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Lanthanum carbonate.

Melanie S Joy1, Abhijit Kshirsagar, Corina Candiani

  • 1School of Medicine, Division of Nephrology, University of North Carolina, Carolina Kidney Center, Chapel Hill, NC 27599-7155, USA. Melanie_Joy@med.unc.edu

The Annals of Pharmacotherapy
|February 2, 2006
PubMed
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Lanthanum carbonate effectively lowers phosphate levels in chronic kidney disease (CKD) patients on dialysis. This phosphate binder is safe, with mainly gastrointestinal side effects, and avoids hypercalcemia.

Area of Science:

  • Nephrology
  • Pharmacology
  • Internal Medicine

Background:

  • Hyperphosphatemia is a common complication in patients with chronic kidney disease (CKD).
  • Phosphate binders are essential for managing hyperphosphatemia in CKD.
  • Non-calcium-based phosphate binders offer an alternative to traditional calcium salts.

Purpose of the Study:

  • To review the pharmacology, pharmacokinetics, clinical efficacy, and safety of lanthanum carbonate.
  • To evaluate lanthanum carbonate as a phosphate binder for CKD patients.

Main Methods:

  • Literature search of PubMed (1965-October 2005).
  • Inclusion of scientific posters and abstracts from nephrology meetings (1999-2005).
  • Review of all published articles and meeting presentations on lanthanum carbonate.

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Main Results:

  • Lanthanum carbonate is approved for phosphate reduction in stage 5 CKD patients on dialysis.
  • Recommended dose: 250-500 mg with meals, up to 1500 mg daily.
  • Demonstrated short- and long-term safety, with primarily gastrointestinal adverse effects.
  • Effective in reducing serum phosphorus and calcium-phosphorus product, with minimal impact on calcium and parathyroid hormone levels.

Conclusions:

  • Lanthanum carbonate is a safe and effective phosphate binder for CKD.
  • It does not pose a significant risk of hypercalcemia or worsening metabolic acidosis.
  • Its comparative role against other phosphate binders (calcium salts, sevelamer) requires further determination.