Lanthanum Carbonate

Excerpt

Until recently, calcium salts were the only available phosphate binders considered safe for use in patients with chronic renal failure. These compounds eliminated the serious toxicity problems seen with aluminium-containing phosphate binders. However, the need for large doses and concomitant administration of potent vitamin D analogues led to other adverse events such as recurrent hypercalcaemia and adynamic bone disease. Hyperphosphataemia or increased serum calcium × phosphorus product levels are associated with increased mortality in haemodialysis patients and a direct relationship has been found between high serum calcium × phosphorus product levels and cardiac and vascular calcifications.[1,2] These reports have emphasised the need for safe calcium-free phosphate binders. Sevelamer is the only calcium- and aluminium-free phosphate binder currently approved in patients with end-stage renal disease. There is a lower incidence of hypercalcaemia with sevelamer compared with calcium-based phosphate binders. …