• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Cardiology

Non-calcium-based phosphate binders not found to affect arterial stiffness or aortic calcification

byKathleen LauandAlex Chan
November 9, 2020
in Cardiology, Nephrology
Reading Time: 2 mins read
0
Share on FacebookShare on Twitter

RELATED REPORTS

Catheter ablation reduces rates of persistent atrial fibrillation and atrial tachyarrhythmia

Empagliflozin use is associated with slower progression of chronic kidney disease

Clinical decision-making strategy improves acute heart failure outcomes

1. Non-calcium-based phosphate binders did not affect arterial stiffness or aortic calcification compared to placebo in moderate-to-severe chronic kidney disease.

Evidence Rating Level: 1 (Excellent)

Abnormal phosphate homeostasis is characteristic of chronic kidney disease, with hyperphosphatemia strongly associated with increased arterial stiffness secondary to calcification. Positive phosphate balance may contribute to rising fibroblast growth factor 23 (FGF23) levels. Both high FGF23 levels and arterial stiffness and calcification are associated with worsening kidney function and cardiovascular events and mortality. Although calcium-based phosphate binders are most commonly prescribed to treat hyperphosphatemia, non-calcium-based phosphate binders, like lanthanum carbonate, have been associated with reduced vascular calcification. Consequently, limited trials have described non-calcium-based phosphate binder therapy lowering serum phosphate and FGF23 levels; however, their effects on cardiovascular markers remain unknown. IMPROVE-CKD, or the IMpact of Phosphate Reduction on Vascular Endpoints in CKD, is an investigator-initiated, multicentre, international,double-blinded, placebo-controlled trial. 138 participants with stage 3b-4 CKD (eGFR 15-44mL/min/1.73m2) with normophosphatemia were randomized 1:1 to receive either 500mg lanthanum carbonate or matched placebo three times daily for 96 weeks. By the end of the trial, no significant differences were seen in the primary endpoint, mean pulse wave velocity (PWV), or in abdominal aortic calcification (AAC), serum phosphate, parathyroid hormone, FGF23 levels, or 24-hour urinary phosphate. At baseline, there was a greater proportion of AAC in the lanthanum arm (86% vs 77% in placebo, p=0.23). Serious adverse events occurred at similar rates between the groups (46% lanthanum vs 47% placebo), next to a significantly higher rate of life-threatening events in lanthanum (3% vs 0%, p=0.06). The study cohort in general was at a high cardiovascular risk at baseline, with a high mean PWV level (>10m/s) and a high prevalence of AAC (81%). Advanced arterial stiffness and calcification may have contributed to the lack of effect seen with the intermediate cardiovascular outcomes measured. Achievement of only 57% of target recruitment also led to underpowering of the study. Nevertheless, this is the largest and longest placebo-controlled study of its kind and its results cannot justify treating moderate-to-advanced CKD with phosphate binders to reduce cardiovascular risk in normophosphatemia. Further studies that are adequately powered could target a cohort with positive phosphate balance to assess whether phosphate-lowering therapies would improve patient outcomes.

Click to read the study in JASN

Image: PD

©2020 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: cardiologychronic kidney diseasenephrology
Previous Post

2 Minute Medicine Rewind November 9, 2020

Next Post

#VisualAbstract: Lopinavir-ritonavir does not improve clinical outcomes in patients hospitalized with COVID-19

RelatedReports

β-blockers linked to improved survival in preserved ejection fraction heart failure
Cardiology

Catheter ablation reduces rates of persistent atrial fibrillation and atrial tachyarrhythmia

January 27, 2023
Fish oil and aspirin did not reduce arteriovenous fistula failure: The FAVOURED trail
Cardiology

Empagliflozin use is associated with slower progression of chronic kidney disease

January 26, 2023
Remote patient monitoring did not reduce heart failure readmissions: The BEAT-HF trial
Cardiology

Clinical decision-making strategy improves acute heart failure outcomes

January 12, 2023
Pediatric DKA associated with recent acute care visits
Cardiology

Low-carbohydrate, high-fat diet improves glycemic control in type 2 diabetic patients

January 11, 2023
Next Post
#VisualAbstract:Adjuvant radiotherapy does not improve survival following prostatectomy in men with localized or locally advanced prostate cancer

#VisualAbstract: Lopinavir-ritonavir does not improve clinical outcomes in patients hospitalized with COVID-19

Association between anticoagulation, bleeding, and subsequent cancer diagnoses

Fish oil and aspirin did not reduce arteriovenous fistula failure: The FAVOURED trail

Overall seroprevalence of SARS-CoV-2 antibodies relatively low in the USA adult and dialysis populations

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Bisphosphonates, denosumab, abaloparatide, teriparatide, and romosozumab reduce postmenopausal fracture risk
  • Epstein-Barr viral load monitoring reduces risk of post-liver transplant lymphoproliferative disease
  • Homicide deaths are on the rise for children living in the United States
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

Want more physician-written
medical news?

Join over 10 million yearly readers and numerous companies. For healthcare professionals
and the public.

Subscribe for free today!

Subscription options