Study questions safety and effectiveness of common kidney disease drugs

July 19, 2012

Drugs commonly prescribed to patients with chronic kidney disease (CKD) may not be as strongly effective as once thought, and may cause unexpected harm to blood vessels, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN). The findings indicate that additional studies on the drugs, called phosphate binders, are needed.

Higher of phosphorus that are still within the normal range have been linked with , kidney disease, and . Because the kidneys get rid of excess phosphorus by excreting it through the urine, patients with CKD often have elevated blood .

Drugs called phosphate binders can lower blood phosphorus levels, and while they are approved only for patients with , they are often prescribed off-label to patients with CKD. Geoffrey Block, MD (Denver Nephrology) and his colleagues evaluated the effects of these drugs (calcium acetate, lanthanum carbonate, sevelamer carbonate) in patients with moderate to advanced CKD and normal or near normal blood phosphorus levels.

The study included 148 patients who were randomized to receive one of the three phosphate binders or a placebo. The investigators examined patients after three, six, and nine months of treatment. The study is the longest placebo-controlled trial of phosphate binders in patients with CKD conducted to date.

Treatment with phosphate binders significantly lowered patients' urinary phosphorus levels, moderately lowered their blood phosphorus levels, and slowed progression of a disorder that is a common complication of CKD, while treatment with placebo did not. Despite these positive effects, phosphate binders did not have any effect on the blood levels of a hormone that regulates phosphate excretion in the urine, and the drugs caused calcium build-up in blood vessels, which can lead to heart problems. Heart disease is the leading cause of death in patients with CKD.

These findings call into question the safety and effectiveness of phosphate binders in patients with CKD.

"While we continue to believe that serum, or blood, phosphorus is a key component of the increased cardiovascular risk associated with kidney disease, our results suggest the use of the currently approved phosphate binding drugs does not result in substantial reductions in serum phosphorus and may be associated with harm in this population," said Dr. Block. "Future clinical trials should be conducted in all populations with adequate placebo controls and should address alternative or complementary methods to reduce serum phosphorus," he added.

Explore further: Kidney drugs hampered by high blood phosphate

More information: The article, entitled "A Randomized Trial of Phosphate Binders in Patients with Moderate Chronic Kidney Disease," will appear online on July 19, 2012, doi: 10.1681/ASN.2012030223

Related Stories

Kidney drugs hampered by high blood phosphate

August 18, 2011
High blood phosphate levels can set chronic kidney disease (CKD) patients on a rapid path to kidney failure, according to a study appearing in an upcoming issue of the Journal of the American Society Nephrology (JASN). To ...

Recommended for you

Two Group A Streptococcus genes linked to 'flesh-eating' bacterial infections

September 22, 2017
Group A Streptococcus bacteria cause a variety of illnesses that range from mild nuisances like strep throat to life-threatening conditions including pneumonia, toxic shock syndrome and the flesh-eating disease formally known ...

Ecosystem approach makes urinary tract infection more treatable

September 22, 2017
The biological term 'ecosystem' is not usually associated with urinary tract infections, but this should change according to Wageningen scientists.

Residents: Frontline defenders against antibiotic resistance?

September 22, 2017
Antibiotic resistance continues to grow around the world, with sometimes disastrous results. Some strains of bacteria no longer respond to any currently available antibiotic, making death by infections that were once easily ...

Individualized diets for irritable bowel syndrome better than placebo

September 21, 2017
Patients with irritable bowel syndrome who follow individualized diets based on food sensitivity testing experience fewer symptoms, say Yale researchers. Their study is among the first to provide scientific evidence for this ...

Superbug's spread to Vietnam threatens malaria control

September 21, 2017
A highly drug resistant malaria 'superbug' from western Cambodia is now present in southern Vietnam, leading to alarming failure rates for dihydroartemisinin (DHA)-piperaquine—Vietnam's national first-line malaria treatment, ...

A dose of 'wait-and-see' reduces unnecessary antibiotic use

September 21, 2017
Asking patients to take a 'wait-and-see' approach before having their antibiotic prescriptions filled significantly reduces unnecessary use, a University of Queensland study has shown.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.