Abstract | BACKGROUND: METHODS: We retrospectively collected data on maintenance hemodialysis patients at 22 facilities (n = 2292) beginning in December 2008, a time point immediately prior to the commercial availability of lanthanum in Japan. We compared 3-year all-cause mortality among patients who initiated lanthanum (n = 560) and those who were not treated with lanthanum during the study period (n = 560) matched by the propensity score of receiving lanthanum. Several sensitivity analyses were performed to test the robustness of the primary analysis. RESULTS: After the market introduction of lanthanum, the percentage of patients receiving the binder increased gradually to 27%. In the propensity score-matched analysis, the mortality rate for the lanthanum group was not significantly lower than the non- lanthanum group [hazard ratio (HR), 0.71; 95% confidence interval (CI), 0.47-1.09). However, stratification by serum phosphorus disclosed significant survival benefit of lanthanum for patients with serum phosphorus >6.0 mg/dL (HR, 0.52; 95% CI, 0.28-0.95), but not in patients with serum phosphorus ≤6.0 mg/dL (HR, 1.00; 95% CI, 0.55-1.84). The survival benefit of lanthanum in patients with serum phosphorus >6.0 mg/dL was consistent across subgroups and robust in different analytical approaches. CONCLUSIONS: Treatment with lanthanum was independently associated with a significant survival benefit in hemodialysis patients with inadequately controlled hyperphosphatemia. Further studies are required to confirm these findings.
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Authors | Hirotaka Komaba, Takatoshi Kakuta, Hajime Suzuki, Miho Hida, Takao Suga, Masafumi Fukagawa |
Journal | Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
(Nephrol Dial Transplant)
Vol. 30
Issue 1
Pg. 107-14
(Jan 2015)
ISSN: 1460-2385 [Electronic] England |
PMID | 25422311
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © The Author 2014. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. |
Chemical References |
- Phosphorus
- lanthanum carbonate
- Lanthanum
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Topics |
- Aged
- Female
- Humans
- Hyperphosphatemia
(prevention & control)
- Kidney Failure, Chronic
(drug therapy)
- Lanthanum
(therapeutic use)
- Male
- Middle Aged
- Phosphorus
(blood)
- Renal Dialysis
(mortality)
- Retrospective Studies
- Survival Rate
- Treatment Outcome
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