title: The effect of lanthanum carbonate on metabolic acidosis in patients with chronic kidney disease stage IV, V and V-D.
abstract: OBJECTIVE
  Hyperphosphatemia and metabolic acidosis are frequently encountered in advanced chronic kidney disease (CKD) patients. Correction of metabolic acidosis in patients with advanced CKD leads to a decrease in the progression of renal impairment and improves nutritional outcomes. Lanthanum carbonate is used for control of hyperphosphatemia. This study evaluated the effect of lanthanum carbonate on metabolic acidosis in CKD IV-V patients and in patients on dialysis.
  
  
  METHODS
  Retrospective data of patients in whom lanthanum carbonate therapy was initiated were collected from 2009 to 2013 in a single dialysis center. Of the 79 patients in whom lanthanum carbonate was introduced, 51 patients were included in the analysis. Of the 51 patients, 39 patients received chronic hemodialysis, two patients received peritoneal dialysis therapy, and 10 patients had stage IV-V CKD not on dialysis. The primary outcome was the serum bicarbonate change after the introduction of lanthanum carbonate.
  
  
  RESULTS
  There was a significant increase in mean serum bicarbonate concentration of 2.79 mmol/L (p ≤ 0.001) compared to baseline. The increase remained in the CKD IV-V patients (2.50 mmol/L, p = 0.005) and in the patients on dialysis (2.81 mmol/L, p < 0.001). Serum bicarbonate remained higher (p > 0.05) than baseline up to 6 months after lanthanum carbonate introduction.
  
  
  CONCLUSIONS
  In this study, lanthanum carbonate introduction increased serum bicarbonate concentration in a small sample of CKD IV-V patients and in patients on dialysis. Further studies are needed to confirm this effect and investigate whether the correction of metabolic acidosis by using lanthanum carbonate in CKD IV-V patients can improve clinical outcomes.
authors.affiliation: Nephrology Department, Maisonneuve-Rosemont Hospital, Montreal, Canada, william.beaubien-souligny@umontreal.ca.
authors.forename: William
authors.initials: W
authors.lastname: Beaubien-Souligny
authors.forename: Sarah
authors.initials: S
authors.lastname: Bezzaoucha
authors.forename: Vincent
authors.initials: V
authors.lastname: Pichette
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Lafrance
authors.forename: Robert
authors.initials: R
authors.lastname: Bell
authors.forename: Caroline
authors.initials: C
authors.lastname: Lamarche
authors.forename: Denis
authors.initials: D
authors.lastname: Ouimet
authors.forename: Michel
authors.initials: M
authors.lastname: Vallee
mesh_terms: D000138:Acidosis / Q000209:etiology / Q000628:therapy; D001639:Bicarbonates / Q000097:blood*; D002170:Canada; D002614:Chelating Agents / Q000008:administration & dosage / Q000009:adverse effects; D018450:Disease Progression; D016903:Drug Monitoring; D005260:Female; D006801:Humans; D054559:Hyperphosphatemia / Q000188:drug therapy / Q000209:etiology; D007677:Kidney Function Tests / Q000379:methods; D007811:Lanthanum / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D062072:Patient Acuity; D006435:Renal Dialysis / Q000379:methods*; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D001639:Bicarbonates; D002614:Chelating Agents; C119467:lanthanum carbonate; D007811:Lanthanum