Department of Nephrology, Immunology, and Vascular Medicine, Shonan Kamakura General Hospital, Kamakura, Japan.
J Cardiovasc Pharmacol Ther. 2013 Sep;18(5):439-46. doi: 10.1177/1074248413486355. Epub 2013 Apr 23.
Coronary artery calcification (CAC) is associated with future cardiovascular events and/or death of patients on hemodialysis (HD). We investigated whether progression of CAC in patients on HD could be delayed by switching from a calcium (Ca)-based phosphate (Pi) binder to lanthanum carbonate.
DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: The CAC scores were evaluated at study enrollment and after 6 months in 52 patients on HD using calcium carbonate (CC) as a Pi binder. Patients were randomly divided into 2 groups assigned to receive either CC or lanthanum carbonate (LC), and the CAC scores were evaluated after a 6-month treatment period. Progression of CAC was assessed, as were serum levels of Ca, Pi, and intact parathyroid hormone (iPTH).
Forty-two patients completed the study (23 receiving CC and 19 receiving LC). In the 6 months prior to randomization, all patients were treated with CC. During this 6-month period, the CAC scores increased significantly in all 42 patients. Once randomized, there was significantly less progression in the group treated with LC than with CC. Changes in CAC scores from 6 to 12 months were significantly smaller in the LC group than the CC group (-288.9 ± 1176.4 vs 107.1 ± 559.6, P = .036), and percentage changes were also significantly different (-6.4% vs 41.2%, P = .024). Serum Ca, Pi, and iPTH levels were similar in both groups during the study period.
This pilot study suggested that LC delayed progression of CAC in patients on HD compared with CC.
冠状动脉钙化（CAC）与血液透析（HD）患者的未来心血管事件和/或死亡有关。我们研究了是否可以通过将钙（Ca）基磷酸盐（Pi）结合剂转换为碳酸镧来延迟 HD 患者 CAC 的进展。
设计、设置、参与者和测量：使用碳酸钙（CC）作为 Pi 结合剂，在 52 名接受 HD 的患者中，在研究入组时和 6 个月后评估 CAC 评分。患者被随机分为两组，分别接受 CC 或碳酸镧（LC）治疗，并在 6 个月的治疗期间评估 CAC 评分。评估 CAC 的进展情况，以及血清 Ca、Pi 和完整甲状旁腺激素（iPTH）水平。
42 名患者完成了研究（23 名接受 CC，19 名接受 LC）。在随机分组前的 6 个月内，所有患者均接受 CC 治疗。在这 6 个月期间，所有 42 名患者的 CAC 评分均显著增加。一旦随机分组，接受 LC 治疗的组 CAC 进展明显少于接受 CC 治疗的组。LC 组从 6 个月到 12 个月的 CAC 评分变化明显小于 CC 组（-288.9 ± 1176.4 与 107.1 ± 559.6，P =.036），变化百分比也明显不同（-6.4%与 41.2%，P =.024）。在研究期间，两组患者的血清 Ca、Pi 和 iPTH 水平相似。
这项初步研究表明，与 CC 相比，LC 延迟了 HD 患者 CAC 的进展。
