Where have all the lanthanum salts gone, long time passing?

Abstract

The Nijmegen Biomedical Study is a population-based cross-sectional study conducted in the eastern part of the Netherlands. As part of the overall study, we provide reference values of estimated glomerular filtration rate (GFR) for this Caucasian population without expressed risk. Age-stratified, randomly selected inhabitants received a postal questionnaire on lifestyle and medical history. In a large subset of the responders, serum creatinine was measured. The GFR was then measured using the abbreviated Modification of Diet in Renal Disease (MDRD) formula. To limit possible bias, serum creatinine was calibrated against measurements performed in the original MDRD laboratory. The study cohort included 2823 male and 3274 female Caucasian persons aged 18-90 years. A reference population of apparently healthy subjects was selected by excluding persons with known hypertension, diabetes, cardiovascular-or renal diseases. This healthy study cohort included 1660 male subjects and 2072 female subjects, of which 869 of both genders were 65 years or older. The median GFR was 85 ml/min/1.73 m 2 in 30-to 34-year-old men and 83 ml/min/1.73 m 2 in similar aged women. In these healthy persons, GFR declined approximately 0.4 ml/min/year. Our study provides age-and gender-specific reference values of GFR in a population of Caucasian persons without identifiable risk.

Impact of Treatment with Calcimimetics on Hyperparathyroidism and Vascular Mineralization

“…Lanthanum carbonate has been shown to reduce serum phosphorus levels. However, because of similarities to aluminum, concerns about long-term safety with lanthanum have been voiced (36). Although recently presented preliminary evidence suggests that there are no aluminum-like effects on bone in the clinic (37), the long-term effects remain to be elucidated.…”

Blast from the Past: The Aluminums Ghost on the Lanthanum Salts

“…The Study Group "Trace Elements, Environment and Uremia" (part of the Italian Society of Nephrology) has written a letter [12] in reply to an article which recently appeared in a Nephrology Journal [ 10]. The article reports the results of a multi-centric study on the accumulation of Lanthanum carbonate in the bone tissue of recruited patients undergoing dialysis and more than half of the recruits of this study sample were tested in dialysis centres in Eastern Europe.…”

Accumulation of Metals and Minerals from Phosphate Binders

“…Recently, lanthanum carbonate has been reported to be both effective [64,65] and safe [66][67][68][69] when used as a phosphate binder. Lanthanum carbonate is associated with a signifi cantly lower incidence of hypercalcemia than are calcium-based phosphate binders [70] , but concerns remain regarding long-term use of this metal-based medication in patients with renal failure [5,71] . In clinical trials in healthy subjects, short-term use of lanthanum carbonate was associated with a low level of systemic absorption, with an elimination half-life of 36 h and negligible changes in serum lanthanum levels [72] .…”

“…However, the potential for neurotoxic effects with accumulation of lanthanum in the brain and nervous tissues remains a concern [71] . There are several possible mechanistic pathways for neurotoxic effects of elemental lanthanum and certain lanthanum salts.…”

“…Concerns persist because lanthanum is absorbed from the intestinal tract, and systemic effects have been observed in animal studies [71,109] . Little information has been reported regarding lanthanum absorption, compartmentalization, and excretion in humans The effect of uremia on absorption and accumulation of this metal when large doses are ingested over very long periods has not been determined [60] .…”