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Effects of lanthanum carbonate on bone markers and bone mineral density in incident hemodialysis patients

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Abstract

Introduction

Recent clinical studies demonstrated the favorable effects of calcium-free phosphate binders on mortality and vascular calcification in hemodialysis (HD) patients. The aim of the present study was to investigate the effects of a calcium-free phosphate binder, lanthanum carbonate (LC), on bone metabolic markers and bone mineral density (BMD), compared with those of calcium carbonate (CC), in subjects new to HD.

Materials and Methods

The present study included 65 subjects from our previous randomized controlled trial (LC group, N = 31; CC group, N = 34). We investigated the effects of LC on serum intact parathyroid hormone (iPTH), osteocalcin (OC), bone-specific alkaline phosphatase (BAP), tartrate-resistant acid phosphatase 5b (TRACP-5b), sclerostin levels, and BMD, compared with those of CC in patients new to HD at baseline and at 12 and 18 months.

Results

Serum OC levels at 18 months were significantly higher in the LC group than in the CC group. During the study period, serum BAP and TRACP-5b and iPTH levels tended to be higher in the LC group than in the CC group. At 18 months, the percentage of low bone turnover, based on a serum BAP cutoff value, was significantly lower in the LC group than in the CC group. There were no significant differences in the lumbar and femoral BMD between the two groups.

Conclusions

The results of the present study suggest that LC has potential in preventing low bone turnover, in comparison to CC, in patients new to HD.

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References

  1. Nickolas TL, Leonard MB, Shane E (2008) Chronic kidney disease and bone fracture: a growing concern. Kidney Int 74:721–731

    Article  Google Scholar 

  2. Wakasugi M, Kazama JJ, Taniguchi M et al (2013) Increased risk of hip fracture among Japanese hemodialysis patients. J Bone Miner Metab 31:315–321

    Article  Google Scholar 

  3. Tentori F, McCullough K, Kilpatrick RD et al (2014) High rates of death and hospitalization follow bone fracture among hemodialysis patients. Kidney Int 85:166–173

    Article  Google Scholar 

  4. Young EW, Albert JM, Satayathum S et al (2005) Predictors and consequences of altered mineral metabolism: the dialysis outcomes and practice patterns study. Kidney Int 67:1179–1187

    Article  CAS  Google Scholar 

  5. Jamal SA, Vandermeer B, Raggi P et al (2013) Effect of calcium-based versus non-calcium-based phosphate binders on mortality in patients with chronic kidney disease: an updated systematic review and meta-analysis. Lancet 382:1268–1277

    Article  CAS  Google Scholar 

  6. Ketteler M, Block GA, Evenepoel P et al (2017) Executive summary of the 2017 KDIGO Chronic Kidney Disease–Mineral and Bone Disorder (CKD–MBD) guideline update: what’s changed and why it matters. Kidney Int 92:26–36

    Article  Google Scholar 

  7. Fujii H, Kono K, Nakai K, Goto S, Nishii T, Kono A, Nishi S (2018) Effects of lanthanum carbonate on coronary artery calcification and cardiac abnormalities after initiating hemodialysis. Calcif Tissue Int 102:310–320

    Article  CAS  Google Scholar 

  8. Toussaint ND, Lau KK, Polkinghorne KR, Kerr PG (2011) Attenuation of aortic calcification with lanthanum carbonate versus calcium-based phosphate binders in haemodialysis: a pilot randomized controlled trial. Nephrology 16:290–298

    Article  CAS  Google Scholar 

  9. D’Haese PC, Spasovski GB, Sikole A et al (2003) A multicenter study on the effects of lanthanum carbonate (Fosrenol™) and calcium carbonate on renal bone disease in dialysis patients. Kidney Int 85:S73–S78

    Article  Google Scholar 

  10. Malluche HH, Siami GA, Swanepoel C et al (2008) Improvements in renal osteodystrophy in patients treated with lanthanum carbonate for two years. Clin Nephrol 70:284–295

    CAS  PubMed  Google Scholar 

  11. Inaba M, Okuno S, Nagayama H et al (2015) Restoration of parathyroid function after change of phosphate binder from calcium carbonate to lanthanum carbonate in hemodialysis patients with suppressed serum parathyroid hormone. J Ren Nutr 25:242–246

    Article  CAS  Google Scholar 

  12. Wada K, Wada Y, Uchida HA, Tsuruoka S (2015) Effects of lanthanum carbonate versus calcium carbonate on vascular stiffness and bone mineral metabolism in hemodialysis patients with type 2 diabetes mellitus: a randomized controlled trial. Int J Nephrol Renov Dis 8:111–118

    Article  CAS  Google Scholar 

  13. Zhang C, Wang S, Zhao S, Zhang X (2017) Effect of lanthanum carbonate on coronary artery calcification and bone mineral density in maintenance hemodialysis patients with diabetes complicated with adynamic bone disease: a prospective pilot study. Med (Baltim) 96:e8664

    Article  CAS  Google Scholar 

  14. Soohoo M, Feng M, Obi Y et al (2016) Changes in markers of mineral and bone disorders and mortality in incident hemodialysis patients. Am J Nephrol 43:85–96

    Article  CAS  Google Scholar 

  15. Fukagawa M, Yokoyama K, Koiwa F et al (2013) Clinical practice guideline for the management of chronic kidney disease-mineral and bone disorder. Ther Apher Dial 17:247–288

    Article  Google Scholar 

  16. Coen G, Ballanti P, Bonucci E et al (1998) Bone markers in the diagnosis of low turnover osteodystrophy in haemodialysis patients. Nephrol Dial Transplant 13:2294–2302

    Article  CAS  Google Scholar 

  17. Salam S, Gallagher O, Gossiel F, Paggiosi M, Khwaja A, Eastell R (2018) Diagnostic accuracy of biomarkers and imaging for bone turnover in renal osteodystrophy. J Am Soc Nephrol 29:1557–1565

    Article  CAS  Google Scholar 

  18. World Health Organization (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser 843:1–129

    Google Scholar 

  19. Nishizawa Y, Ohta H, Miura M et al (2013) Guidelines for the use of bone metabolic markers in the diagnosis and treatment of osteoporosis (2012 edition). J Bone Miner Metab 31:1–15

    Article  CAS  Google Scholar 

  20. London GM, Marty C, Marchais SJ, Guerin AP, Metivier F, de Vernejoul MC (2004) Arterial calcifications and bone histomorphometry in end-stage renal disease. J Am Soc Nephrol 15:1943–1951

    Article  Google Scholar 

  21. Barreto DV, Barreto FC, Carvalho AB et al (2008) Association of changes in bone remodeling and coronary calcification in hemodialysis patients: a prospective study. Am J Kidney Dis 52:1139–1150

    Article  CAS  Google Scholar 

  22. Ureña P, Hruby M, Ferreira A, Ang KS, de Vernejoul MC (1996) Plasma total versus bone alkaline phosphatase as markers of bone turnover in hemodialysis patients. J Am Soc Nephrol 7:506–512

    PubMed  Google Scholar 

  23. Fusaro M, Giannini S, Gallieni M et al (2016) Calcimimetic and vitamin D analog use in hemodialyzed patients is associated with increased levels of vitamin K dependent proteins. Endocrine 51:333–341

    Article  CAS  Google Scholar 

  24. Quarles LD, Lobaugh B, Murphy G (1992) Intact parathyroid hormone overestimates the presence and severity of parathyroid-mediated osseous abnormalities in uremia. J Clin Endocrinol Metab 75:145–150

    CAS  PubMed  Google Scholar 

  25. Atsumi K, Kushida K, Yamazaki K, Shimizu S, Ohmura A, Inoue T (1999) Risk factors for vertebral fractures in renal osteodystrophy. Am J Kidney Dis 33:287–293

    Article  CAS  Google Scholar 

  26. Iimori S, Mori Y, Akita W et al (2012) Diagnostic usefulness of bone mineral density and biochemical markers of bone turnover in predicting fracture in CKD stage 5D patients—a single-center cohort study. Nephrol Dial Transplant 27:345–351

    Article  CAS  Google Scholar 

  27. Zhai CJ, Yang XW, Sun J, Wang R (2015) Efficacy and safety of lanthanum carbonate versus calcium-based phosphate binders in patients with chronic kidney disease: a systemic review and meta-analysis. Int Uro Nephrol 47:527–535

    Article  CAS  Google Scholar 

  28. Harini D, Indra R, Rajaram A, Rajaram R (2014) Induction of osteoblast differentiation in human adipose derived stem cells by lanthanum ions. J Rare Earths 32:1080–1088

    Article  CAS  Google Scholar 

  29. Wang X, Yuan L, Huang J, Zhang TL, Wang K (2008) Lanthanum enhances in vitro osteoblast differentiation via pertussis toxin-sensitive gi protein and ERK signaling pathway. J Cell Biochem 105:1307–1315

    Article  CAS  Google Scholar 

  30. Fumoto T, Masako I, Kyoji I (2014) Lanthanum carbonate stimulates bone formation in a rat model of renal insufficiency with low bone turnover. J Bone Miner Metab 32:484–493

    Article  CAS  Google Scholar 

  31. Sabbagh Y, Graciolli FG, O’Brien S et al (2012) Repression of osteocyte Wnt/beta-catenin signaling is an early event in the progression of renal osteodystrophy. J Bone Miner Res 27:1757–1772

    Article  CAS  Google Scholar 

  32. Delgado-Calle J, Sato AY, Bellido T (2017) Role and mechanism of action of sclerostin in bone. Bone 96:29–37

    Article  CAS  Google Scholar 

  33. Seifert ME, de las Fuentes L, Rothstein M et al (2013) Effects of phosphate binder therapy on vascular stiffness in early stage chronic kidney disease. Am J Nephrol 38:158–167

    Article  CAS  Google Scholar 

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Correspondence to Hideki Fujii.

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Conflict of interest

This study was partly supported by Bayer Yakuhin Co, and Hideki Fujii and Shinichi Nishi have received a speaker honorarium from Bayer Yakuhin Co. The other authors declare that they have no other conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Goto, K., Goto, S., Fujii, H. et al. Effects of lanthanum carbonate on bone markers and bone mineral density in incident hemodialysis patients. J Bone Miner Metab 37, 1075–1082 (2019). https://doi.org/10.1007/s00774-019-01018-8

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  • DOI: https://doi.org/10.1007/s00774-019-01018-8

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