Abstract: Objective To evaluate the short- term efficacy of lanthanum carbonate in treating maintenance hemodialysis (MHD) patients with hyperphosphatemia. Methods A single center, open- labeled study from Peking Union Medical College Hospital was performed. Phosphate binders were discontinued during a two-week washout period. Patients with more than 1.78 mmol/L serum phosphorus after two-week washout period were eligible for the study. The dose was adjusted after first two weeks as necessary to achieve lower serum phosphorus. Lanthanum carbonate was administered to 12 MHD patients for 4 weeks, followed by taking
the original dose of calcium carbonate for 4 weeks. Results All patients fulfilled the whole study. After 4 weeks of treatment with lanthanum carbonate, serum phosphorus decreased significantly in 10 patients, and serum phosphorus was controlled to less than 1.78 mmol/L in 6 patients (2.33±0.09 vs. 1.51±0.06 mmol/L, P= 0.003). After continued use of the original dose of calcium carbonate for 4 weeks, serum phosphorus increased in 9 patients (1.76±0.10 vs. 2.23± 0.10 mmol/L, P=0.040). However, the levels of serum calcium and serum intact parathyroid hormone kept steady after the 10 weeks’observation. The levels of serum FGF23 and α-Kloth decreased after taking lanthanum carbonate in all 12 patients (P<0.05), and the level of FGF23 slightly increased after taking calcium carbonate for 4 weeks. Conclusions Lanthanum carbonate can control serum phosphorus, reduce the levels of serum FGF23 in a short term.

Key words: Hemodialysis, Hyperphosphatemia, Lanthanum carbonate, FGF23, α- Klotho