Lanthanum Carbonate Provides Control of Phosphorus Levels in Patients New to Phosphate Binder Therapy and Patients Changed From Other Phosphate Binders

Objective

This retrospective study examined whether patients in an outpatient clinical setting with chronic kidney disease (CKD) stage 5, and who were either new to phosphate binder treatment or were previously treated with other phosphate binders, received benefit from treatment with lanthanum carbonate (LC).

Design

This was a retrospective analysis of patient records.

Setting

Patients were treated at the Western New York Dialysis Center, LLC (Orchard Park, NY).

Patients

Patients (n = 33) were identified through records as having CKD stage 5 and currently receiving or about to begin dialysis treatment. Naive patients (n = 16) had serum phosphorus levels >5.5 mg/dL and did not have previous exposure to phosphate binder treatment. “Changed” patients (n = 17) were treated with sevelamer hydrochloride or calcium-based binders before changing treatment to LC.

Interventions

Patients received 500 to 1,500 mg LC thrice daily as needed, to achieve serum phosphorus levels ≤5.5 mg/dL.

Results

Serum phosphorus control with LC was rapid (within 1 month) and sustained (after 6 months) in 81% of naive patients; serum albumin levels were maintained at 3.61 ± 0.28 g/dL over a period of 13.81 ± 8.4 months. Treatment with LC maintained serum phosphorus control after 10 to 12 months in 65% of patients in whom treatment was changed from other phosphate binders; serum albumin levels were maintained at 3.78 ± 0.35 g/dL after the change.

Conclusions

In this clinical setting, outpatients treated with LC maintained serum phosphorus control and serum albumin levels, suggesting that LC may be effective as an alternative to other phosphate binders or as first-line therapy for controlling serum phosphorus for ≤6 months in patients with CKD stage 5 beginning dialysis.