Nav: Home

No benefit from drug used to reduce heart disease in kidney patients

September 14, 2020

Following a large-scale clinical trial, researchers have found that lanthanum carbonate does not reduce the risk of cardiovascular disease developing in patients with chronic kidney disease.

The drug is routinely prescribed to patients with chronic kidney disease to help reduce the risk of both bone disease and cardiovascular disease, with cardiovascular disease the most common complication and cause of death for this group.

The new findings follow a seven-year clinical trial led by a collaboration of kidney disease specialists from Australia, New Zealand and Malaysia as well as The University of Queensland's Australasian Kidney Trials Network, which is based at the Translational Research Institute.

Co-Principal Investigator, Associate Professor Nigel Toussaint from The Royal Melbourne Hospital, says high phosphate levels are a common problem in kidney disease and are linked to the onset and degree of cardiovascular disease.

"Phosphate binder medication has long been a treatment for high phosphate levels in people with kidney disease, especially those on dialysis," said A/Prof Toussaint.

"There was some evidence that phosphate lowering may be effective in reducing risk factors for cardiovascular disease, but there were no adequate studies looking at the effect of lanthanum carbonate on cardiovascular risk factors in people with chronic kidney disease not on dialysis.

"In our clinical trial involving more than 270 patients from 18 hospitals, we found that lanthanum carbonate did not have a beneficial effect on cardiovascular disease indicators such as arterial stiffness or aortic calcification when compared to placebo."

The study was the largest trial of its kind to look at the effect of lanthanum carbonate, a phosphate binder medication, in people with chronic kidney disease.

The results will be critical for Nephrologists to determine the best treatment pathways for patients and provide high value care, according to lead New Zealand Investigator, Professor Rob Walker from Dunedin Hospital.

"The pill and symptom burden along with the economic impact for people with chronic diseases is very high, and if we can determine that certain treatments provide limited benefit then that is just as important as finding something that works," said Prof Walker.

Australasian Kidney Trials Network Chair of the Executive Operations Secretariat, Professor Carmel Hawley said that while further trials were needed to ensure consistency of the findings and generalizability of the results, in relation to phosphate binders, the use of these medications was associated with significant side-effects, particularly gastrointestinal, and they were inconvenient as they have to be taken with meals.

Clinicians enrolled 278 adult participants who had stage 3 or 4 chronic kidney disease from 18 hospitals across Australia, New Zealand and Malaysia. Half the participants received lanthanum carbonate and the other half of participants received a placebo for 96 weeks.

During the trial, clinicians performed pulse wave velocity - a measure of stiffness of arteries - and CT scans looking at calcium build up in arteries. Medical information was collected and blood samples taken. This was the longest trial to date in this study population.

The main results for the IMPROVE-CKD trial were published in the Journal of the American Society of Nephrology, with an editorial also published in the journal.

Lanthanum carbonate reduces the absorption of dietary phosphate from the gut, and its ability to potentially lower phosphate balance in the body was thought to possibly prevent stiffening of blood vessels.

Approximately 1.7 million Australians and 400,000 New Zealanders aged 18 years and over have chronic kidney disease. Many people have a progressive decline in kidney function, also known as progression of chronic kidney disease, to the point of needing dialysis or kidney transplantation. In Australia and New Zealand, about 3600 individuals progress to end-stage kidney disease each year. There are more than 15,500 individuals receiving dialysis.

The IMPROVE-CKD study was sponsored by The University of Queensland, coordinated by the Australasian Kidney Trials Network and funded through research grants from the National Medical and Medical Research Council (NHMRC) and Shire International GmbH, a member of the Takeda group of companies, IST-AUS-000108.

Translational Research Institute

Related Cardiovascular Disease Articles:

Changes by income level in cardiovascular disease in US
Researchers examined changes in how common cardiovascular disease was in the highest-income earners compared with the rest of the population in the United States between 1999 and 2016.
Fighting cardiovascular disease with acne drug
Researchers from the European Molecular Biology Laboratory (EMBL) in Heidelberg and Stanford University have found the cause of dilated cardiomyopathy - a leading cause of heart failure - and identified a potential treatment for it: a drug already used to treat acne.
A talk with your GP may prevent cardiovascular disease
Having a general practitioner (GP) who is trained in motivational interviewing may reduce your risk of getting cardiovascular disease.
Dilemma of COVID-19, aging and cardiovascular disease
Whether individuals should continue to take angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in the context of coronavirus disease 2019 (COVID-19) is discussed in this article.
Air pollution linked to dementia and cardiovascular disease
People continuously exposed to air pollution are at increased risk of dementia, especially if they also suffer from cardiovascular diseases, according to a study at Karolinska Institutet in Sweden published in the journal JAMA Neurology.
New insights into the effect of aging on cardiovascular disease
Aging adults are more likely to have - and die from - cardiovascular disease than their younger counterparts.
Premature death from cardiovascular disease
National data were used to examine changes from 2000 to 2015 in premature death (ages 25 to 64) from cardiovascular disease in the United States.
Ultrasound: The potential power for cardiovascular disease therapy
In the current issue of Cardiovascular Innovations and Applications volume 4, issue 2, pp.
Despite the ACA, millions of Americans with cardiovascular disease still can't get care
Cardiovascular disease (CVD) is the leading cause of death for Americans, yet millions with CVD or cardiovascular risk factors (CVRF) still can't access the care they need, even years after the implementation of the Affordable Care Act (ACA).
Excess weight and body fat cause cardiovascular disease
In the first Mendelian randomization study to look at this, researchers have found evidence that excess weight and body fat cause a range of heart and blood vessel diseases (rather than just being associated with it).
More Cardiovascular Disease News and Cardiovascular Disease Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: The Power Of Spaces
How do spaces shape the human experience? In what ways do our rooms, homes, and buildings give us meaning and purpose? This hour, TED speakers explore the power of the spaces we make and inhabit. Guests include architect Michael Murphy, musician David Byrne, artist Es Devlin, and architect Siamak Hariri.
Now Playing: Science for the People

#576 Science Communication in Creative Places
When you think of science communication, you might think of TED talks or museum talks or video talks, or... people giving lectures. It's a lot of people talking. But there's more to sci comm than that. This week host Bethany Brookshire talks to three people who have looked at science communication in places you might not expect it. We'll speak with Mauna Dasari, a graduate student at Notre Dame, about making mammals into a March Madness match. We'll talk with Sarah Garner, director of the Pathologists Assistant Program at Tulane University School of Medicine, who takes pathology instruction out of...
Now Playing: Radiolab

What If?
There's plenty of speculation about what Donald Trump might do in the wake of the election. Would he dispute the results if he loses? Would he simply refuse to leave office, or even try to use the military to maintain control? Last summer, Rosa Brooks got together a team of experts and political operatives from both sides of the aisle to ask a slightly different question. Rather than arguing about whether he'd do those things, they dug into what exactly would happen if he did. Part war game part choose your own adventure, Rosa's Transition Integrity Project doesn't give us any predictions, and it isn't a referendum on Trump. Instead, it's a deeply illuminating stress test on our laws, our institutions, and on the commitment to democracy written into the constitution. This episode was reported by Bethel Habte, with help from Tracie Hunte, and produced by Bethel Habte. Jeremy Bloom provided original music. Support Radiolab by becoming a member today at     You can read The Transition Integrity Project's report here.