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Abstract: ASN Annual Meeting -- San Diego |
Kalil RS, Flanigan MG, Stanford W, et al.
The Effect of Lanthanum Carbonate (LC) (Fosrenol) on Coronary Artery Calcification (CAC) and Endothelial Function (FMD) in Hemodialysis (HD) Patients. A Pilot, Prospective Study.
ASN Annual Meeting -- San Diego
J Am Soc Nephrol (Nov) 20:399A 2009
Uremia is a state of chronic inflammation. Atherosclerosis is an inflammatory disease, and coronary artery calcification (CAC) is a marker of atherosclerosis. Endothelial dysfunction is highly prevalent in patients receiving HD.
Methods: Prospective, randomized trial enrolling adult HD patients after a phosphate binder wash-out period of 10 days, randomized to stay on the same therapy (Calcium-based, or Sevelamer or both) or switch to LC (1:1). A baseline and 6 month CAC (Agaston score measured by MSCT), and endothelial function (measured by flow-mediated dilation of brachial artery - FMD), were obtained. At 12 months, a CAC only was obtained. Laboratory parameters were monitored according to standard of care.
Results: 13 patients were studied and completed at least 2 visits (LC, N=7 and C N=6). CAC scores (Log) were as follows-LC group: 7.2140.615, 7.112
Progression or regression of CAC did not correlate with changes in FMD, and % change in FMD at 6 months compared to baseline was similar between both groups (P=0.77).
Conclusion: There is dissociation between progression of CAC and FMD in HD patients. Lanthanum Carbonate halts progression of CAC in hemodialysis patients independently of amelioration in endothelial function. Further studies will be necessary to evaluate whether the beneficial effects of LC on CAC will impact on patient survival.
© Copyright 2009-2010 American Society of Nephrology.Reproduced with permission.
Until September of 2010 all ASN abstracts from the 2009 Annual Meeting are available at this link.
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