Takashi Shigematsu1, Shigeo Negi. 1. Division of Nephrology and Blood Purification Medicine, Department of Medicine, Wakayama Medical University, Wakayama, Japan. taki@wakayama-med.ac.jp
Abstract
BACKGROUND: Increased blood levels of fibroblast growth factor-23 (FGF-23) are associated with increased mortality. We evaluated the effect of combined therapy with lanthanum carbonate (LaC), a new phosphate binder and calcium carbonate (CaC) on serum levels of phosphate and FGF-23. METHODS: This was a single-arm, open-label, multicenter study. Hemodialysis patients with a serum phosphate level >6.0 mg/dL despite CaC therapy were also given LaC for 16 weeks at a dose up to 2250 mg/day. CaC was given at a fixed dose throughout the 16-week period. RESULTS: Of 42 patients enrolled, 36 completed the 16-week study. The serum phosphate level showed a significant decrease from 6.9 ± 1.4 mg/dL at week 0 to 5.5 + 1.2 mg/dL at week 16 (-20.0%, P < 0.05). The median FGF-23 level showed a significant decrease from 8250 ng/L at week 0 to 5000 ng/L at week 16 (-39.2%, P < 0.05). In contrast, corrected serum calcium and the serum parathyroid hormone level showed no significant changes. A significant positive correlation (r = 0.442, P = 0.007) was demonstrated between the percent reduction of serum FGF-23 and that of serum phosphate. CONCLUSION: Both serum phosphate and FGF-23 levels were significantly decreased by treatment with LaC plus CaC.
BACKGROUND: Increased blood levels of fibroblast growth factor-23 (FGF-23) are associated with increased mortality. We evaluated the effect of combined therapy with lanthanum carbonate (LaC), a new phosphate binder and calcium carbonate (CaC) on serum levels of phosphate and FGF-23. METHODS: This was a single-arm, open-label, multicenter study. Hemodialysis patients with a serum phosphate level >6.0 mg/dL despite CaC therapy were also given LaC for 16 weeks at a dose up to 2250 mg/day. CaC was given at a fixed dose throughout the 16-week period. RESULTS: Of 42 patients enrolled, 36 completed the 16-week study. The serum phosphate level showed a significant decrease from 6.9 ± 1.4 mg/dL at week 0 to 5.5 + 1.2 mg/dL at week 16 (-20.0%, P < 0.05). The median FGF-23 level showed a significant decrease from 8250 ng/L at week 0 to 5000 ng/L at week 16 (-39.2%, P < 0.05). In contrast, corrected serum calcium and the serum parathyroid hormone level showed no significant changes. A significant positive correlation (r = 0.442, P = 0.007) was demonstrated between the percent reduction of serum FGF-23 and that of serum phosphate. CONCLUSION: Both serum phosphate and FGF-23 levels were significantly decreased by treatment with LaC plus CaC.
Authors: Cristian Rodelo-Haad; Maria E Rodríguez-Ortiz; Alejandro Martin-Malo; M Victoria Pendon-Ruiz de Mier; M Luisa Agüera; Juan R Muñoz-Castañeda; Sagrario Soriano; Francisco Caravaca; M Antonia Alvarez-Lara; Arnold Felsenfeld; Pedro Aljama; Mariano Rodriguez Journal: PLoS One Date: 2018-08-07 Impact factor: 3.240