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Effects of lanthanum carbonate on vascular calcification in elderly maintenance hemodialysis patients
Xiao-Hui Wang1,2, Xin Zhang2, Chang-Jun Mu2
1Department of Nephrology, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
Insights
Lanthanum carbonate effectively reduced itching and lowered serum phosphorus and intact parathyroid hormone (iPTH) levels in elderly maintenance hemodialysis (MHD) patients. This treatment also attenuated abdominal aortic calcification (AAC) progression in these patients.
Area of Science:
- Nephrology
- Vascular Biology
- Mineral Metabolism
Background:
- Elderly patients undergoing maintenance hemodialysis (MHD) often experience complications like skin pruritus and vascular calcification.
- Abdominal aortic calcification (AAC) is a common comorbidity in MHD patients, associated with increased cardiovascular risk.
- Elevated serum phosphorus and intact parathyroid hormone (iPTH) levels are implicated in the pathogenesis of vascular calcification.
Purpose of the Study:
- To investigate the effect of lanthanum carbonate on abdominal aortic calcification (AAC) in elderly maintenance hemodialysis (MHD) patients.
- To evaluate the impact of lanthanum carbonate on skin pruritus, serum phosphorus, calcium-phosphorus products, and iPTH levels.
- To analyze the correlation between serum phosphorus levels and AAC scores.
Main Methods:
- A randomized controlled trial involving 54 elderly MHD patients with skin pruritus.
- Patients were divided into a control group (routine MHD) and a case group (routine MHD + lanthanum carbonate).
- Evaluated itching severity, serum calcium, phosphorus, calcium-phosphorus products, iPTH, and AAC scores at baseline and after 3 months.
Main Results:
- Lanthanum carbonate significantly reduced itching scores compared to baseline and the control group.
- The case group showed significant reductions in serum phosphorus, calcium-phosphorus products, and iPTH levels after 3 months.
- AAC scores were significantly lower in the lanthanum carbonate group, with a positive correlation observed between serum phosphorus and AAC scores.
Conclusions:
- Lanthanum carbonate is effective in alleviating itching in elderly MHD patients.
- The treatment also contributes to reducing serum phosphorus and iPTH levels, thereby attenuating vascular calcification.
- Lanthanum carbonate represents a potential therapeutic option for managing complications associated with MHD.
Abstract:
The effect of lanthanum carbonate on abdominal aortic calcification (AAC) in the elderly maintenance hemodialysis (MHD) patients was investigated. Fifty-four cases subjected to routine MHD complicated with skin pruritus admitted to our hospital were selected and randomly divided into case group (n=28) and control group (n=26). The control group was given routine MHD alone. The case group was given lanthanum carbonate additionally on the basis of routine MHD. The changes of itching degrees at first and third month, and serum calcium, phosphorus, calcium-phosphorus products, intact parathyroid hormone (iPTH) levels and AAC scores at third month after treatments were compared between the two groups. The correlation between calcium-phosphorus products and AAC scores was also analyzed. There was no significant difference in the baseline of blood urea nitrogen (BUN), serum creatinine (Scr), uric acid, albumin, hemoglobin, C reactive protein (CRP), low density lipoprotein (LDL), high density lipoprotein (HDL), triglyceride, total cholesterol between case group and control group (P>0.05 for all). There was also no significant difference in the baseline itching scores between the case group and the control group (P>0.05). At 1st and 3rd month after treatment, the itching scores in the case group were 14.2 ± 3.2 and 10.5 ± 2.3, respectively, which were significantly lower than the baseline and those in the control group (P<0.05 for all). At 1st and 3rd month after treatment, the itching scores in the control group were 23.6 ± 5.9 and 24.8 ± 6.3, respectively, which were significantly higher than the baseline (P<0.05). There was no significant difference in the baseline of serum calcium, phosphorus, calcium-phosphorus products, iPTH levels between the case group and control group (P>0.05). At 3rd month after treatment, serum phosphorus, calcium-phosphorus products and iPTH levels in the case group were decreased significantly as compared with the baseline (P<0.05), and the serum calcium, phosphorus, calcium-phosphorus products, and iPTH levels were statistically decreased as compared with those in the control group (P<0.05). The AAC scores showed statistically significant difference between the case group and the control group (P<0.05). The serum phosphorus and AAC scores showed a positive correlation in both two groups. It was suggested that the administration of lanthanum carbonate in the elderly MHD patients can effectively relieve itching, and simultaneously reduce serum phosphorus and iPTH levels, resulting in the attenuation of vascular calcification.
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