Switching phosphate binders may help treatment failures

Data from a small study suggest that dialysis patients can achieve adequate phosphorus control if they switch to lanthanum carbonate after unsuccessful treatment with other phosphate binders.

Originally published on Renal and Urology News - World Review For Urologists and Nephrologists.

Click here to register to receive Renal and Urology News conference highlights by email

Linda Noto, RD, of Western New York Dialysis Centers in Orchard Park, NY, reported results of a 12-month study of 17 dialysis patients (mean age 66 years) who switched to lanthanum carbonate because their previous binders (calcium carbonate, calcium acetate, and sevelamer hydrochloride) were either ineffective, patients could not tolerate the medication, or the treatments resulted in elevated calcium levels. Patients also received education and counselling related to phosphorus control. Of the 17 patients, 14 had serum phosphorus levels exceeding the 5.5 mg/dL threshold recommended in Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines.

Following the switch to lanthanum carbonate, mean serum phosphorus levels declined significantly from 6.37 to 5.27 mg/dL after 12 months of treatment. The overall proportion of patients with phosphorus levels within the KDOQI guidelines rose from three of 17 patients (18%) before the switch to 11 of 17 patients (65%) by 12 months after the switch. Of 14 patients whose serum phosphorus levels exceeded 5.5 mg/dL before the switch, six fell to within KDOQI guidelines at months 1-3 and nine fell to within the guidelines at months 10-12.

During the 12 months of lanthanum carbonate treatment, patients had a mean serum albumin level of 3.78 g/dL, suggesting that their nutritional status was maintained.

The observed decrease in phosphorus levels is likely attributable to lanthanum carbonate rather than education and counselling because these latter interventions were implemented before the switch to lanthanum carbonate, the researchers noted.

More news from the National Kidney Foundation 2009 Spring Clinical Meetings

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

Every patient in England has access to extended hours GP appointments

Every patient in England has access to extended hours GP appointments

Every patient in England now has access to extended hours GP appointments, NHS England...

GP at Hand takes down video that sent 'wrong message' about antibiotics

GP at Hand takes down video that sent 'wrong message' about antibiotics

GP at Hand has removed a promotional video from its website that showed a patient...

GP Job of the Week: Salaried GP, Manchester

GP Job of the Week: Salaried GP, Manchester

The Robert Darbishire Practice is a not-for-profit social enterprise looking for...

Subject access requests to GP practices increased by a third under GDPR

Subject access requests to GP practices increased by a third under GDPR

The number of subject access requests (SARs) GP practices receive each month has...

RCGP criticises GP at Hand video showing antibiotics prescribed for sore throat

RCGP criticises GP at Hand video showing antibiotics prescribed for sore throat

A promotional video for Babylon GP at Hand that shows a patient with a sore throat...

Review into overprescribing aims to give GPs power to challenge hospital scrips

Review into overprescribing aims to give GPs power to challenge hospital scrips

A government review of overprescribing in the NHS could see GPs given more power...