title: Evaluation of aortic calcification with lanthanum carbonate vs. calcium-based phosphate binders in maintenance hemodialysis patients with type 2 diabetes mellitus: an open-label randomized controlled trial.
abstract: Vascular calcification (VC) contributes to cardiovascular disease in hemodialysis (HD) patients, especially with diabetes mellitus (DM) complications. No randomized studies have been published regarding the effect of lanthanum carbonate (LC) on VC progression in DM patients. The aim of this study was to evaluate the effects of lanthanum carbonate on the progression of VC in HD patients with type 2 DM. We conducted a randomized controlled trial comparing LC with calcium carbonate (CC) in 43 HD patients at a single dialysis center. Estimations of aortic calcification index (ACI) by abdominal computed tomography were performed twice for each patient (at baseline and 12 months). Forty-one patients completed the study (19 LC, 22 CC). When ACI at baseline was ≦0.48 (median of baseline ACI), median change in ACI (Δ%ACI) was 20.44 (11.50-36.80%) in the LC group, and 40.00 (33.30-92.60%) in the CC group (P = 0.026). On the other hand, when ACI at baseline was >0.48, the median change in ACI (Δ%ACI) was 6.42 (3.13-24.40%) in the LC group, and 8.08 (5.68-12.20%) in the CC group (P = 1.000). Serum markers of chronic kidney disease-mineral and bone disorder (CKD-MBD), HbA1c, dose of vitamin D analogues, and side-effects of medications did not change in either group throughout the study except int-PTH increased in the LC group. This study indicated that administration of LC inhibited the progression of VC in patients receiving HD for type 2 DM, only in cases of slight VC compared with CC.
authors.affiliation: Division of Nephrology and Dialysis, Nippon Kokan Fukuyama Hospital, Hiroshima, Japan; Department of Internal Medicine, Central Hospital, Hiroshima, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Wada
authors.forename: Yuko
authors.initials: Y
authors.lastname: Wada
mesh_terms: D000368:Aged; D001018:Aortic Diseases / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D002114:Calcinosis / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D002119:Calcium Carbonate / Q000627:therapeutic use; D002614:Chelating Agents / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D007811:Lanthanum / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000378:metabolism; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000628:therapy; D014057:Tomography, X-Ray Computed
chemical_list: D002614:Chelating Agents; D010710:Phosphates; C119467:lanthanum carbonate; D007811:Lanthanum; D002119:Calcium Carbonate
keywords: Calcium; Diabetes mellitus; Hemodialysis; Lanthanum carbonate; Vascular calcification