title: Lanthanum carbonate for hyperphosphatemia in patients on peritoneal dialysis.
abstract: BACKGROUND
  The efficacy of the phosphate binder lanthanum carbonate has been demonstrated for hemodialysis patients, but no studies have focused on patients undergoing continuous ambulatory peritoneal dialysis (CAPD). We evaluated whether lanthanum carbonate could control phosphate levels in patients on CAPD. ♢
  
  
  METHODS
  In this 48-week open-label prospective study, 28 patients on CAPD with a phosphate level of 6 mg/dL or greater were given lanthanum carbonate titrated from 750 mg to 2250 mg daily to achieve a target serum phosphate level of less than 6 mg/dL. The primary efficacy endpoint was reduction of serum phosphate to less than 6 mg/dL. Serum levels of calcium and parathyroid hormone were also evaluated, as were the Ca×P product and adverse effects. ♢
  
  
  RESULTS
  From week 4 to the end of the study at week 48, we observed a significant reduction of serum phosphate to 5.25 ± 0.97 mg/dL from 6.88 ± 1.06 mg/dL at study start (p < 0.01). At the end of the study, 78.6% of participants had achieved the target of less than 6 mg/dL. Because no change of serum calcium occurred, the Ca×P product declined significantly during the study. Intact parathyroid hormone declined gradually over the study period, but the change had not reached significance at the end of the study (p = 0.11). The mean final dose of lanthanum carbonate was 946 mg daily. The only adverse effect reported was mild nausea in 1 patient. ♢
  
  
  CONCLUSIONS
  Lanthanum carbonate is an effective phosphate binder that can control serum phosphate and Ca×P product in CAPD patients with hyperphosphatemia. Lanthanum carbonate was well tolerated in our population.
authors.affiliation: Division of Nephrology, Murakami Memorial Hospital, Asahi University, Gifu 500-8523 Japan. mohno@murakami.asahi-u.ac.jp
authors.forename: Michiya
authors.initials: M
authors.lastname: Ohno
authors.forename: Hiroshige
authors.initials: H
authors.lastname: Ohashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Oda
authors.forename: Haruko
authors.initials: H
authors.lastname: Yokoyama
authors.forename: Miho
authors.initials: M
authors.lastname: Okada
authors.forename: Mayu
authors.initials: M
authors.lastname: Nagaya
authors.forename: Kumiko
authors.initials: K
authors.lastname: Izumi
authors.forename: Hitomi
authors.initials: H
authors.lastname: Ito
authors.forename: Shuji
authors.initials: S
authors.lastname: Katoh
mesh_terms: D000368:Aged; D002118:Calcium / Q000097:blood; D002614:Chelating Agents / Q000627:therapeutic use; D000069449:Cinacalcet; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D054559:Hyperphosphatemia / Q000188:drug therapy*; D007676:Kidney Failure, Chronic / Q000628:therapy; D007811:Lanthanum / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000627:therapeutic use; D010281:Parathyroid Hormone / Q000097:blood; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011073:Polyamines / Q000627:therapeutic use; D011446:Prospective Studies; D000069603:Sevelamer
chemical_list: D002614:Chelating Agents; D009281:Naphthalenes; D010281:Parathyroid Hormone; D011073:Polyamines; C119467:lanthanum carbonate; D007811:Lanthanum; D000069603:Sevelamer; D002118:Calcium; D000069449:Cinacalcet