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, 20 (1), 39

Comparison of the Effects of Lanthanum Carbonate and Calcium Carbonate on the Progression of Cardiac Valvular Calcification After Initiation of Hemodialysis

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Comparison of the Effects of Lanthanum Carbonate and Calcium Carbonate on the Progression of Cardiac Valvular Calcification After Initiation of Hemodialysis

Kentaro Watanabe et al. BMC Cardiovasc Disord.

Abstract

Background: Although mineral metabolism disorder influences cardiac valvular calcification (CVC), few previous studies have examined the effects of non-calcium-containing and calcium-containing phosphate binders on CVC in maintenance hemodialysis patients. The aim of the present study was to compare the effects of lanthanum carbonate (LC) with calcium carbonate (CC) on the progression of CVC in patients who initiated maintenance hemodialysis and to investigate clinical factors related to CVC.

Methods: The current study included 50 subjects (mean age 65 years, 72% males) from our previous randomized controlled trial (LC group, N = 24; CC group, N = 26). CVC was evaluated as CVC score (CVCS) using echocardiography at baseline and 18 months after initiation of hemodialysis. We compared CVCS and the changes between the two groups. We also analyzed the associations between CVCS and any other clinical factors including arterial plaque score (PS) and serum phosphorus levels.

Results: Baseline characteristics of study participants including CVCS were almost comparable between the two groups. At 18 months, there were no significant differences in mineral metabolic markers or CVCS between the two groups, and CVCS were significantly correlated with PS (r = 0.39, p < 0.01). Furthermore, changes in CVCS were significantly correlated with average phosphorus levels (r = 0.36, p < 0.05), which were significantly higher in high serum phosphorus and high PS group compared to low serum phosphorus and low PS group (p < 0.05).

Conclusions: In the present study, there were no significant differences between LC and CC with regard to progression of CVC. However, serum phosphorus levels and arterial plaque seem to be important for the progression and formation of CVC in hemodialysis patients.

Keywords: Arterial plaque; Calcium carbonate; Cardiac valvular calcification; Initiation of hemodialysis; Lanthanum carbonate.

Conflict of interest statement

H.F. and S.N. have received a speaker honorarium from Bayer Yakuhin Co. The other authors declare that they have no other conflicts of interest.

Figures

Fig. 1
Fig. 1
Flowchart of participants in the present study
Fig. 2
Fig. 2
CVCS in the LC or CC group. a Total CVCS at baseline and 18 months. b Change in total CVCS from baseline to 18 months. Bars indicate the means and error bars indicate the standard deviation (SD). CVCS, cardiac valvular calcification score; LC, lanthanum carbonate group; CC, calcium carbonate; NS, not significant
Fig. 3
Fig. 3
CVCS based on average serum phosphate levels and the amount of plaque. a Changes in total CVCS from baseline to 18 months in the LP and HP group. b Changes in total CVCS from baseline to 18 months in the LPS group and in the HPS group. c Changes in total CVCS from baseline to 18 months in the LP + LPS and HP + HPS group. Bars indicate the means and error bars indicate the standard deviation (SD). CVCS, cardiac valvular calcification score; LP, low phosphorus group; HP, high phosphorus group; LPS, low plaque score group; HPS, high plaque score group

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