Efficacy of Combined CHAp and Lanthanum Carbonate in Therapy for Hyperphosphatemia
Although, lanthanum carbonate has not been approved
by the FDA for treatment of hyperphosphatemia, we prospectively
evaluated the efficacy of the combination of Calcium hydroxyapatite
(CHAp) and Lanthanum Carbonate (LaC) for the treatment of
hyperphosphatemia on mice. CHAp was prepared by co-precipitation
method using Ca(OH)2, H3PO4, NH4OH with calcination at 1200ºC.
Lanthanum carbonate was prepared by chemical method using
NaHCO3 and LaCl3 at low pH environment, below 4.0. The
structures were characterized by FTIR spectra and SEM -EDX
analysis. The study group included 16 subjects-mice divided into four
groups according to the administered substance: lanthanum carbonate
(group A), CHAp (group B), lanthanum carbonate + CHAp (group C)
and salt water (group D). The results indicate a phosphate decrease
when subjects (mice) were treated with CHAp and lanthanum
carbonate (0.5% CMC), in a single dose of 1500 mg/kg. Serum
phosphate concentration decreased [(from 4.5 ± 0.8 mg/dL) to
4.05 ± 0.2 mg/dL), P < 0.01] in group A and in group C (to 3.6
± 0.2 mg/dL) at 12 hours from the administration. The combination
of CHAp and lanthanum carbonate is a suitable regimen for
hyperphosphatemia treatment because it avoids both the
hypercalcemia of CaCO3 and the adverse effects of CHAp.
[1] S. Damment, “Pharmacology of the Phosphate Binder, Lanthanum
Carbonate”, Laboratory Studies, vol. 33, no. 2, pp. 217-224, 2011.
[2] V. P. Persy, G. J. Behets, A. R. Bervoets, M. E. De Broe, P. C. D’Haese,
“Lanthanum: a safe phosphate binder”, Semin Dial, vol. 19, pp. 195-199,
2006.
[3] J. Pairon, F. Roos, P. Sebastien, B. Chamak, I. Abd-alsamad, J.
Bernaudin, J. Bignon, P. Brochard, “Biopersistence of cerium in the
human respiratory tract and ultrastructural findings”, Am. J. Ind. Med.
vol. 27, pp. 349-358, 1995.
[4] A. J. Hutchison, M. E. Barnett, R. J. Krause, G. A. Siami, “Lanthanum
carbonate treatment, for up to 6 years, is not associated with adverse
effects on the liver in patients with chronic kidney disease Stage 5
receiving hemodialysis”, Clin. Nephrol., vol. 7, no. 3, pp. 286-295,
2009.
[5] S. M. Sprague, H. Abboud, P. Qiu, M. Dauphin, P. Zhang, W. Finn.
“Lanthanum carbonate reduces phosphorus burden in patients with CKD
stages 3 and 4: a randomized trial”, Clin J Am Soc Nephrol, vol. 4, pp.
178-185, 2009.
[6] A. J. Hutchison, M. E. Barnett, R. Krause, J. T. Kwan, G. A. Siami,
“Lanthanum Study Group Long-term efficacy and safety profile of
lanthanum carbonate: Results for up to 6 years of treatment”, Nephron
Clin Pract., vol. 110, no. 1, pp. c15-23, 2008.
[7] G. J. Behets, G. Dams, S. R. Vercauteren, S. J. Damment, R. Bouillon,
M. E. De Broe, P. C. D’Haese, “Does the phosphate binder lanthanum
carbonate affect bone in rats with chronic renal failure?”, J. Am. Soc.
Nephrol., vol. 15, pp. 2219-2228, 2004.
[8] T. Shigematsu, Y. Nakashima, M. Ohya, Tatsuta K., Koreeda D.,
Yoshimoto W., Yamanaska S., Sakaguchi T., Hanba Y., Mima T., Negi
“The management of hyperphosphatemia by lanthanum carbonate in
chronic kidney disease patients”, Inter. J. of Nephrology and
Renovascular Disease, May 2012.
[9] I. Mohammed, A. Hutchison, “Phosphate binding therapy in dialysis
patients: focus on lanthanum carbonate”, Ther. Clin. Risk Manag., vol 4,
no. 5, pp. 887-893, 2008.
[10] W. F. Finn, “Lanthanum carbonate versus standard therapy for the
treatment of hyperphosphatemia: safety and efficacy in chronic
maintenance hemodialysis patients”, Clin. Nephrol., vol. 65, pp. 191-
202, 2006.
[11] A. J. Hutchison, F. Al-Baaj, “Lanthanum carbonate for the treatment of
hyperphosphatemia in renal failure and dialysis patients”, Expert Opin.
Pharmacother., vol. 6, pp. 319-28, 2005.
[12] G.J. Behets, G. Dams, S.J. Damment, P. Martin, M. E. Broe, De,
D'Haese, “Differences in gastrointestinal calcium absorption after the
ingestion of calcium-free phosphate binders”, American Journal of
Physiology - Renal Physiology, vol.306, no. 1, pp. F61-F67, 2014.
[13] A. Palasz, P. Czekaj, “Toxicological and cytophysiological aspects of
lanthanides action”, II Department of Histology and Embryology,
Silesian Medical Academy, Katowice, Poland, vol. 47, no. 4, pp. 1107-
1114, 2000.
[14] Z. Deng, L. Wang, D. Zhang, J. Liu, C. Liu, J. Ma, “Lanthanumcontaining
hydroxyapatite coating on ultrafine-grained titanium by
micro-arc oxidation: A promising strategy to enhance overall
performance of titanium”, Med. Sci. Monit., vol. 20, pp. 163-166, 2014.
[15] D. G. Guo, A. H. Wang, Y. Han, K. W. Xu, “Characterization,
physicochemical properties and biocompatibility of La-incorporated
apatites”, Acta Biomater. vol. 5, no. 9, pp. 3512-3523, November. 2009.
[16] J.C. Zhang, T.L. Zhang, S.J. Xu, K. Wang, S.F. Yu, “Effects of
lanthanum on formation and bone-resorbing activity of osteoclast-like
cells”, J. Rare Earths, vol. 22, no. 6, pp. 891-895, 2004.
[17] H. Hayashi, M. Machida, T. Sekine., H. Yamaguchi, Kiriyama, T.
Kumita S., “Beam-hardening artifacts on computed tomography images
caused by lanthanum carbonate hydrate in a patient on dialysis”, Jpn. J.
Radiol., vol. 28, no. 4, pp. 322-324, May 2010.
[18] G. N. Nadkarni, J. Uribarri, “Phosphorus and the kidney: what is known
and what is needed”, Adv. Nutr., vol. 5, pp. 98-103, 2014.
[1] S. Damment, “Pharmacology of the Phosphate Binder, Lanthanum
Carbonate”, Laboratory Studies, vol. 33, no. 2, pp. 217-224, 2011.
[2] V. P. Persy, G. J. Behets, A. R. Bervoets, M. E. De Broe, P. C. D’Haese,
“Lanthanum: a safe phosphate binder”, Semin Dial, vol. 19, pp. 195-199,
2006.
[3] J. Pairon, F. Roos, P. Sebastien, B. Chamak, I. Abd-alsamad, J.
Bernaudin, J. Bignon, P. Brochard, “Biopersistence of cerium in the
human respiratory tract and ultrastructural findings”, Am. J. Ind. Med.
vol. 27, pp. 349-358, 1995.
[4] A. J. Hutchison, M. E. Barnett, R. J. Krause, G. A. Siami, “Lanthanum
carbonate treatment, for up to 6 years, is not associated with adverse
effects on the liver in patients with chronic kidney disease Stage 5
receiving hemodialysis”, Clin. Nephrol., vol. 7, no. 3, pp. 286-295,
2009.
[5] S. M. Sprague, H. Abboud, P. Qiu, M. Dauphin, P. Zhang, W. Finn.
“Lanthanum carbonate reduces phosphorus burden in patients with CKD
stages 3 and 4: a randomized trial”, Clin J Am Soc Nephrol, vol. 4, pp.
178-185, 2009.
[6] A. J. Hutchison, M. E. Barnett, R. Krause, J. T. Kwan, G. A. Siami,
“Lanthanum Study Group Long-term efficacy and safety profile of
lanthanum carbonate: Results for up to 6 years of treatment”, Nephron
Clin Pract., vol. 110, no. 1, pp. c15-23, 2008.
[7] G. J. Behets, G. Dams, S. R. Vercauteren, S. J. Damment, R. Bouillon,
M. E. De Broe, P. C. D’Haese, “Does the phosphate binder lanthanum
carbonate affect bone in rats with chronic renal failure?”, J. Am. Soc.
Nephrol., vol. 15, pp. 2219-2228, 2004.
[8] T. Shigematsu, Y. Nakashima, M. Ohya, Tatsuta K., Koreeda D.,
Yoshimoto W., Yamanaska S., Sakaguchi T., Hanba Y., Mima T., Negi
“The management of hyperphosphatemia by lanthanum carbonate in
chronic kidney disease patients”, Inter. J. of Nephrology and
Renovascular Disease, May 2012.
[9] I. Mohammed, A. Hutchison, “Phosphate binding therapy in dialysis
patients: focus on lanthanum carbonate”, Ther. Clin. Risk Manag., vol 4,
no. 5, pp. 887-893, 2008.
[10] W. F. Finn, “Lanthanum carbonate versus standard therapy for the
treatment of hyperphosphatemia: safety and efficacy in chronic
maintenance hemodialysis patients”, Clin. Nephrol., vol. 65, pp. 191-
202, 2006.
[11] A. J. Hutchison, F. Al-Baaj, “Lanthanum carbonate for the treatment of
hyperphosphatemia in renal failure and dialysis patients”, Expert Opin.
Pharmacother., vol. 6, pp. 319-28, 2005.
[12] G.J. Behets, G. Dams, S.J. Damment, P. Martin, M. E. Broe, De,
D'Haese, “Differences in gastrointestinal calcium absorption after the
ingestion of calcium-free phosphate binders”, American Journal of
Physiology - Renal Physiology, vol.306, no. 1, pp. F61-F67, 2014.
[13] A. Palasz, P. Czekaj, “Toxicological and cytophysiological aspects of
lanthanides action”, II Department of Histology and Embryology,
Silesian Medical Academy, Katowice, Poland, vol. 47, no. 4, pp. 1107-
1114, 2000.
[14] Z. Deng, L. Wang, D. Zhang, J. Liu, C. Liu, J. Ma, “Lanthanumcontaining
hydroxyapatite coating on ultrafine-grained titanium by
micro-arc oxidation: A promising strategy to enhance overall
performance of titanium”, Med. Sci. Monit., vol. 20, pp. 163-166, 2014.
[15] D. G. Guo, A. H. Wang, Y. Han, K. W. Xu, “Characterization,
physicochemical properties and biocompatibility of La-incorporated
apatites”, Acta Biomater. vol. 5, no. 9, pp. 3512-3523, November. 2009.
[16] J.C. Zhang, T.L. Zhang, S.J. Xu, K. Wang, S.F. Yu, “Effects of
lanthanum on formation and bone-resorbing activity of osteoclast-like
cells”, J. Rare Earths, vol. 22, no. 6, pp. 891-895, 2004.
[17] H. Hayashi, M. Machida, T. Sekine., H. Yamaguchi, Kiriyama, T.
Kumita S., “Beam-hardening artifacts on computed tomography images
caused by lanthanum carbonate hydrate in a patient on dialysis”, Jpn. J.
Radiol., vol. 28, no. 4, pp. 322-324, May 2010.
[18] G. N. Nadkarni, J. Uribarri, “Phosphorus and the kidney: what is known
and what is needed”, Adv. Nutr., vol. 5, pp. 98-103, 2014.
@article{"International Journal of Medical, Medicine and Health Sciences:69770", author = "Andreea Cârâc and Elena Moroşan and Ana Corina Ioniță and Rica Boscencu and Geta Cârâc", title = "Efficacy of Combined CHAp and Lanthanum Carbonate in Therapy for Hyperphosphatemia", abstract = "Although, lanthanum carbonate has not been approved
by the FDA for treatment of hyperphosphatemia, we prospectively
evaluated the efficacy of the combination of Calcium hydroxyapatite
(CHAp) and Lanthanum Carbonate (LaC) for the treatment of
hyperphosphatemia on mice. CHAp was prepared by co-precipitation
method using Ca(OH)2, H3PO4, NH4OH with calcination at 1200ºC.
Lanthanum carbonate was prepared by chemical method using
NaHCO3 and LaCl3 at low pH environment, below 4.0. The
structures were characterized by FTIR spectra and SEM -EDX
analysis. The study group included 16 subjects-mice divided into four
groups according to the administered substance: lanthanum carbonate
(group A), CHAp (group B), lanthanum carbonate + CHAp (group C)
and salt water (group D). The results indicate a phosphate decrease
when subjects (mice) were treated with CHAp and lanthanum
carbonate (0.5% CMC), in a single dose of 1500 mg/kg. Serum
phosphate concentration decreased [(from 4.5 ± 0.8 mg/dL) to
4.05 ± 0.2 mg/dL), P < 0.01] in group A and in group C (to 3.6
± 0.2 mg/dL) at 12 hours from the administration. The combination
of CHAp and lanthanum carbonate is a suitable regimen for
hyperphosphatemia treatment because it avoids both the
hypercalcemia of CaCO3 and the adverse effects of CHAp.
", keywords = "Calcium hydroxyapatite, hyperphosphatemia,
lanthanum carbonate, phosphatebinder, structures.", volume = "9", number = "2", pages = "208-4", }
