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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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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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