Efficacy and safety of lanthanum carbonate versus calcium-based phosphate binders in patients with chronic kidney disease: a systematic review and meta-analysis.

Abstract

PURPOSE:

We conducted this review to assess the relative efficacy and safety of lanthanum carbonate versus calcium-based phosphate binders in chronic kidney disease.

METHODS:

We systematically searched PubMed, EMBASE, the Cochrane Controlled Trial Register of Controlled Trials and Chinese Biological Medical Database for randomized controlled trials comparing lanthanum carbonate with calcium-based phosphate binders in adult patients with chronic kidney disease. Study quality was assessed using the criteria outlined in the Cochrane Handbook for Systematic Reviews of intervention. Meta-analysis was conducted by reviewer manager software, version 5.3.

RESULTS:

Eleven trials with 1,501 participants were included. Lanthanum carbonate appeared to be associated with a significant reduction in progression of vascular calcification and a beneficial effect on bone outcomes without aluminum-like toxicity. Lanthanum carbonate achieved similar proportions of phosphate-controlled patients (RR 0.63, 95% CI 0.27-1.44) with lower incidence of hypercalcemia (RR 0.13, 95% CI 0.05-0.35) in comparison with calcium-based phosphate binders. Lanthanum carbonate was associated with significantly lower serum calcium, similar serum Ca × P product and higher serum iPTH compared with calcium salts in patients with chronic kidney disease.

CONCLUSION:

Lanthanum carbonate could delay the progression of vascular calcification and benefit chronic kidney disease patients on bone outcomes. Lanthanum carbonate could achieve similar proportion of phosphate-controlled patients as calcium-based phosphate binders with lower incidence of hypercalcemia.

• Authors: Chun-Juan Zhai, Xiao-Wei Yang, Jing Sun, Rong Wang
• Journal: International urology and nephrology (Int Urol Nephrol) Vol. 47 Issue 3 Pg. 527-35 (Mar 2015) ISSN: 1573-2584 [Electronic] Netherlands
• PMID: 25399356 (Publication Type: Comparative Study, Journal Article, Meta-Analysis, Review, Systematic Review)

Chemical References

• Chelating Agents
• Parathyroid Hormone
• Phosphorus
• lanthanum carbonate
• Lanthanum
• Calcium Carbonate
• Calcium

Topics

• Bone Density (drug effects)
• Calcium (blood)
• Calcium Carbonate (therapeutic use)
• Chelating Agents (adverse effects, therapeutic use)
• Humans
• Hypercalcemia (blood)
• Lanthanum (adverse effects, therapeutic use)
• Parathyroid Hormone (blood)
• Phosphorus (blood)
• Radiography
• Randomized Controlled Trials as Topic
• Renal Insufficiency, Chronic (drug therapy)
• Vascular Calcification (diagnostic imaging, prevention & control)