title: The effect of phosphate binders, calcium and lanthanum carbonate on FGF23 levels in chronic kidney disease patients.
abstract: BACKGROUND
  Recent publications show that elevation of FGF23 is independently associated with progression or renal disease, left ventricular hypertrophy and cardiovascular mortality. Dietary restriction of phosphate and phosphate binders are used for control phosphate balance and elevation of serum FGF23 levels. The aim of this study is to compare the effectiveness of calcium carbonate vs. lanthanum carbonate in reducing serum FGF23 levels in Chronic Kidney Disease (CKD) patients.
  
  
  METHODS
  32 patients from the Nephrology outpatient clinic with CKD 4 - 5 non-dialysis were included. Patients receive a 4-month treatment period of calcium carbonate or lanthanum carbonate. Patients had normal serum calcium concentration, 25 (OH) levels >30 ng/ml and they were not on VDR activators or cinacalcet.
  
  
  RESULTS
  As compared with calcium carbonate, patients on lanthanum carbonate had lower serum levels of FGF23 (226 ± 11 vs. 158 ± 9 pg/ml) and less urinary excretion of phosphate. No significant changes in serum calcium and PTH levels were observed in both groups.
  
  
  CONCLUSIONS
  In conclusion, in CKD 4 - 5 patients lanthanum carbonate is effective in reducing phosphate load and FGF23 levels; this effect was not observed with calcium carbonate.
authors: Reina Sofia University Hospital, Spain. maria.soriano.sspa@juntadeandalucia.es
authors: Sagrario
authors: S
authors: Soriano
authors: Raquel
authors: R
authors: Ojeda
authors: Mencarnación
authors: M
authors: Rodríguez
authors: Yolanda
authors: Y
authors: Almadén
authors: Mariano
authors: M
authors: Rodríguez
authors: Alejandro
authors: A
authors: Martín-Malo
authors: Pedro
authors: P
authors: Aljama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000097:blood; D002119:Calcium Carbonate / Q000627:therapeutic use*; D002614:Chelating Agents / Q000627:therapeutic use*; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D006801:Humans; D007811:Lanthanum / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000097:blood / Q000652:urine; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000188:drug therapy* / Q000652:urine; D018709:Statistics, Nonparametric; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood
chemical_list: D002614:Chelating Agents; C000717427:FGF23 protein, human; D010281:Parathyroid Hormone; D010710:Phosphates; D014807:Vitamin D; C119467:lanthanum carbonate; D005346:Fibroblast Growth Factors; D007811:Lanthanum; D000089703:Fibroblast Growth Factor-23; C104450:25-hydroxyvitamin D; D002119:Calcium Carbonate; D002118:Calcium