title: Effects of lanthanum carbonate and calcium carbonate on fibroblast growth factor 23 and hepcidin levels in chronic hemodialysis patients.
abstract: BACKGROUND
  Phosphate binders have an impact on fibroblast growth factor 23 (FGF23); however, the effect of phosphate binders on serum hepcidin has not been explored. We conducted a 24-week multicenter randomized controlled trial to investigate the effects of lanthanum carbonate or calcium carbonate monotherapy on serum phosphate, FGF23, and hepcidin levels in chronic hemodialysis patients.
  
  
  METHODS
  Forty-six patients were recruited, and daily dietary phosphorus was controlled between 600-800 mg. Serum calcium, phosphate, albumin, alkaline phosphatase (ALP), FGF23, intact parathyroid hormone (iPTH), hepcidin, high-sensitivity CRP (hsCRP), 25(OH)D, 1,25(OH)2D, fetuin-A, and osteopontin were checked as scheduled.
  
  
  RESULTS
  Twenty-five patients completed the study. Mean serum FGF23 level was significantly decreased after a 24-week treatment with lanthanum (8677.5 ± 7490.0 vs. 4692.8 ± 5348.3 pg/mL, p = 0.013, n = 13), but not with calcium (n = 12). The reduction of serum hepcidin in lanthanum group was positively correlated with the decrement of serum phosphate (r = 0.631, p = 0.021) and serum hsCRP (r = 0.670, p = 0.012) levels, respectively. Serum ALP, iPTH, vitamin D, fetuin-A, and osteopontin revealed no significant inter- or intragroup differences.
  
  
  CONCLUSIONS
  In summary, a decrease in serum FGF23 levels and a trend of decline in hepcidin levels were observed only in lanthanum group.
authors.affiliation: Division of Nephrology, of Internal Medicine, Department Saint Mary's Hospital Luodong, Yilan, Taiwan.
authors.forename: Yu-Ming
authors.initials: YM
authors.lastname: Chang
authors.affiliation: Division of Nephrology, of Internal Medicine, Department Saint Mary's Hospital Luodong, Yilan, Taiwan.
authors.forename: Shih-Ching
authors.initials: SC
authors.lastname: Tsai
authors.affiliation: Division of Nephrology, of Internal Medicine, Department Saint Mary's Hospital Luodong, Yilan, Taiwan.
authors.forename: Chih-Chung
authors.initials: CC
authors.lastname: Shiao
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Hsin-Jen Hospital, 5th F, 387 Chong-Cheng Road, Xinzhuang District, 242, New Taipei City, Taiwan. hh258527@ms23.hinet.net.|Dialysis Center, Hsin-Ren Clinics, New Taipei City, Taiwan. hh258527@ms23.hinet.net.
authors.forename: Hung-Hsiang
authors.initials: HH
authors.lastname: Liou
authors.affiliation: Department of Nursing, Saint Mary's Hospital Luodong, Yilan, Taiwan.
authors.forename: Chuan-Lan
authors.initials: CL
authors.lastname: Yang
authors.affiliation: Nutrition Room, Saint Mary's Hospital Luodong, Yilan, Taiwan.
authors.forename: Nai-Yu
authors.initials: NY
authors.lastname: Tung
authors.affiliation: Department of Nursing, Saint Mary's Hospital Luodong, Yilan, Taiwan.
authors.forename: Kua-Sui
authors.initials: KS
authors.lastname: Hsu
authors.affiliation: Department of Nursing, Saint Mary's Hospital Luodong, Yilan, Taiwan.
authors.forename: I-Ling
authors.initials: IL
authors.lastname: Chen
authors.affiliation: Dialysis Center, Hsin-Ren Clinics, New Taipei City, Taiwan.
authors.forename: Mei-Chyn
authors.initials: MC
authors.lastname: Liu
authors.affiliation: Division of Nephrology, of Internal Medicine, Department Saint Mary's Hospital Luodong, Yilan, Taiwan.
authors.forename: Jsun-Liang
authors.initials: JL
authors.lastname: Kao
authors.affiliation: Division of Nephrology, of Internal Medicine, Department Saint Mary's Hospital Luodong, Yilan, Taiwan.
authors.forename: Rong-Na
authors.initials: RN
authors.lastname: Jhen
authors.affiliation: Department of Nursing, Saint Mary's Hospital Luodong, Yilan, Taiwan.
authors.forename: Ya-Ting
authors.initials: YT
authors.lastname: Huang
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002119:Calcium Carbonate / Q000009:adverse effects / Q000627:therapeutic use*; D002614:Chelating Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015536:Down-Regulation; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D064451:Hepcidins / Q000097:blood*; D006801:Humans; D007811:Lanthanum / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000097:blood*; D016226:Phosphorus, Dietary / Q000008:administration & dosage / Q000097:blood; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D013624:Taiwan; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D002614:Chelating Agents; C000717427:FGF23 protein, human; C578702:HAMP protein, human; D064451:Hepcidins; D010710:Phosphates; D016226:Phosphorus, Dietary; C119467:lanthanum carbonate; D005346:Fibroblast Growth Factors; D007811:Lanthanum; D000089703:Fibroblast Growth Factor-23; D002119:Calcium Carbonate
keywords: FGF23; Hemodialysis; Hepcidin; Phosphate binders