Effects Of Calcium Carbonate And Lanthanum Carbonate On FGF23 And Vascular Endothelial Function In Maintenance Hemodialysis Patients

[Objective] To compare the effects and to research the mechanism of lanthanum carbonate and calcium carbonate on serum phosphate,FGF23 and vascular function on patients maintaining hemodialysis.[Methods] Twenty-five patients with hemodialysis received lanthanum carbonate treatment, while twenty-five patients with hemodialysis received calcium carbonate treatment.All patients were observed for 8 weeks. The measurements of serum FGF23,FMD and other clinical biochemical indices were performed for all patients before and after treatment.[Results] As expected, before treatment, FMD was associated inversely with FGF23 and serum phosphate. After treatment, FMD was associated inversely with serum phosphate(γ=-0.38,P=0.001)and FGF23(γ=-0.42,P<0.001)。The FMD increased from 6.1% to7.3% in lanthanum-carbonate patients, whereas it was unchanged in the calcium-carbonate group(6.1% vs 6.1%)。On multiple regression analysis,FGF23,not serum phosphate,maintained a strong and independent association with FMD.[Conclusions] The study shows that treatment with lanthanum carbonate was associated with decreased levels of serum phosphate and FGF23, and an improvement of endothelial function in patients maintaining hemodialysis. Lanthanum carbonate is a new phosphate binder.The decline of FGF23 levels by lanthanum carbonate induces changes in FMD.That makes wider clinical application of the phosphate binder. The study explored from a clinical perspective the role of serum phosphate and FGF23 in the process of arterial sclerosis in CKD patients, and help to further reveal the arteriosclerosis.