title: Effects of switch from sevelamer hydrochloride to lanthanum carbonate on serum K and bone metabolic turnover.
abstract: Effects of switch from sevelamer hydrochloride (Sev) to lanthanum carbonate (La) on serum potassium (K) and bone metabolic markers in maintenance dialysis patients were examined. A switch from Sev to La was made for 14 dialysis patients (mean dialysis period and age: 65.3 months and 58.5 years old) to examine changes of biochemical and bone metabolic markers after 8 weeks. The Sev dosage immediately before the switch was 1857 ± 1325 mg/day, and the La dosage 8 weeks after the switch was 821 ± 301 mg/day. The serum calcium (Ca) level, which was 8.9 mg/dL before the switch, increased to 9.5 mg/dL after the switch (P < 0.05) whereas there was no change in the serum phosphorus level (P levels) or the calcium × phosphorus product. A decrease in the serum K level (4.6 vs. 4.4 mEq/L, P < 0.05), an increase in the total cholesterol level (131 vs. 142 mg/dL, P < 0.05), and a decrease in the serum ALP level (334.5 vs. 282 IU/L, P < 0.05) were observed, but there was no change in the intact parathyroid hormone (PTH) level. A significant negative correlation between the HCO3 level and the serum K level before dialysis was observed. These results suggest that a switch from Sev to La provided a decrease in the serum K level and normalization of bone metabolic markers, which was not mediated by PTH.
authors.affiliation: Department of Blood Purification Therapy, Toyama City Hospital, Imaizumi Hokubu-machi 2-1, Toyama City, Japan. oota@tch.toyama.toyama.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ota
authors.forename: Masayo
authors.initials: M
authors.lastname: Hirose
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Izumiya
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Ishida
mesh_terms: D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D001639:Bicarbonates / Q000097:blood; D016723:Bone Remodeling / Q000187:drug effects*; D001842:Bone and Bones / Q000187:drug effects / Q000378:metabolism; D002118:Calcium / Q000097:blood; D002784:Cholesterol / Q000097:blood; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007811:Lanthanum / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D011073:Polyamines / Q000008:administration & dosage / Q000627:therapeutic use*; D011188:Potassium / Q000097:blood*; D006435:Renal Dialysis / Q000379:methods; D000069603:Sevelamer
chemical_list: D001639:Bicarbonates; D010281:Parathyroid Hormone; D011073:Polyamines; D010758:Phosphorus; C119467:lanthanum carbonate; D007811:Lanthanum; D002784:Cholesterol; D000069603:Sevelamer; D000469:Alkaline Phosphatase; D011188:Potassium; D002118:Calcium