title: Effect of lanthanum carbonate versus calcium-based phosphate binders in dialysis patients: a meta-analysis.
abstract: BACKGROUND
  The effects of lanthanum carbonate (LC) vs. calciumbased phosphate binders in dialysis patients have been a matter of debate.
  
  
  METHODS
  We electronically searched PubMed, Embase, CENTRAL, and CBM for all randomized controlled trials comparing LC with calcium-based phosphate binders in adult dialysis patients. Quality assessment was performed using the Cochrane risk of bias tool. Metaanalysis was conducted by RevMan 5.2.
  
  
  RESULTS
  Nine studies were eligible for our meta-analysis. There was no significant difference in all-cause mortality (RR 0.84, 95% CI 0.25 - 2.83) and cardiovascular events (RR 0.84, 95% CI 0.55 - 1.29) between LC and calcium-based phosphate binders. LC was associated with similar proportions of phosphate-controlled patients (RR 0.63, 95% CI 0.27 - 1.44) and lower incidence of hypercalcemia (RR 0.13, 95% CI 0.05 - 0.35) in comparison to calcium-based phosphate binders. Compared with calcium salts, LC was associated with significantly lower serum calcium, similar serum Ca x P product and higher serum iPTH.
  
  
  CONCLUSIONS
  Despite the trends observed, we found no statistically significant differences in all-cause mortality and cardiovascular events between LC and calcium-based phosphate binders in dialysis patients. The conclusion was limited by lack of large sample and long-term trials. LC could reduce the incidence of hypercalcemia while comparable with calcium-based phosphate binders in reducing serum phosphorus level.
authors.forename: Chun-Juan
authors.initials: CJ
authors.lastname: Zhai
authors.forename: Xin-Shuang
authors.initials: XS
authors.lastname: Yu
authors.forename: Qiao-Ling
authors.initials: QL
authors.lastname: Sun
authors.forename: Lin
authors.initials: L
authors.lastname: Li
authors.forename: Li-Ting
authors.initials: LT
authors.lastname: Zhang
authors.forename: Ai-Yan
authors.initials: AY
authors.lastname: Zhou
authors.forename: Rong
authors.initials: R
authors.lastname: Wang
mesh_terms: D002118:Calcium / Q000097:blood; D002130:Calcium Phosphates / Q000627:therapeutic use*; D002614:Chelating Agents / Q000627:therapeutic use*; D015314:Dialysis Solutions / Q000627:therapeutic use*; D006801:Humans; D006934:Hypercalcemia / Q000517:prevention & control; D007811:Lanthanum / Q000627:therapeutic use*; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D006435:Renal Dialysis / Q000379:methods*
chemical_list: D002130:Calcium Phosphates; D002614:Chelating Agents; D015314:Dialysis Solutions; D010281:Parathyroid Hormone; D010758:Phosphorus; C119467:lanthanum carbonate; D007811:Lanthanum; D002118:Calcium