.affiliation: Chiyoda Hospital, Japan. t.toida@fc.miyazaki-u.ac.jp
authors.forename: Tatsunori
authors.initials: T
authors.lastname: Toida
authors.forename: Keiichi
authors.initials: K
authors.lastname: Fukudome
authors.forename: Shouichi
authors.initials: S
authors.lastname: Fujimoto
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yamada
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sato
authors.forename: Susumu
authors.initials: S
authors.lastname: Chiyotanda
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kitamura
mesh_terms: D000135:Acid Phosphatase / Q000097:blood; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D000704:Analysis of Variance; D002118:Calcium / Q000097:blood*; D002119:Calcium Carbonate / Q000627:therapeutic use*; D002614:Chelating Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D018592:Cross-Over Studies; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology / Q000517:prevention & control; D054559:Hyperphosphatemia / Q000209:etiology / Q000517:prevention & control; D007527:Isoenzymes / Q000097:blood; D007811:Lanthanum / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000150:complications / Q000628:therapy; D000071681:Tartrate-Resistant Acid Phosphatase; D014807:Vitamin D / Q000008:administration & dosage
chemical_list: D002614:Chelating Agents; C000717427:FGF23 protein, human; D007527:Isoenzymes; D010281:Parathyroid Hormone; D014807:Vitamin D; D010758:Phosphorus; C119467:lanthanum carbonate; D005346:Fibroblast Growth Factors; D007811:Lanthanum; D000089703:Fibroblast Growth Factor-23; D000469:Alkaline Phosphatase; D000135:Acid Phosphatase; D000071681:Tartrate-Resistant Acid Phosphatase; D002119:Calcium Carbonate; D002118:Calcium