title: Impact of Lanthanum Carbonate on Prognosis of Chronic Hemodialysis Patients: A Retrospective Cohort Study (Kawashima Study).
abstract: In hemodialysis patients, mineral and bone disorder is an important risk factor for cardiovascular disease and subsequent death through the progression of vascular calcification. Serum phosphorus plays a major role in this process. In the present study, we retrospectively analyzed the effects of oral phosphate binder, lanthanum carbonate (LC), on the mortality in hemodialysis patients. Among a total of 841 patients who underwent maintenance hemodialysis on 1 July 2010, patients who were treated with LC (LC group, N = 324) and those who were treated without LC (NLC group, N = 517) were compared with respect to their all-cause mortality for a long-term observation period of up to 36 months. The mortality rate was compared using the Cox proportional hazard model adjusted by the propensity score. The adjusted hazard ratio for mortality in the LC group versus NLC group was 0.515 (95% confidence interval, 0.328-0.807), suggesting that the use of LC is associated with an almost 50% reduction in the mortality rate. The present retrospective study including all hemodialysis patients demonstrated, for the first time, an association between the use of LC and improved prognosis in hemodialysis patients. Randomized controlled trials should be done in the future to validate our present findings.
authors.affiliation: Department of Kidney Disease (Dialysis & Kidney Transplantation), Kawashima Dialysis Clinic, Tokushima, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Tsuchida
authors.affiliation: Department of Nephrology, Tokushima University, Tokushima, Japan.
authors.forename: Kojiro
authors.initials: K
authors.lastname: Nagai
authors.affiliation: Department of Urology (Dialysis & Kidney Transplantation), Kawashima Hospital, Tokushima, Japan.
authors.forename: Narushi
authors.initials: N
authors.lastname: Yokota
authors.affiliation: Department of Kidney Disease (Dialysis & Kidney Transplantation), Kawashima Hospital, Tokushima, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Minakuchi
authors.affiliation: Department of Kidney Disease (Dialysis & Kidney Transplantation), Kawashima Hospital, Tokushima, Japan.
authors.forename: Shu
authors.initials: S
authors.lastname: Kawashima
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D002614:Chelating Agents / Q000008:administration & dosage; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D007811:Lanthanum / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010758:Phosphorus / Q000097:blood; D011379:Prognosis; D016016:Proportional Hazards Models; D006435:Renal Dialysis / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D061205:Vascular Calcification / Q000188:drug therapy* / Q000209:etiology
chemical_list: D002614:Chelating Agents; D010758:Phosphorus; C119467:lanthanum carbonate; D007811:Lanthanum
keywords: Hemodialysis; Hyperphosphatemia; Lanthanum carbonate; Survival; Vascular calcification