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Renal Week_1209 11/24/09 12:21 PM Page 2 www.renalandurologynews.com DECEMBER 2009 Renal & Urology News 15 s Renal Week 2009, San Diego Binders Unequal in Phosphorus Lowering Binders Plus Lanthanum carbonate provided greater reductions in HD patients Vitamin D BY JODY A. CHARNOW LANTHANUM carbonate treat- Aid Survival ment achieved greater reductions in serum phosphorus than did seve- A STUDY of Japanese dialysis patients lamer hydrochloride in a study of demonstrated that a combination of hemodialysis (HD) patients with oral vitamin D and a phosphorus binder elevated serum phosphorus. is associated with lower mortality. The study enrolled 182 HD patients The study, by Tsuneo Konta, MD, with serum phosphorus levels of PhD, Associate Professor of 6 mg/dL or higher and calcium levels of 8.4 mg/dL or higher. Investigators Nephrology at Yamagata University led by Stuart M. Sprague, DO, of School of Medicine in Yamagata, NorthShore University HealthSystem, Japan, included 466 patients at Northwestern University, Evanston, 17 hospitals who were on mainte- Ill., randomized patients to receive nance dialysis at the end of 2003. either lanthanum carbonate or seve- The American Society of Nephrology’s Renal Week 2009 drew 12,750 attendees, Investigators divided patients into lamer hydrochloride for four weeks. including 6,511 physicians to the San Diego Convention Center. one of four groups. One group Following a two-week washout peri- received both oral vitamin D and a od, patients switched to the other “completer” population consisting of “These results suggest that lan- phosphorus binder (reference group); phosphate binder. Clinicians initiated 119 subjects who completed four thanum carbonate is an effective treatment at a dose of 2,250 mg/day weeks of treatment with both binders phosphate binder for sustained con- another group received neither med- for lanthanum carbonate (one 750-mg and had a valid serum phosphorus trol of serum phosphorus in dialysis ication; a third group received tablet three times daily with meals) measurement at week 4 of each treat- patients,” the authors concluded. oral vitamin D but not a phosphorus and 4,800 mg/day for sevelamer ment period. “This is an important study as it is the binder; and the fourth group hydrochloride (two 800-mg tablets In the completer group, lanthanum only randomized comparative study of received a phosphorus binder but three times a day with meals), which carbonate was associated with a signif- two noncalcium containing phosphate not vitamin D. Investigators followed was increased to 3,000 mg/day for icant 0.50 mg/dL greater reduction in binders,” Dr. Sprague told Renal & patients for up to five years. lanthanum (three 1000-mg tablets serum phosphorus at week 4 com- Urology News. “This study demon- Compared with the reference group, daily) and 6400 mg/day (eight 800 mg pared with sevelamer hydrochloride, strated that three lanthanum carbonate the patients who did not take either tablets daily). Dr. Sprague’s group reported. In ad
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