Yu-Ming Chang1, Shih-Ching Tsai1, Chih-Chung Shiao1, Hung-Hsiang Liou2,3, Chuan-Lan Yang4, Nai-Yu Tung5, Kua-Sui Hsu4, I-Ling Chen4, Mei-Chyn Liu6, Jsun-Liang Kao1, Rong-Na Jhen1, Ya-Ting Huang4. 1. Division of Nephrology, of Internal Medicine, Department Saint Mary's Hospital Luodong, Yilan, Taiwan. 2. Division of Nephrology, Department of Internal Medicine, Hsin-Jen Hospital, 5th F, 387 Chong-Cheng Road, Xinzhuang District, 242, New Taipei City, Taiwan. hh258527@ms23.hinet.net. 3. Dialysis Center, Hsin-Ren Clinics, New Taipei City, Taiwan. hh258527@ms23.hinet.net. 4. Department of Nursing, Saint Mary's Hospital Luodong, Yilan, Taiwan. 5. Nutrition Room, Saint Mary's Hospital Luodong, Yilan, Taiwan. 6. Dialysis Center, Hsin-Ren Clinics, New Taipei City, Taiwan.
Abstract
BACKGROUND:Phosphate binders have an impact on fibroblast growth factor 23 (FGF23); however, the effect of phosphate binders on serum hepcidin has not been explored. We conducted a 24-week multicenter randomized controlled trial to investigate the effects of lanthanum carbonate or calcium carbonate monotherapy on serum phosphate, FGF23, and hepcidin levels in chronic hemodialysis patients. METHODS:Forty-six patients were recruited, and daily dietary phosphorus was controlled between 600-800 mg. Serum calcium, phosphate, albumin, alkaline phosphatase (ALP), FGF23, intact parathyroid hormone (iPTH), hepcidin, high-sensitivity CRP (hsCRP), 25(OH)D, 1,25(OH)2D, fetuin-A, and osteopontin were checked as scheduled. RESULTS:Twenty-five patients completed the study. Mean serum FGF23 level was significantly decreased after a 24-week treatment with lanthanum (8677.5 ± 7490.0 vs. 4692.8 ± 5348.3 pg/mL, p = 0.013, n = 13), but not with calcium (n = 12). The reduction of serum hepcidin in lanthanum group was positively correlated with the decrement of serum phosphate (r = 0.631, p = 0.021) and serum hsCRP (r = 0.670, p = 0.012) levels, respectively. Serum ALP, iPTH, vitamin D, fetuin-A, and osteopontin revealed no significant inter- or intragroup differences. CONCLUSIONS: In summary, a decrease in serum FGF23 levels and a trend of decline in hepcidin levels were observed only in lanthanum group.
RCT Entities:
BACKGROUND:Phosphate binders have an impact on fibroblast growth factor 23 (FGF23); however, the effect of phosphate binders on serum hepcidin has not been explored. We conducted a 24-week multicenter randomized controlled trial to investigate the effects of lanthanum carbonate or calcium carbonate monotherapy on serum phosphate, FGF23, and hepcidin levels in chronic hemodialysis patients. METHODS: Forty-six patients were recruited, and daily dietary phosphorus was controlled between 600-800 mg. Serum calcium, phosphate, albumin, alkaline phosphatase (ALP), FGF23, intact parathyroid hormone (iPTH), hepcidin, high-sensitivity CRP (hsCRP), 25(OH)D, 1,25(OH)2D, fetuin-A, and osteopontin were checked as scheduled. RESULTS: Twenty-five patients completed the study. Mean serum FGF23 level was significantly decreased after a 24-week treatment with lanthanum (8677.5 ± 7490.0 vs. 4692.8 ± 5348.3 pg/mL, p = 0.013, n = 13), but not with calcium (n = 12). The reduction of serum hepcidin in lanthanum group was positively correlated with the decrement of serum phosphate (r = 0.631, p = 0.021) and serum hsCRP (r = 0.670, p = 0.012) levels, respectively. Serum ALP, iPTH, vitamin D, fetuin-A, and osteopontin revealed no significant inter- or intragroup differences. CONCLUSIONS: In summary, a decrease in serum FGF23 levels and a trend of decline in hepcidin levels were observed only in lanthanum group.
Authors: Majd A I Mirza; Tomas Hansen; Lars Johansson; Håkan Ahlström; Anders Larsson; Lars Lind; Tobias E Larsson Journal: Nephrol Dial Transplant Date: 2009-05-09 Impact factor: 5.992
Authors: María E Rodriguez-Ortiz; Ignacio Lopez; Juan R Muñoz-Castañeda; Julio M Martinez-Moreno; Alan Peralta Ramírez; Carmen Pineda; Antonio Canalejo; Philippe Jaeger; Escolastico Aguilera-Tejero; Mariano Rodriguez; Arnold Felsenfeld; Yolanda Almaden Journal: J Am Soc Nephrol Date: 2012-05-10 Impact factor: 10.121