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The effect of lanthanum carbonate on metabolic acidosis in patients with chronic kidney disease stage IV, V and V-D

  • Nephrology - Original Paper
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Abstract

Purpose

Hyperphosphatemia and metabolic acidosis are frequently encountered in advanced chronic kidney disease (CKD) patients. Correction of metabolic acidosis in patients with advanced CKD leads to a decrease in the progression of renal impairment and improves nutritional outcomes. Lanthanum carbonate is used for control of hyperphosphatemia. This study evaluated the effect of lanthanum carbonate on metabolic acidosis in CKD IV–V patients and in patients on dialysis.

Methods

Retrospective data of patients in whom lanthanum carbonate therapy was initiated were collected from 2009 to 2013 in a single dialysis center. Of the 79 patients in whom lanthanum carbonate was introduced, 51 patients were included in the analysis. Of the 51 patients, 39 patients received chronic hemodialysis, two patients received peritoneal dialysis therapy, and 10 patients had stage IV–V CKD not on dialysis. The primary outcome was the serum bicarbonate change after the introduction of lanthanum carbonate.

Results

There was a significant increase in mean serum bicarbonate concentration of 2.79 mmol/L (p ≤ 0.001) compared to baseline. The increase remained in the CKD IV–V patients (2.50 mmol/L, p = 0.005) and in the patients on dialysis (2.81 mmol/L, p < 0.001). Serum bicarbonate remained higher (p > 0.05) than baseline up to 6 months after lanthanum carbonate introduction.

Conclusion

In this study, lanthanum carbonate introduction increased serum bicarbonate concentration in a small sample of CKD IV–V patients and in patients on dialysis. Further studies are needed to confirm this effect and investigate whether the correction of metabolic acidosis by using lanthanum carbonate in CKD IV–V patients can improve clinical outcomes.

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References

  1. Kestenbaum B, Sampson JN, Rudser KD, Patterson DJ, Seliger SL, Young B, Sherrard DJ, Andress DL (2005) Serum phosphate levels and mortality risk among people with chronic kidney disease. J Am Soc Nephro 16(2):520–528. doi:10.1681/ASN.2004070602

    Article  CAS  Google Scholar 

  2. Kraut JA (2011) Effect of metabolic acidosis on progression of chronic kidney disease. Am J Physiol Renal Physiol 300(4):F828–F829. doi:10.1152/ajprenal.00074.2011

    Article  CAS  PubMed  Google Scholar 

  3. Dobre M, Yang W, Chen J, Drawz P, Hamm LL, Horwitz E, Hostetter T, Jaar B, Lora CM, Nessel L, Ojo A, Scialla J, Steigerwalt S, Teal V, Wolf M, Rahman M, Investigators C (2013) Association of serum bicarbonate with risk of renal and cardiovascular outcomes in CKD: a report from the Chronic Renal Insufficiency Cohort (CRIC) study. Am J Kidney Dis 62(4):670–678. doi:10.1053/j.ajkd.2013.01.017

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  4. Vashistha T, Kalantar-Zadeh K, Molnar MZ, Torlen K, Mehrotra R (2013) Dialysis modality and correction of uremic metabolic acidosis: relationship with all-cause and cause-specific mortality. Clin J Am Soc Nephrol 8(2):254–264. doi:10.2215/CJN.05780612

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  5. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group (2013) KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl 3:1–150

  6. de Brito-Ashurst I, Varagunam M, Raftery MJ, Yaqoob MM (2009) Bicarbonate supplementation slows progression of CKD and improves nutritional status. J Am Soc Nephrol 20(9):2075–2084. doi:10.1681/ASN.2008111205

    Article  PubMed Central  PubMed  Google Scholar 

  7. Joy MS, Finn WF (2003) Randomized, double-blind, placebo-controlled, dose-titration, phase III study assessing the efficacy and tolerability of lanthanum carbonate: a new phosphate binder for the treatment of hyperphosphatemia. Am J Kidney Dis 42(1):96–107

    Article  CAS  PubMed  Google Scholar 

  8. Hutchison AJ, Maes B, Vanwalleghem J, Asmus G, Mohamed E, Schmieder R, Backs W, Jamar R, Vosskuhler A (2005) Efficacy, tolerability, and safety of lanthanum carbonate in hyperphosphatemia: a 6-month, randomized, comparative trial versus calcium carbonate. Nephron Clin Pract 100(1):c8–c19. doi:10.1159/000084653

    Article  CAS  PubMed  Google Scholar 

  9. Finn WF (2006) Lanthanum carbonate versus standard therapy for the treatment of hyperphosphatemia: safety and efficacy in chronic maintenance hemodialysis patients. Clin Nephrol 65(3):191–202

    Article  CAS  PubMed  Google Scholar 

  10. Kasai S, Sato K, Murata Y, Kinoshita Y (2012) Randomized crossover study of the efficacy and safety of sevelamer hydrochloride and lanthanum carbonate in Japanese patients undergoing hemodialysis. Ther Apher Dial 16(4):341–349. doi:10.1111/j.1744-9987.2012.01071.x

    Article  CAS  PubMed  Google Scholar 

  11. Shigematsu T, Lanthanum Carbonate Research G (2008) Lanthanum carbonate effectively controls serum phosphate without affecting serum calcium levels in patients undergoing hemodialysis. Ther Apher Dial 12(1):55–61. doi:10.1111/j.1744-9987.2007.00541.x

    Article  CAS  PubMed  Google Scholar 

  12. Sprague SM, Abboud H, Qiu P, Dauphin M, Zhang P, Finn W (2009) Lanthanum carbonate reduces phosphorus burden in patients with CKD stages 3 and 4: a randomized trial. Clin J Am Soc Nephrol 4(1):178–185. doi:10.2215/CJN.02830608

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  13. Toida T, Fukudome K, Fujimoto S, Yamada K, Sato Y, Chiyotanda S, Kitamura K (2012) Effect of lanthanum carbonate vs. calcium carbonate on serum calcium in hemodialysis patients: a crossover study. Clin Nephrol 78(3):216–223

    Article  CAS  PubMed  Google Scholar 

  14. Chiang SS, Chen JB, Yang WC (2005) Lanthanum carbonate (Fosrenol) efficacy and tolerability in the treatment of hyperphosphatemic patients with end-stage renal disease. Clin Nephrol 63(6):461–470

    Article  CAS  PubMed  Google Scholar 

  15. Block GA, Wheeler DC, Persky MS, Kestenbaum B, Ketteler M, Spiegel DM, Allison MA, Asplin J, Smits G, Hoofnagle AN, Kooienga L, Thadhani R, Mannstadt M, Wolf M, Chertow GM (2012) Effects of phosphate binders in moderate CKD. J Am Soc Nephrol 23(8):1407–1415. doi:10.1681/ASN.2012030223

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Scaria PT, Gangadhar R, Pisharody R (2009) Effect of lanthanum carbonate and calcium acetate in the treatment of hyperphosphatemia in patients of chronic kidney disease. Indian J Pharmacol 41(4):187–191. doi:10.4103/0253-7613.56074

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  17. Filiopoulos V, Koutis I, Trompouki S, Hadjiyannakos D, Lazarou D, Vlassopoulos D (2011) Lanthanum carbonate versus sevelamer hydrochloride: improvement of metabolic acidosis and hyperkalemia in hemodialysis patients. Ther Apher Dial 15(1):20–27. doi:10.1111/j.1744-9987.2010.00868.x

    Article  CAS  PubMed  Google Scholar 

  18. Chan WL, Rounsley K, Chapman E, Collings K, Dale C, De Waal S, Patel V, Tanner J, Turner E, Moore J, Borrows R (2010) Lanthanum carbonate is an effective hypophosphatemic agent for hemodialysis patients intolerant of other phosphate binders. Ther Apher Dial 20(4):270–277. doi:10.1053/j.jrn.2009.10.009

    CAS  Google Scholar 

  19. Thet Z, Win AK, Pedagogos E, Beavis J, Crikis S, Nelson C (2013) Differential effects of phosphate binders on pre-dialysis serum bicarbonate in end-stage kidney disease patients on maintenance haemodialysis. BMC nephrol 14:205. doi:10.1186/1471-2369-14-205

    Article  PubMed Central  PubMed  Google Scholar 

  20. National Kidney F (2002) K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 39(2 Suppl 1):S1–S266

    Google Scholar 

  21. Coen G, Mazzaferro S, Ballanti P, Sardella D, Chicca S, Manni M, Bonucci E, Taggi F (1996) Renal bone disease in 76 patients with varying degrees of predialysis chronic renal failure: a cross-sectional study. Nephrol Dial Transplant 11(5):813–819

    Article  CAS  PubMed  Google Scholar 

  22. Ketteler M, Rix M, Fan S, Pritchard N, Oestergaard O, Chasan-Taber S, Heaton J, Duggal A, Kalra PA (2008) Efficacy and tolerability of sevelamer carbonate in hyperphosphatemic patients who have chronic kidney disease and are not on dialysis. Clin J Am Soc Nephrol 3(4):1125–1130. doi:10.2215/CJN.05161107

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  23. Bezzaoucha S, Pichette V, Lafrance JP, Bell R, Laurin LP, Vallee M (2013) The role of sevelamer carbonate in increasing serum bicarbonate in hyperphosphatemic predialysis patients who have metabolic acidosis. Int J Clin Pharmacol Ther 51(12):989–990. doi:10.5414/CP201941

    Article  CAS  PubMed  Google Scholar 

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Conflict of interest

We declare that the results presented in this paper have not been published previously in whole or part, except in abstract format during the 2013 ASN annual meeting.

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Authors and Affiliations

  1. Nephrology Department, Maisonneuve-Rosemont Hospital, Montreal, Canada

    William Beaubien-Souligny, Sarah Bezzaoucha, Vincent Pichette, Jean-Philippe Lafrance, Robert Bell, Caroline Lamarche, Denis Ouimet & Michel Vallee

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  1. William Beaubien-Souligny
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  2. Sarah Bezzaoucha
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  3. Vincent Pichette
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  4. Jean-Philippe Lafrance
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  8. Michel Vallee
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Correspondence to William Beaubien-Souligny.

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Beaubien-Souligny, W., Bezzaoucha, S., Pichette, V. et al. The effect of lanthanum carbonate on metabolic acidosis in patients with chronic kidney disease stage IV, V and V-D. Int Urol Nephrol 47, 1165–1171 (2015). https://doi.org/10.1007/s11255-015-1003-3

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  • DOI: https://doi.org/10.1007/s11255-015-1003-3

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