Phosphate Binder Linked With Reduced Mortality
In a meta-analysis, hemodialysis patients using lanthanum carbonate to lower phosphorus levels had a 55% decreased risk of death compared with those taking other binders.
A new meta-analysis from China associates lanthanum carbonate (LC) use with reduced risk for death compared with calcium carbonate, calcium acetate, and sevelamer.
Fang Wang, MD, of, the First Affiliated Hospital of Zhengzhou University in China, and colleagues pooled data from 9 randomized controlled trials evaluating phosphate binder use in 2813 hemodialysis patients. Users of LC, a non-aluminum, non-calcium binder, had a significant 55% decreased risk of all-cause mortality compared with the other drugs. Cardiovascular events did not differ among groups.
All of the binders lowered serum phosphorus levels to a similar extent. Lanthanum carbonate (LC) recipients had higher serum intact parathyroid hormone (iPTH) and lower serum calcium levels.
“This suggests that LC might prevent oversuppression of iPTH secretion and have a beneficial effect on adynamic bone disorder and vascular calcification,” Dr Wang's team stated in Kidney & Blood Pressure Research.
These conclusions need to be confirmed by future research. The investigators acknowledged that included studies had small sample sizes and variable quality. The team also could not compare LC with other phosphate binders individually.
Wang F, Lub X, Zhangb J, Xiong R, Li H, Wang S. Effect of lanthanum carbonate on all-cause mortality in patients receiving maintenance hemodialysis: a meta-analysis of randomized controlled trials. Kidney Blood Press Res. 2018;43:536-544. DOI: 10.1159/000488700