Lathanum Doesn't Reduce Heart Disease Risk in Kidney Patients

Lanthanum carbonate does not reduce the risk of cardiovascular disease developing in patients with chronic kidney disease, according to a clinical trial IMPROVE-CKD published in the Journal of the American Society of Nephrology.

This trial is led by a collaboration of kidney disease specialists from Australia, New Zealand and Malaysia as well as The University of Queensland's Australasian Kidney Trials Network, which is based at the Translational Research Institute.

‘New trial results help Nephrologists to determine the best treatment pathways for patients and provide high value care.’
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Co-Principal Investigator, Associate Professor Nigel Toussaint from The Royal Melbourne Hospital, says high phosphate levels are a common problem in kidney disease and are linked to the onset and degree of cardiovascular disease.

"Phosphate binder medication has long been a treatment for high phosphate levels in people with kidney disease, especially those on dialysis," said A/Prof Toussaint.

"There was some evidence that phosphate lowering may be effective in reducing risk factors for cardiovascular disease, but there were no adequate studies looking at the effect of lanthanum carbonate on cardiovascular risk factors in people with chronic kidney disease not on dialysis.

"In our clinical trial involving more than 270 patients from 18 hospitals, we found that lanthanum carbonate did not have a beneficial effect on cardiovascular disease indicators such as arterial stiffness or aortic calcification when compared to placebo."

The results will be critical for Nephrologists to determine the best treatment pathways for patients and provide high value care, according to lead New Zealand Investigator, Professor Rob Walker from Dunedin Hospital.

"The pill and symptom burden along with the economic impact for people with chronic diseases is very high, and if we can determine that certain treatments provide limited benefit then that is just as important as finding something that works," said Prof Walker.

Australasian Kidney Trials Network Chair of the Executive Operations Secretariat, Professor Carmel Hawley said that while further trials were needed to ensure consistency of the findings and generalizability of the results, in relation to phosphate binders, the use of these medications was associated with significant side-effects, particularly gastrointestinal, and they were inconvenient as they have to be taken with meals.

Drug-Induced Kidney Disease | Nephrotoxicity
Drug-induced nephrotoxicity is caused by nephrotoxic drugs or toxins which damage kidneys and can lead to nephritis or renal toxicity. The causative drug must be identified and its use must be avoided which can otherwise lead to high levels of toxins and severe damage to kidneys.

Clinicians enrolled 278 adult participants who had stage 3 or 4 chronic kidney disease from 18 hospitals across Australia, New Zealand and Malaysia. Half the participants received lanthanum carbonate and the other half of participants received a placebo for 96 weeks.

During the trial, clinicians performed pulse wave velocity - a measure of stiffness of arteries - and CT scans looking at calcium build up in arteries. Medical information was collected and blood samples taken. This was the longest trial to date in this study population.

Lanthanum carbonate reduces the absorption of dietary phosphate from the gut, and its ability to potentially lower phosphate balance in the body was thought to possibly prevent stiffening of blood vessels.

Source-Eurekalert