Abstract: Objective To explore the effect of lanthanum carbonate on vascular calcification and bone mineral density in maintenance hemodialysis (MHD) patients with diabetes complicated with adynamic bone disease. Methods A total of 92 MHD cases were divided into calcium carbonate (CC) group and lanthanum carbonate (LC) group. We compared serum calcium, phosphate, FGF23, bone alkaline phosphate (BALP), procollagen I N-terminal peptide (PINP), C-terminal telopeptide (β-CTX), matrix gla protein (MGP) and hsCRP, coronary artery calcification score (CACS) and bone mineral density at baseline and after 12 months between the two groups. SPSS 17.0 for Windows was used for statistical analyses. Results After the treatment for 12 months, serum levels of phosphate, FGF23 and MGP decreased significantly and serum levels of iPTH, BALP, PINP and β-CTX, CACS, and bone mineral density increased significantly in LC group, as compared with those at baseline (P＜0.05). After the treatment for 12 months, serum levels of calcium, phosphate, FGF23 and MGP, and CACS were lower in LC group than in CC group, and serum levels of iPTH, BALP, PINP and β-CTX, and bone mineral density were higher in LC group than in CC group. Pearson’s correlation analyses revealed that bone mineral density in forearm correlated positively with iPTH and MGP and negatively with CACS, and that CACS correlated positively with serum calcium, phosphate and FGF23 and negatively with serum MGP. Multivariate linear regression revealed that the changes of bone mineral density in forearm and collum femoris and serum FGF23 were the independent influence factors for the change of CACS (P＜0.05). Conclusions Slower progression of coronary artery calcification, improved bone turnover and increased bone mineral density occurred in the LC group as compared with those in the CC group. These results may result from the effects that lanthanum carbonate improves phosphate and MGP metabolism and directly antagonizes vascular calcification.

Key words: maintenance hemodialysis, adynamic bone disease, lanthanum carbonate