Effects of Lanthanum Carbonate on Serum Calcium and Phosphorus of CAPD Patients with Chronic Renal Failure Receiving Calcitriol Pulse Therapy Due to Secondary Hyperparathyroidism_Chinese Journal of Evidence-Based Medicine

Authors：

 SONGFang-rong ¹ , CHENGHai ² , ZHAODong-ming ² , YUJun ² ,  GAOYan ²

1. Weifang Medical University, Weifang 261053, China;
2. The East District of Qingdao Municipal Hospital, Qingdao 266071, China;

Corresponding author：

GAOYan, Email: wjdwyd@163.com

Keywords：

Lanthanum carbonate; Calcitriol; Continuous ambulatory peritoneal dialysis; Secondary hyperparathyroidism

DOI：

10.7507/1672-2531.20140108

Video：

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Objective To explore and discuss the effects of lanthanum carbonate on serum calcium and phosphorus of continuous ambulatory peritoneal dialysis (CAPD) patients with chronic renal failure receiving calcitriol pulse therapy due to secondary hyperparathyroidism (SHPT). Methods CAPD patients caused by SHPT in peritoneal dialysis centre of the Qingdao Municipal Hospital of Eastern Hospital from March to June, 2013 were selected and randomly divided into two groups (lanthanum carbonate group and calcium carbonate group). The lanthanum carbonate group were treated with oral lanthanum carbonate and calcitriol pulse therapy, while the calcium carbonate group were treated with calcium carbonate and calcitriol. Change of levels of serum calcium, phosphorus and iPTH were observed and statistic analysis was conducted using SPSS 17.0. Results A total of 40 CAPD patients were included, 20 cases in each group. After 12-week treatment, levels of serium phosphate (t=5.095, P=0.000) and iPTH (t=1.225, P=0.000) in the lanthanum carbonate group were significantly lower than those before treatment. The levels of serum calcium (t=1.127, P=0.001) and phosphate (t=2.035, P=0.000) in the lanthanum carbonate group were significantly lower than those in the calcium carbonate group (P < 0.05). Conclusion Lanthanum carbonate serves as a useful approach to improve hypercalcemia and the hyperphosphatemia in CAPD patients receiving calcitriol pulse therapy due to SHPT.

Citation： SONGFang-rong, CHENGHai, ZHAODong-ming, YUJun, GAOYan. Effects of Lanthanum Carbonate on Serum Calcium and Phosphorus of CAPD Patients with Chronic Renal Failure Receiving Calcitriol Pulse Therapy Due to Secondary Hyperparathyroidism. Chinese Journal of Evidence-Based Medicine, 2014, 14(6): 651-654. doi: 10.7507/1672-2531.20140108 Copy

1.	Moe S, Drueke T, Cunningham J, et al. Definition, evaluation, and classification of renal osteodystrophy:a position statement from Kidney Disease:Improving Global Outcomes (KDIGO). Kidney Int, 2006, 69(11):1945-1953.
2.	陈玉琼, 王美云.血液灌流联合血液透析治疗尿毒症顽固性皮肤瘙痒.江苏大学学报:医学版, 2007, 17(4):338-339.
3.	《活性维生素D的合理应用》专家协作组.活性维生素D在慢性肾脏病继发性甲旁亢中合理应用的专家共识.中华肾脏病杂志, 2005, 21(11):698-699.
4.	Malberti F. Management of hyperphosphatemia in dialysis patients: the role of phosphate binders. G Ital Nefrol, 2010, 27(Suppl 52):47-54.
5.	Giachelli CM. Vascular calcification mechanisms. J Am Soc Nephrol, 2004, 15(12):2959-2964.
6.	Levin A, Bakris GL, Molitch M, et al. Prevalence of abnormal serum vitamin D, PTH, calcium, and phosphorus in patients with chronic kidney disease:results of the study to evaluate early kidney disease. Kidney Int, 2007, 71(1):31-38.
7.	Martinez I, Saracho R, Montenegro J, et al. The importance of dietary calcium and phosphorus in the secondary hyperparathyroidism of patients with early renal failure. Am J Kidney Dis, 1997, 29(3): 496-502.
8.	孙志宏, 安惠霞, 杨霞.慢性肾衰血透患者甲状旁腺激素与营养的关系研究.哈尔滨医科大学学报, 2008, 42(5):485-487.
9.	Feldman D, Sampson JN, Rudser KD, et al. Treatment of secondary hyperparathyroidism in patients with chronic renal failure maintained on hemodialysis (CKD stage 5). Endocrinologia J, 1986, 32(6): 863-874.
10.	Ishida M, Yao N, Yachiku S, et al. Management of calcium, phosphorus and bone metalbolian in dialysis patients using sevelamer hydrochloride and vitamin D therapy. Ther Apher Dial, 2005, 9(Suppl 1):16-21.
11.	Voormolen N, Noordzij M, Grootendorst DC, et al. High plasma phosphate as a risk factor for decline in renal function and mortality in pre-dialysis patients. Nephrol Dial Transplant, 2007, 22(3):2909-2916.
12.	Block GA, Klassen PS, Lazarus JM, et al. Mineral metabolism, mortality, and morbidity in maintenance hemodialysi. J Am Soc Nephrol, 2004, 15(3):2208-2218.
13.	Coladonato JA, Szczech L, Friedman EA, et al. Does calcium kill ESRD patients? The skeptic, s perspective. Nephrol Dial Transplant, 2002, 17(2):229-232.
14.	Toida T, Fukudome K, Fujimoto S, et al. Effect of lanthanum carbonate vs. calcium carbonate on serum calcium in hemodialysis patients:a crossover study. Clin Nephrol, 2012, 3(2):216-223.
15.	Joy MS, Finn WF. Result of a randomized phase Ⅲ dosetitrating, parallel group study of 1anthanum carbonate for reduction and maintenance of serum phosphate in chronic hemodialysis patients. J Am Soc Nephrol, 2001, 12:388A.
16.	Hutchison AJ, Maes B, Vanwalleghem J, et al. Efficacy, tolerability, and safety of lanthanum carbonate in hyperphosphatemia:a 6-month, randomized, comparative trial versus calcium carbonate. Nephron Clin Pract, 2005, 100(1):c8-c19.
17.	Hutchison AJ, Maes B, Vanwalleghem J, et al. Long-term efficacy and tolerability of lanthanum Carbonate:Results from a 3-Year Study. Nephron Clin Pract, 2006, 102(1):c61-c71.
18.	Daugirdas JT, Finn WF, Emmett M, et al. The phosphate binder equivalent dose. Semin Dial, 2011, 21(1):41-49.

1. Moe S, Drueke T, Cunningham J, et al. Definition, evaluation, and classification of renal osteodystrophy:a position statement from Kidney Disease:Improving Global Outcomes (KDIGO). Kidney Int, 2006, 69(11):1945-1953.
2. 陈玉琼, 王美云.血液灌流联合血液透析治疗尿毒症顽固性皮肤瘙痒.江苏大学学报:医学版, 2007, 17(4):338-339.
3. 《活性维生素D的合理应用》专家协作组.活性维生素D在慢性肾脏病继发性甲旁亢中合理应用的专家共识.中华肾脏病杂志, 2005, 21(11):698-699.
4. Malberti F. Management of hyperphosphatemia in dialysis patients: the role of phosphate binders. G Ital Nefrol, 2010, 27(Suppl 52):47-54.
5. Giachelli CM. Vascular calcification mechanisms. J Am Soc Nephrol, 2004, 15(12):2959-2964.
6. Levin A, Bakris GL, Molitch M, et al. Prevalence of abnormal serum vitamin D, PTH, calcium, and phosphorus in patients with chronic kidney disease:results of the study to evaluate early kidney disease. Kidney Int, 2007, 71(1):31-38.
7. Martinez I, Saracho R, Montenegro J, et al. The importance of dietary calcium and phosphorus in the secondary hyperparathyroidism of patients with early renal failure. Am J Kidney Dis, 1997, 29(3): 496-502.
8. 孙志宏, 安惠霞, 杨霞.慢性肾衰血透患者甲状旁腺激素与营养的关系研究.哈尔滨医科大学学报, 2008, 42(5):485-487.
9. Feldman D, Sampson JN, Rudser KD, et al. Treatment of secondary hyperparathyroidism in patients with chronic renal failure maintained on hemodialysis (CKD stage 5). Endocrinologia J, 1986, 32(6): 863-874.
10. Ishida M, Yao N, Yachiku S, et al. Management of calcium, phosphorus and bone metalbolian in dialysis patients using sevelamer hydrochloride and vitamin D therapy. Ther Apher Dial, 2005, 9(Suppl 1):16-21.
11. Voormolen N, Noordzij M, Grootendorst DC, et al. High plasma phosphate as a risk factor for decline in renal function and mortality in pre-dialysis patients. Nephrol Dial Transplant, 2007, 22(3):2909-2916.
12. Block GA, Klassen PS, Lazarus JM, et al. Mineral metabolism, mortality, and morbidity in maintenance hemodialysi. J Am Soc Nephrol, 2004, 15(3):2208-2218.
13. Coladonato JA, Szczech L, Friedman EA, et al. Does calcium kill ESRD patients? The skeptic, s perspective. Nephrol Dial Transplant, 2002, 17(2):229-232.
14. Toida T, Fukudome K, Fujimoto S, et al. Effect of lanthanum carbonate vs. calcium carbonate on serum calcium in hemodialysis patients:a crossover study. Clin Nephrol, 2012, 3(2):216-223.
15. Joy MS, Finn WF. Result of a randomized phase Ⅲ dosetitrating, parallel group study of 1anthanum carbonate for reduction and maintenance of serum phosphate in chronic hemodialysis patients. J Am Soc Nephrol, 2001, 12:388A.
16. Hutchison AJ, Maes B, Vanwalleghem J, et al. Efficacy, tolerability, and safety of lanthanum carbonate in hyperphosphatemia:a 6-month, randomized, comparative trial versus calcium carbonate. Nephron Clin Pract, 2005, 100(1):c8-c19.
17. Hutchison AJ, Maes B, Vanwalleghem J, et al. Long-term efficacy and tolerability of lanthanum Carbonate:Results from a 3-Year Study. Nephron Clin Pract, 2006, 102(1):c61-c71.
18. Daugirdas JT, Finn WF, Emmett M, et al. The phosphate binder equivalent dose. Semin Dial, 2011, 21(1):41-49.

Chinese Journal of Evidence-Based Medicine

Effects of Lanthanum Carbonate on Serum Calcium and Phosphorus of CAPD Patients with Chronic Renal Failure Receiving Calcitriol Pulse Therapy Due to Secondary Hyperparathyroidism

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