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

New cellular approach found to control progression of chronic kidney disease

December 15, 2017
Researchers have demonstrated for the first time that extracellular vesicles - tiny protein-filled structures - isolated from amniotic fluid stem cells (AFSCs) can be used to effectively slow the progression of kidney damage ...

Testing shows differences in efficacy of Zika vaccines after one year

December 15, 2017
(Medical Xpress)—A large team of researchers with members from Harvard Medical School, Walter Reed Army Institute of Research, Bioqual Inc. and MIT has found that the efficacy of the three types of Zika vaccines currently ...

How to regulate fecal microbiota transplants

December 15, 2017
(Medical Xpress)—A small team of researchers at the University of Maryland, some with affiliations to the Veterans Affairs Maryland Health Care System, has written and published a Policy Forum piece in the journal Science ...

Screening could catch a quarter of hip fractures before they happen

December 15, 2017
Community screening for osteoporosis could prevent more than a quarter of hip fractures in older women - according to new research led by the University of East Anglia (UEA).

Urine test developed to test for tuberculosis

December 14, 2017
(Medical Xpress)—An international team of researchers has developed a urine test that can be used to detect tuberculosis (TB) in human patients. In their paper published in Science Translational Medicine, the group describes ...

40 years after first Ebola outbreak, survivors show signs they can stave off new infection

December 14, 2017
Survivors of the first known Ebola outbreak, which occurred in the Democratic Republic of the Congo in 1976, may be key to development of vaccines and therapeutic drugs to treat future outbreaks, according to a new study ...

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.