Effect Of Lanthanum Carbonate vs Calcium Acetate As A Phosphate Binder In Stage 3-4 CKD- ‘Treat To Goal Study’
Journal Title: Stanley Medical Journal - Year 2016, Vol 3, Issue 4
Abstract
Context: Hyperphosphatemia is a common in stage 3-4 CKD and influences the progression and prognosis in CKD patients. The efficacy and tolerability of non-calcium phosphate binders has not been studied in any open-label RCT. This study tried to compare the efficacy of lanthanum carbonate with conventional calcium-based phosphate binders such as calcium acetate. Aim: 1. Compare the efficacy of lanthanum carbonate vs calcium acetate as a phosphate binder 2. Compare the propensity of the above two drugs in producing/preventing hypercalcemia 3. Economic comparison between the two drugs 4. Settings and Design: ‘Treat to Goal’ open-labeled randomized cross-over comparison study Methods and Materials: Seventeen patients were randomized to receive either lanthanum carbonate or calcium acetate for 8 weeks. After a washout period of 2 weeks, patients were crossed to receive alternate drug for 8 weeks. For patients whose phosphorus was still not in target range, combination of the two drugs were given for 8 weeks. Serum calcium, serum phosphorus, Ca X P product and serum creatinine were estimated at frequent intervals. Paired ‘T’ test was used to compare the means of the two groups. Results: In the 15 patients who completed the study both lanthanum and calcium acetate were equally good phosphate binders. Although rise in calcium and Ca X P product was more with calcium acetate, it was not statistically significant. Conclusion: Both lanthanum carbonate and calcium acetate are equally effective phosphate binders and reduce phosphorus levels to a similar extent. Serum calcium and Ca X P products showed a rising trend with calcium acetate but it was not statistically significant. The cost of lanthanum carbonate was 17 times more than that of calcium acetate which is an important consideration in a developing country like ours
Authors and Affiliations
K. S. Sajeev Kumar, Mohandas M K, Ramdas Pisharody, Rakesh S Nair
Intrapleural instillation of Tranexamic acid for the control of postoperative bleeding following thoracic surgical procedures for chronic inflammatory pleural/pulmonary diseases - A Randomised prospective clinical study
Context Postoperative bleeding following open thoracic surgical procedures for chronic inflammatory pleural/pulmonary diseases (CIPPD) is adding considerable morbidity and mortality by increasing the need for more blood...
METASTATIC MALIGNANCIES PRESENTING AS NODAL ENLARGEMENT
Metastatic malignancy is a more common etiology of peripheral lymphadenopathy than lymphoma,especially in patients over 40 years of age. FNAC has proved to be a valuable tool in diagnosing .These...
A COMPARATIVE STUDY ON GLOMERULAR FILTRATION RATE ESTIMATED FROM SERUM CREATININE BETWEEN COCKCROFT-GAULT AND CKD-EPI EQUATIONS IN THE GENERAL POPULATION
Introduction: Chronic Kidney Disease is prevalent more in the developing countries than in the developed countries. It is increasing at an annual growth rate of 8%. It is a key determinant of the poor outcome of major No...
A STUDY ON NUTRITIONAL STATUS OF SCHOOL CHILDREN IN RURAL, SEMI URBAN AND URBAN AREAS OF TAMIL NADU.
BACKGROUND: The health and nutritional status of children is an index of national investment in the development of its future manpower. Malnutrition affects the child’s physical and cognitive growth and increases the su...
A rare case of annular pancreas - its diagnostic and treatment challenges
Annular pancreas is a rare congenital anomaly of the pancreatic ducts. This malformation in adults is usually asymptomatic, but can manifests as pancreatitis, duodenal stenosis, or duodenal or gastric ulceration. Its var...