The Case ∣ A peritoneal dialysis patient with an unusual abdominal Film

Chuang, Chiao Lin; Chiou, See-Ying; Li, S.-Y.; Jian, Deng; Chen, J.-Y.

doi:10.1038/sj.ki.5002413

Cited by 15 publications

(21 citation statements)

References 3 publications

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“…Published case studies have demonstrated the presence of lanthanum particles in the gastrointestinal tract using radiographic techniques . Additionally, two recent reports have documented lanthanum deposition in the human gastric mucosa; however, the clinical significance of these observations is unclear.…”

Section: Overview Of Key Studiesmentioning

confidence: 99%

Lanthanum carbonate: safety data after 10 years

et al. 2016

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Despite 10 years of post‐marketing safety monitoring of the phosphate binder lanthanum carbonate, concerns about aluminium‐like accumulation and toxicity persist. Here, we present a concise overview of the safety profile of lanthanum carbonate and interim results from a 5‐year observational database study (SPD405‐404; ClinicalTrials.gov identifier: NCT00567723). The pharmacokinetic paradigms of lanthanum and aluminium are different in that lanthanum is minimally absorbed and eliminated via the hepatobiliary pathway, whereas aluminium shows appreciable absorption and is eliminated by the kidneys. Randomised prospective studies of paired bone biopsies revealed no evidence of accumulation or toxicity in patients treated with lanthanum carbonate. Patients treated with lanthanum carbonate for up to 6 years showed no clinically relevant changes in liver enzyme or bilirubin levels. Lanthanum does not cross the intact blood–brain barrier. The most common adverse effects are mild/moderate nausea, diarrhoea and flatulence. An interim Kaplan–Meier analysis of SPD405‐404 data from the United States Renal Data System revealed that the median 5‐year survival was 51.6 months (95% CI: 49.1, 54.2) in patients who received lanthanum carbonate (test group), 48.9 months (95% CI: 47.3, 50.5) in patients treated with other phosphate binders (concomitant therapy control group) and 40.3 months (95% CI: 38.9, 41.5) in patients before the availability of lanthanum carbonate (historical control group). Bone fracture rates were 5.9%, 6.7% and 6.4%, respectively. After more than 850 000 person‐years of worldwide patient exposure, there is no evidence that lanthanum carbonate is associated with adverse safety outcomes in patients with end‐stage renal disease.

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Section: Overview Of Key Studiesmentioning

confidence: 99%

Lanthanum carbonate: safety data after 10 years

et al. 2016

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“…[6][7][8][9] Most such reports have been made by nephrologists and dialysis physicians. Radiologists who perform CT examination also need to be familiar with the characteristics of lanthanum carbonate hydrate.…”

Section: Discussionmentioning

confidence: 99%

Beam-hardening artifacts on computed tomography images caused by lanthanum carbonate hydrate in a patient on dialysis

et al. 2010

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Lanthanum carbonate hydrate is a nonaluminum, noncalcium phosphate binder containing lanthanum (La). It is effective in decreasing the serum phosphate level in patients on dialysis. Because the atomic number of the La contained in lanthanum carbonate hydrate is relatively high, at 57, this agent may cause strong artifacts on computed tomography (CT) images, which may be mistakenly interpreted as foreign bodies. We recently performed CT examination of a patient on Fosrenol chewable tablets (i.e., lanthanum carbonate hydrate). The CT images were difficult to evaluate because of strong beam hardening artifacts, and differentiation from foreign body aspiration was required. We report here our experience and a discussion of the characteristics of this artifact.

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“…Lanthanum binds to phosphate ionically with low systemic absorption. Recent studies have demonstrated that ingested lanthanum carbonate can be detected on plain X-ray film [1][2][3]. We examined abdominal computed tomography (CT) scans to clarify its location more precisely in 9 HD patients (53 ± 2 [41-60] years old, male/female = 7/2) who had been taking it for 5-112 days.…”

Section: Radio-opaque Appearance Of Lanthanum Carbonatementioning

confidence: 99%