Effects of Lanthanum Carbonate on Calcium and Phosphorus Metabolism in Maintenance Hemodialysis Patients with High Calcium and High Phosphorus / 中国药房

ABSTRACT

OBJECTIVE:To investigate the effects of lanthanum carbonate on calcium and phosphate metabolism in maintenance hemodialysis(MHD)patients with high calcium and high phosphorus. METHODS:A total of 40 MHD patients with high calcium and high phosphorus in our hospital during May 2014-May 2015 were divided into control group(22 cases)and observation group (18 cases)according to therapy plan. Both groups received diet guidance and MHD treatment. Control group was given Hydrotalcite chewable tablets 1 g,during meal,tid. Observation group was additionally given Lanthanum carbonate chewable tablets 500 mg(for patients with blood phosphorus ≥2.26 mmol/L)or 250 mg(for patients with blood phosphorus <2.26 mmol/L),during meal,tid (adjusting after 4 weeks).Both groups received treatment for 3 months.The calcium and phosphorus metabolism indexes[blood calci-um,blood phosphorus,calcium and phosphorus product,immunoreactive parathyroid hormone(iPTH)and alkaline phosphatase] and phosphorus reducing efficacies were observed in 2 groups before and after treatment,and the occurrence of ADR was recorded. RE-SULTSBefore treatment,there was no statistical significance in calcium and phosphorus metabolism indexes between 2 groups(P>0.05).After treatment,there was no statistical significance in calcium and phosphorus metabolism indexes of control group,iPTH or alkaline phosphatase of observation group compared to before treatment(P>0.05);blood calcium,blood phosphorus,calcium and phosphorus product of observation group were significantly lower than before treatment and also lower than control group at corre-sponding time,with statistical significance(P<0.05).Total response rate of phosphorus reducing in observation group(88.89%)was significantly higher than control group(40.91%),with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between observation group(11.11%)and control group(4.55%)(P>0.05). CONCLUSIONS:The lanthanum carbonate can effectively decrease blood calcium and blood phosphorus levels in MHD patients with good safety.