Lanthanum carbonate vs conventional phosphate binders for the treatment of hyperphosphatemia in maintenance hemodialysis patients: a meta-analysis / 中华肾脏病杂志

ABSTRACT

Objective To assess the effect and safety of lanthanum carbonate vs conventional phosphate binders for hyperphosphatemia in patients undergoing maintenance hemodialysis.Methods According to the collaborative search strategy,MEDLINE (1996 to 2012.12),EBCO (1996 to 2012.12),the clinical control test database of Cochrane Library and Chinese Wanfang database (1996to 2012.12) were searched.Related literature,whether Published or not and meeting summary included,were searched by hand.Quality assessment and data extraction were conducted by two independent investigators.Meta-analysis was conducted by RevMan 5.0.The following outcomes were assessedserum phosphorus levels,serum iPTH levels,serum calcium levels and adverse events.Results were expressed as OR with 95％ confidence interval for dichotomous outcomes and WMD with 95％ confidence interval for continuous outcomes.Results A total of 10 reports were identified which met the inclusion criteria.The meta-analysis showed that the efficacy of treating hyperparathyroidism in hemodialysis patients was similar between lanthanum carbonate and conventional phosphate binders (WMD =-0.06,95％ CI-0.27 to 0.15,P =0.57) and the incidences of discontinuing due to adverse events were also similar.However,there were fewer hypercalcemic episodes and lower serum calcium levels in the lanthanum carbonate group compared to calcium-based phosphorus binders group.Conclusion Lanthanum carbonate is effective and well tolerated in treating hyperphosphatemia in hemodialysis patients with fewer hypercalcemia and lower serum calcium levels compared to calciumbased phosphate binders.