title: Lanthanum carbonate delays progression of coronary artery calcification compared with calcium-based phosphate binders in patients on hemodialysis: a pilot study.
abstract: OBJECTIVE
  Coronary artery calcification (CAC) is associated with future cardiovascular events and/or death of patients on hemodialysis (HD). We investigated whether progression of CAC in patients on HD could be delayed by switching from a calcium (Ca)-based phosphate (Pi) binder to lanthanum carbonate.
  
  
  METHODS
  The CAC scores were evaluated at study enrollment and after 6 months in 52 patients on HD using calcium carbonate (CC) as a Pi binder. Patients were randomly divided into 2 groups assigned to receive either CC or lanthanum carbonate (LC), and the CAC scores were evaluated after a 6-month treatment period. Progression of CAC was assessed, as were serum levels of Ca, Pi, and intact parathyroid hormone (iPTH).
  
  
  RESULTS
  Forty-two patients completed the study (23 receiving CC and 19 receiving LC). In the 6 months prior to randomization, all patients were treated with CC. During this 6-month period, the CAC scores increased significantly in all 42 patients. Once randomized, there was significantly less progression in the group treated with LC than with CC. Changes in CAC scores from 6 to 12 months were significantly smaller in the LC group than the CC group (-288.9 ± 1176.4 vs 107.1 ± 559.6, P = .036), and percentage changes were also significantly different (-6.4% vs 41.2%, P = .024). Serum Ca, Pi, and iPTH levels were similar in both groups during the study period.
  
  
  CONCLUSIONS
  This pilot study suggested that LC delayed progression of CAC in patients on HD compared with CC.
authors.affiliation: Department of Nephrology, Immunology, and Vascular Medicine, Shonan Kamakura General Hospital, Kamakura, Japan. ohtake@shonankamakura.or.jp
authors.forename: Takayasu
authors.initials: T
authors.lastname: Ohtake
authors.forename: Shuzo
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Machiko
authors.initials: M
authors.lastname: Oka
authors.forename: Rei
authors.initials: R
authors.lastname: Furuya
authors.forename: Masao
authors.initials: M
authors.lastname: Iwagami
authors.forename: Daimu
authors.initials: D
authors.lastname: Tsutsumi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Mochida
authors.forename: Kyoko
authors.initials: K
authors.lastname: Maesato
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Ishioka
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Moriya
authors.forename: Sumi
authors.initials: S
authors.lastname: Hidaka
mesh_terms: D000368:Aged; D002114:Calcinosis / Q000188:drug therapy / Q000473:pathology; D002118:Calcium / Q000097:blood; D002119:Calcium Carbonate / Q000627:therapeutic use*; D002614:Chelating Agents / Q000627:therapeutic use*; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000473:pathology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007811:Lanthanum / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000097:blood; D010865:Pilot Projects; D011446:Prospective Studies; D006435:Renal Dialysis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002614:Chelating Agents; D010281:Parathyroid Hormone; D010710:Phosphates; C119467:lanthanum carbonate; D007811:Lanthanum; D002119:Calcium Carbonate; D002118:Calcium
keywords: calcium carbonate; coronary artery calcification; hemodialysis; lanthanum; phosphate binder