PHILADELPHIA—The non-calcareous phosphate binders lanthanum carbonate and sevelamer are risk-free and effective in treating hyperphosphatemia in patients undergoing hemodialysis (HD) and are associated with a lower incidence of hypercalciuria than calcareous phosphate binders, researchers reported here at Kidney Week 2014.
In a meta-analysis, Yan Jiang and collaborators at Zhejiang University in Hangzhou, China, researchers looked at 25 trials that included 3,111 patients to study the efficacy and safety of 4 different phosphate binders in end-stage renal disease (ESRD) patients.
Calcium carbonate, calcium acetate, sevelamer, and lanthanum carbonate did not differ in their effects on serum phosphorus, calcium phosphate, and parathyroid hormone levels. In contrast to calcium carbonate and calcium acetate, however, sevelamer and lanthanum carbonate had no significant impact on serum calcium levels. The incidence of hypercalcemia was much lower with sevelamer and lanthanum carbonate compared with calcium carbonate and calcium acetate.
“Additional large randomized, double blinded clinical trials are still required to investigate the effects of different phosphate binders on mortality or other patient-level outcomes,” the authors concluded.