EFFICACY AND SAFETY OF LANTHANUM CARBONATE (FOSBAIT) IN HYPERPHOSPHATEMIA ASSOCIATED WITH CHRONIC IQDNEY DISEASE.

Introduction: Hyperphosphatemia is a well known complication of chronic kidney disease. Significant morbidity and mortality particularly due to cardiovascular diseases is associated with high level of phosphate. Measures to control phosphorus level include dietary phosphorus restriction, dialysis, and oral phosphate binders. Currently most common treatment for this condition is oral phosphate binders. Lanthanum carbonate (Fosbait®) is newly introduced compound in this genre. Aims and Objectives: This study aimed to evaluate the efficacy and safety of lanthanum carbonate (Fosbait®) in Indian patients with hyperphosphatemia associated with CKD. Materials and Methods: Total 31 CKD patients, stage 3 and 4 (predialysis) and stage 5 (dialysis) with serum phosphorus level > 5.5 and > 5.9 respectively, were recruited in the study over the duration of 10 months. All hypophosphatemic agents were withdrawn during the washout period, vitamin D analogues were continued. All patients were given lanthanum carbonate (Fosbait®) in chewable tablet form, in dose range of 750 mg to 2250 mg a day in three divided doses immediately after throe major meals. Levels of serum phosphorus and calcium were assessed fortnightly, while level of iPTH was measured on week 0 and week 10. Dosage was titrated accordingly up to six subsequent weeks and thereafter dose of the drug was kept constant till 10 weeks. Result: Mean age of patients was 46.85 years and male to female ratio was 1.6:1. We noted 36.49%reduction in mean serum phosphorus level (from 6.47±0.84 mg/dl to 4.11±0.72 mg/dl, P= 0.005). Significant reduction in serum phosphorus level was observed in 87.5% of dialysis and 84.61% of non dialysis patients. Reduction in mean serum iPTH was 10.20% (from 181.86±19.8 pg/ml to 163.30±23.2 pg/ml, P=0.408). Mean serum calcium phosphorus product reduction by 31.83% had been noted (from 59.54±10.5 to 25.94±13.4, P=0.005). Reduction of mean serum calcium level was noted by 21.68% (from 8.96±1.1 to 7.50±1.4, P=0.005). Side effects observed were body ache in 26% of the patients, anorexia, abdominal pain, dysphagia, dry mouth and diarrhea in 11.5% patients. Conclusion: We conclude that lanthanum carbonate (Fosbait®) is effective in correcting hyperphosphatemia in indian CKD patients with tolrable side efeects. [ABSTRACT FROM AUTHOR]