title: Effects of switching from calcium carbonate to lanthanum carbonate on bone mineral metabolism in hemodialysis patients.
abstract: Phosphate binders are useful for the treatment of hyperphosphatemia in hemodialysis (HD) patients. This study was performed to examine the effects of switching from calcium carbonate (CC) to lanthanum carbonate (LC) on bone mineral metabolism and inflammatory markers in HD patients. We conducted 29 stable HD patients receiving CC, which was replaced by LC and followed-up for 12 weeks. Patients underwent determinants of blood chemistries such as serum calcium (Ca), phosphorus, parathyroid hormone (PTH) and vitamin D status, and interleukin-6 (IL-6) mRNA levels in whole blood cells were evaluated by real-time PCR just before and after the treatment with LC. Corrected Ca [corrected] levels were significantly reduced, but serum phosphorus levels (P levels) were unchanged after LC treatment. Switching to LC increased whole-PTH, osteocalcin, 1,25(OH)(2) D(3) levels and 1,25(OH)(2) D(3)/25(OH)D(3) ratio. 1,25(OH)(2) D(3)/25(OH)D(3) ratio was negatively correlated with HD duration. Furthermore, whole blood cell IL-6 mRNA levels were significantly reduced by LC treatment. We provided that the switching from CC to LC improved Ca overload and ameliorated vitamin D and inflammatory status in HD patients. These observations suggest that LC may play a protective role for the progression of atherosclerosis and vascular calcification in these patients.
authors.affiliation: Division of Nephrology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume city, Fukuoka, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Manabe
authors.forename: Kei
authors.initials: K
authors.lastname: Fukami
authors.forename: Ryotaro
authors.initials: R
authors.lastname: Ando
authors.forename: Kazuko
authors.initials: K
authors.lastname: Sakai
authors.forename: Takuo
authors.initials: T
authors.lastname: Kusumoto
authors.forename: Takuma
authors.initials: T
authors.lastname: Hazama
authors.forename: Takeki
authors.initials: T
authors.lastname: Adachi
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kaida
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Nakayama
authors.forename: Seiji
authors.initials: S
authors.lastname: Ueda
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kohno
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Wada
authors.forename: Sho-ichi
authors.initials: S
authors.lastname: Yamagishi
authors.forename: Seiya
authors.initials: S
authors.lastname: Okuda
mesh_terms: D000368:Aged; D001842:Bone and Bones / Q000187:drug effects* / Q000378:metabolism; D002118:Calcium / Q000097:blood; D002119:Calcium Carbonate / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000188:drug therapy / Q000209:etiology; D015850:Interleukin-6 / Q000378:metabolism; D007811:Lanthanum / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D011446:Prospective Studies; D012333:RNA, Messenger / Q000378:metabolism; D060888:Real-Time Polymerase Chain Reaction; D006435:Renal Dialysis / Q000379:methods*; D014807:Vitamin D / Q000097:blood
chemical_list: D015850:Interleukin-6; D010281:Parathyroid Hormone; D012333:RNA, Messenger; D014807:Vitamin D; D010758:Phosphorus; C119467:lanthanum carbonate; D007811:Lanthanum; D002119:Calcium Carbonate; D002118:Calcium