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Evaluation of Aortic Calcification With Lanthanum Carbonate vs. Calcium‐Based Phosphate Binders in Maintenance Hemodialysis Patients With Type 2 Diabetes Mellitus: An Open‐Label Randomized Controlled Trial
Author(s) -
Wada Kentaro,
Wada Yuko
Publication year - 2014
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.12153
Subject(s) - medicine , lanthanum carbonate , hemodialysis , gastroenterology , phosphate binder , diabetes mellitus , randomized controlled trial , calcification , kidney disease , type 2 diabetes mellitus , hyperphosphatemia , endocrinology
Vascular calcification ( VC ) contributes to cardiovascular disease in hemodialysis ( HD ) patients, especially with diabetes mellitus ( DM ) complications. No randomized studies have been published regarding the effect of lanthanum carbonate ( LC ) on VC progression in DM patients. The aim of this study was to evaluate the effects of lanthanum carbonate on the progression of VC in HD patients with type 2 DM . We conducted a randomized controlled trial comparing LC with calcium carbonate ( CC ) in 43 HD patients at a single dialysis center. Estimations of aortic calcification index ( ACI ) by abdominal computed tomography were performed twice for each patient (at baseline and 12 months). Forty‐one patients completed the study (19 LC , 22 CC ). When ACI at baseline was ≦0.48 (median of baseline ACI ), median change in ACI (Δ% ACI ) was 20.44 (11.50–36.80%) in the LC group, and 40.00 (33.30–92.60%) in the CC group ( P = 0.026). On the other hand, when ACI at baseline was >0.48, the median change in ACI (Δ% ACI ) was 6.42 (3.13–24.40%) in the LC group, and 8.08 (5.68–12.20%) in the CC group ( P = 1.000). Serum markers of chronic kidney disease‐mineral and bone disorder ( CKD‐MBD ), HbA1c , dose of vitamin D analogues, and side‐effects of medications did not change in either group throughout the study except int‐ PTH increased in the LC group. This study indicated that administration of LC inhibited the progression of VC in patients receiving HD for type 2 DM , only in cases of slight VC compared with CC .