Journal
RENAL FAILURE
Volume 43, Issue 1, Pages 1378-1393Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/0886022X.2021.1986068
Keywords
Chronic kidney disease; hyperphosphatemia; lanthanum carbonate; efficacy; safety
Categories
Funding
- National Natural Science Foundations of China [81470993, 81272621]
- Baxter IIS Foundation [CHN-RENAL-IIS-2012-039]
- Xijing Hospital Foundation [XJGX15Y45]
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Lanthanum carbonate shows superior efficacy in controlling serum phosphorus levels and reducing adverse events in patients with chronic kidney disease, making it a promising alternative treatment option for hyperphosphatemia.
Objective The aim of this study was to determine the efficacy and safety of lanthanum carbonate (LC) versus calcium salts, non-LC phosphate binders (PBs), sevelamer, or placebo in patients with chronic kidney disease (CKD). Materials and methods A literature search on PubMed, Embase, and Cochrane Library databases was conducted up to 18 June 2021. Data acquisition and quality assessment were performed by two reviewers. Meta-analysis was performed to evaluate the serum biochemical parameters, adverse events, and patient-level outcomes of LC, non-LC PBs, and sevelamer for hyperphosphatemia in patients with CKD. Heterogeneity across studies was assessed utilizing the I (2) statistic and Q-test, and a random effect model was selected to calculate the pooled effect size. Results A total of 26 randomized, controlled trials and 3 observational studies were included. Compared to the other groups, better control effect of serum phosphorus (RR = 2.68, p < 0.001), reduction in serum phosphorus (95%CI = -1.93, -0.99; p < 0.001), Ca x P (95%CI = -13.89, -2.99; p = 0.002), serum intact parathyroid hormone levels (95%CI = -181.17, -3.96, p = 0.041) were found in LC group. Besides, reduced risk of various adverse effects, such as hypotension, abdominal pain, diarrhea, dyspepsia, and a score of coronary artery calcification were identified with LC in comparison to calcium salt, non-LC PBs, or placebo group. Significantly lower risk in mortality with LC treatment vs. non-LC PBs was observed, while no significant difference was identified between LC and calcium salt groups. Conclusion LC might be an alternative treatment for hyperphosphatemia in patients with CKD considering its comprehensive curative effect.
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