Abstract: SA-PO667
The Effects of Lanthanum Carbonate on Bone Metabolic Markers and Bone Mineral Density in Incident Hemodialysis Patients
Session Information
- Bone and Mineral Metabolism: Clinical - II
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 402 Bone and Mineral Metabolism: Clinical
Authors
- Goto, Kimihiko, Kobe University Graduate School of Medicine, Kobe, Japan
- Goto, Shunsuke, Kobe University Graduate School of Medicine, Kobe, Japan
- Fujii, Hideki, Kobe University Graduate School of Medicine, Kobe, Japan
- Kono, Keiji, Kobe University Graduate School of Medicine, Kobe, Japan
- Nishi, Shinichi, Kobe University Graduate School of Medicine, Kobe, Japan
Background
Abnormal bone turnover is a risk factor for cardiovascular disease in hemodialysis (HD) patients. Lanthanum carbonate (LC) is widely used as one of calcium-free phosphate binders and some clinical trials reported the effect of LC on vascular calcification in HD patients. We previously conducted a randomized controlled trial which focused on the effect of LC on coronary artery calcification compared with calcium carbonate (CC) in patients after initiating HD. The aim of the present study was to investigate the effect of LC on bone metabolic markers and bone mineral density (BMD) compared with CC in subjects new to HD.
Methods
We conducted a post hoc analysis from our previous randomized controlled trial. We measured osteocalcin (OC), bone alkaline phosphatase (BAP), tartrate-resistant acid phosphatase 5b (TRACP-5b), and sclerostin in serum at baseline, 12, and 18 months. The measurement of BMD at lumbar spine and femoral neck was performed at the same time. The patients who did not have the data of bone metabolic markers were excluded from this study. Finally, 65 subjects were included in the present study.
Results
Serum OC, BAP, TRACP-5b, and sclerostin levels were comparable between the two groups at baseline. Serum OC levels in the LC group were significantly higher than those in the CC group at 18 months [LC vs CC, 30.0 (18.9-53.2) pg/mL vs 21.7 (15.3-28.3) pg/mL, p = 0.015]. Serum BAP and TRACP-5b levels tended to be higher in the LC group than in the CC group at 18 months [LC vs CC; BAP, 11.9 (8.1-18.5) vs 9.5 (8-12.9) μg/L, P = 0.174; TRACP-5b, 456.0 (228.0-644.0) vs 326.5 (183.3-487.5) mU/dL, P = 0.158, respectively]. Serum sclerostin levels were not different between the two groups. Although serum phosphate levels were comparable between the two groups, serum calcium levels tended to be lower and intact parathyroid hormone levels tended to be higher in the LC group than those in the CC group at 18 months. BMD at both lumbar spine and femoral neck were comparable between the two groups.
Conclusion
In the present study, bone formation and resorption markers were higher in the LC group than in the CC group. Our findings suggested that the treatment of LC was able to maintain proper bone turnover compared with calcium-containing phosphate binders in incident HD patients.