Side Effects of lanthanum: A Synthesis of Findings from 28 Studies

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Original Abstract of the Article

Main Research Findings

Lanthanum carbonate is a medication used to treat hyperphosphatemia in patients with chronic kidney disease (CKD). Lanthanum carbonate acts as a phosphate binder, reducing phosphate absorption in the digestive tract and thereby lowering blood phosphate levels. 15 , 17 , 22 , 21 , 1 , 13 , 10 , 18 , 24 , 20 , 2 , 25 , 12 , 26 , 8 , 11 , 7 , 27 , 9 , 23 , 16 , 5 , 6 , 28 , 14

Reasons for Side Effects

Lanthanum carbonate binds to phosphate in the digestive tract, inhibiting absorption, but some of it may be absorbed from the gut and accumulate in the body. 28 , 2 Accumulation in the gut can cause side effects such as constipation and abdominal symptoms. 10 , 20 Additionally, lanthanum carbonate may accumulate in bones and the liver, and long-term effects are not yet fully understood. 21 , 18

Common Side Effects

Constipation

Constipation is the most common side effect of lanthanum carbonate. This is believed to be caused by lanthanum carbonate increasing water absorption in the digestive tract. Constipation has been reported in about half of patients taking lanthanum carbonate. 10 , 20

Abdominal Symptoms

Lanthanum carbonate can cause abdominal symptoms such as bloating, abdominal pain, nausea, and vomiting. These symptoms are believed to be caused by lanthanum carbonate slowing down the movement of the digestive tract. 20

Metallic Taste

You may experience a metallic taste after taking lanthanum carbonate. 20

Other Side Effects

Rarely, lanthanum carbonate may cause allergic reactions such as rash, itching, shortness of breath, and facial swelling. If you experience any of these symptoms, consult your doctor immediately. 21 Also, lanthanum carbonate is concerning for bone and liver accumulation, but long-term effects are still not fully understood. 21 , 18

Side Effects Management

Constipation Management

To prevent constipation, it is important to stay hydrated. Increasing your intake of foods high in fiber and engaging in light exercise can also be helpful. 10 If constipation persists, consult your doctor and they may prescribe laxatives.

Abdominal Symptom Management

If you are concerned about abdominal symptoms, taking lanthanum carbonate with meals or in smaller doses may help. 20 Dietary changes and lifestyle modifications can also be effective. Consult your doctor if your symptoms don't improve.

Metallic Taste Management

If you experience a metallic taste, drinking water or tea after taking lanthanum carbonate may help to lessen the taste. 20

Other Side Effects Management

If you have an allergic reaction, consult your doctor immediately. Lanthanum carbonate can accumulate in bones and the liver, but regular checkups can help to detect any problems early and provide appropriate treatment. 21 , 18

Comparison of Research

Research Commonalities

Many studies have shown that lanthanum carbonate is effective in treating hyperphosphatemia. Furthermore, lanthanum carbonate is considered a safe and less side effect-prone medication compared to other phosphate binders. 24 , 26 , 14 Lanthanum carbonate binds to phosphate in the digestive tract, inhibiting absorption, but some of it may be absorbed from the gut and accumulate in the body. 28 , 2

Research Differences

The frequency and types of side effects reported for lanthanum carbonate vary across studies. There is also disagreement among research concerning the potential for lanthanum carbonate to accumulate in bones and the liver. 21 , 18

Cautions Regarding Real-World Application

Lanthanum carbonate is an effective medication for treating hyperphosphatemia, but there is a potential for side effects. If taking lanthanum carbonate, follow your doctor's instructions and consult your doctor immediately if side effects occur. In particular, if you experience constipation or abdominal symptoms, discuss these with your doctor and take appropriate measures. 10 , 20

Limitations of Current Research

Lanthanum carbonate is a relatively new medication, and long-term effects are not yet fully understood. Particularly concerning is the potential for accumulation in bones and the liver, but long-term impacts remain unknown. Furthermore, interactions between lanthanum carbonate and other medications have not been adequately studied. 21 , 18

Future Research Needs

Further research is needed to assess the long-term safety and efficacy of lanthanum carbonate. Specifically, long-term follow-up studies are crucial to evaluate the impacts of accumulation in bones and the liver. In addition, detailed research is required to investigate the interactions of lanthanum carbonate with other medications. 21 , 18

Conclusion

Lanthanum carbonate is an effective medication for treating hyperphosphatemia, but it can cause side effects. If taking lanthanum carbonate, follow your doctor's instructions and consult your doctor immediately if side effects occur. Further research is needed to evaluate the long-term safety and efficacy of lanthanum carbonate. 21 , 18

Keywords
Benefit Keywords
CKD
Hyperphosphatemia
Phosphate Binders
1
Lowered phosphate levels
3
ABD treatment
4
Improved PO4 control
Safer phosphate binders
6
Lower serum phosphate
Minimal iron absorption
Reduced pill burden
7
Low toxicity
Minimally invasive
Repeated treatment
Synergistic anticancer effect
Targeted therapy
8
Hyperphosphatemia treatment
9
Phosphate binding
10
Eutrophication mitigation
11
Phosphate binder adherence
12
Hyperphosphatemia treatment
13
Improved CKD-MBD
14
Effective hyperphosphatemia control
Maintains PTH and Ca × Pi product levels
Well tolerated
15
Effective for hyperphosphatemia
Well tolerated
16
Effective treatment
Little or no side effects
17
Hyperphosphatemia treatment
18
Tumor hyperthermia
19
Hyperkalemia treatment
Metabolic acidosis treatment
20
Cardiovascular morbidity reduction
Hyperphosphataemia management
21
Phosphataemia control
22
Phosphate reduction
24
Hyperphosphatemia control
26
Hyperphosphatemia control
27
Hyperphosphatemia control
28
Risk Keywords
Aluminum Toxicity
Calcium Overload
Gastrointestinal Bleeding
1
Lanthanide deposition
2
Out-of-pocket costs
Pill burden
Side effects
3
Calcifications
Gastrointestinal symptoms
Hypercalcemia
Tissue accumulation
7
Accumulation risk
High cost
Side effect
9
Constipation
Peritonitis
10
Lanthanum bioavailability
11
Side effects
13
Side effects
14
Nausea
Vomiting
15
Mild gastrointestinal side effects
16
Gastrointestinal side effects
20
Gastrointestinal side effects
Hypercalcemia
21
Hypotestosteronaemia
Precocious puberty
23
Hypercalcemia
Vascular calcification
24
Cardiovascular mortality
Hypercalcemia
Vascular calcification
25
GI side effects
26
Constipation
Lanthanum accumulation
27
Lanthanum accumulation
28
Literature analysis of 28 papers
Positive Content
24
Neutral Content
2
Negative Content
2
Article Type
2
2
2
12
28
1.

The Rising Risk of Chronic Kidney Disease (CKD) and How it is Dealt with: A Review of Current and Potential Phosphate Binders (PB).

Author: GosikRobert, DanelKrzysztof

CKD
Hyperphosphatemia
Phosphate Binders
Aluminum Toxicity
Calcium Overload
Gastrointestinal Bleeding

This review discusses different phosphate binders (PBs) used for treating hyperphosphatemia, a risk factor for chronic kidney disease (CKD). The review explores the pros and cons of current PBs, highlighting the need for new PBs that can also function as protection modifiers.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

2.

Deposition patterns of iatrogenic lanthanum and gadolinium in the human body depend on delivered chemical binding forms.

Author: BückerPatrick, RichterHenning, RadbruchAlexander, SperlingMichael, BrandMarcus, HollingMarkus, Van MarckVeerle, PaulusWerner, JeibmannAstrid, KarstUwe

Lanthanide deposition

This study investigated lanthanum deposition in two patients who received lanthanum carbonate as a phosphate binder due to chronic kidney injury. The findings showed lanthanum deposition in both patients and compared it to gadolinium deposition.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

Effect of lanthanum carbonate on coronary artery calcification and bone mineral density in maintenance hemodialysis patients with diabetes complicated with adynamic bone disease: A prospective pilot study.

Author: ZhangChunhua, WangShixiang, ZhaoSumei, ZhangXiaodong

ABD treatment

This study evaluated the effect of lanthanum carbonate (LC) on coronary artery calcification (CAC) and bone mineral density (BMD) in patients with adynamic bone disease (ABD) on maintenance hemodialysis (MHD).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

5.

Lanthanum Carbonate - A New Phosphate Binding Drug in Advanced Renal Failure.

Author: AasethJan, Bjorke-MonsenAnne-Lise

Lanthanum (La) is considered a non-essential element. La has been used to improve plant production and animal husbandry performance. The estimated dietary intake of La in humans is below 150 µg, which is lower than 10% of the estimated limit of safe and acceptable daily intake.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

6.

An Update on Phosphate Binders: A Dietitian's Perspective.

Author: GutekunstLisa

Improved PO4 control
Safer phosphate binders

Phosphate binders are used to treat hyperphosphatemia in patients with chronic kidney disease. This article reviews the most common binder categories, discussing their pharmacokinetics, side effects, doses, phosphate affinity, and controversies of use.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Phosphate binders for the treatment of chronic kidney disease: role of iron oxyhydroxide.

Author: CernaroValeria, SantoroDomenico, LacquanitiAntonio, CostantinoGiuseppe, ViscontiLuca, BuemiAntoine, BuemiMichele

Lower serum phosphate
Minimal iron absorption
Reduced pill burden
Calcifications
Gastrointestinal symptoms
Hypercalcemia
Tissue accumulation

This review discusses the use of sucroferric oxyhydroxide for treating hyperphosphatemia in patients with chronic kidney disease. Sucroferric oxyhydroxide has a similar efficacy and safety profile as sevelamer with a lower pill burden.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

9.

Novel iron-containing phosphate binders for treatment of hyperphosphatemia.

Author: SchmidHolger, LedererStephan R

Hyperphosphatemia treatment
Accumulation risk
High cost
Side effect

Phosphate binders (PBs) are crucial for managing hyperphosphatemia in chronic kidney disease. While effective, PBs have side effects, accumulation risks, and high costs. Iron-containing PBs have entered the market, and other candidates are in development.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

11.

Lanthanum from a modified clay used in eutrophication control is bioavailable to the marbled crayfish (Procambarus fallax f. virginalis).

Author: van OosterhoutFrank, GoitomEyerusalem, RoessinkIvo, LürlingMiquel

Eutrophication mitigation
Lanthanum bioavailability

This study investigated the bioavailability of lanthanum (La) from Phoslock, a La-modified bentonite clay used to mitigate eutrophication in lakes. The findings suggest that La from Phoslock is bioavailable to marbled crayfishes, advocating for careful consideration of potential side effects when using this product.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

Reasons for phosphate binder discontinuation vary by binder type.

Author: WangSteven, AnumEmmanuel A, RamakrishnanKarthik, AlfieriThomas, BraunhoferPeter, NewsomeBritt

Phosphate binder adherence

Nonadherence to phosphate binder regimens is a common issue in end-stage renal disease patients. This study analyzes reasons for discontinuation of specific phosphate binders to understand the drivers of nonadherence.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

13.

Optimal use of phosphate binders in chronic kidney disease.

Author: SonikianMakrouhi, PapachristouEvangelos, GoumenosDimitrios S

Hyperphosphatemia treatment
Side effects

Hyperphosphatemia is a major factor in vascular calcification in patients with chronic kidney disease (CKD). Due to phosphate retention in these patients, pharmacological treatment and other measures are needed to control hyperphosphatemia. Although several phosphate binders are available, none have shown overall superiority, and their potency and side effects vary significantly, making it challenging to choose the optimal drug for each patient.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

Efficacy and safety of lanthanum carbonate on chronic kidney disease-mineral and bone disorder in dialysis patients: a systematic review.

Author: ZhangChenglong, WenJi, LiZi, FanJunming

Improved CKD-MBD
Side effects

Lanthanum carbonate, a phosphate binder, is effective and safe for treating CKD-MBD in dialysis patients, though further research is needed to confirm its long-term benefits.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

15.

Efficacy and tolerability of lanthanum carbonate in treatment of hyperphosphatemia patients receiving dialysis--a systematic review and meta-analysis of randomized controlled trials.

Author: HuangWenhui, LiuJing, TangYu, GaoXiaoling, DiBaoshan, ZhangFengwa

Effective hyperphosphatemia control
Maintains PTH and Ca × Pi product levels
Well tolerated
Nausea
Vomiting

Lanthanum carbonate (LC) is a well-tolerated and effective treatment for hyperphosphatemia in dialysis patients. LC was found to be more effective than placebo in controlling hyperphosphatemia and in maintaining PTH and Ca × Pi product levels within recommended ranges. LC is an ideal choice for second-line treatment of hyperphosphatemia.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

16.

Lanthanum carbonate for the treatment of hyperphosphatemia in CKD 5D: multicenter, double blind, randomized, controlled trial in mainland China.

Author: XuJing, ZhangYi-Xiang, YuXue-Qing, LiuZhi-Hong, WangLi-Ning, ChenJiang-Hua, FanYa-Ping, NiZhao-Hui, WangMei, YuanFa-Huan, DingGuo-Hua, ChenXiang-Mei, ZhangAi-Ping, MeiChang-Lin

Effective for hyperphosphatemia
Well tolerated
Mild gastrointestinal side effects

Lanthanum carbonate is an efficacious and well-tolerated oral phosphate binder with a mild AE profile in hemodialysis and CAPD patients. This agent may provide an alternative for the treatment of hyperphosphatemia in CKD 5D patients in mainland China.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

17.

Effectiveness of lanthanum carbonate treatment used in combination with other phosphate binders in peritoneal dialysis patients.

Author: YamadaShunsuke, YoshidaHisako, TaniguchiMasatomo, TanakaShigeru, EriguchiMasahiro, NakanoToshiaki, TsuruyaKazuhiko, KitazonoTakanari

Effective treatment
Little or no side effects

This study evaluated the long-term efficacy and safety of lanthanum carbonate (LaC), a phosphate binder used in peritoneal dialysis (PD) patients. LaC demonstrated effectiveness in managing hyperphosphatemia with minimal side effects, highlighting its potential for long-term use.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

19.

Nanohyperthermia of malignant tumors. I. Lanthanum-strontium manganite magnetic fluid as potential inducer of tumor hyperthermia.

Author: SolopanS, BelousA, YelenichA, BubnovskayaL, KovelskayaA, PodoltsevA, KondratenkoI, OsinskyS

Tumor hyperthermia

Magnetic particles of lanthanum-strontium manganite were synthesized and used to create a magnetic fluid that can be heated to 42-45 °C in an alternating magnetic field. The magnetic fluid and powder showed no acute toxicity or side effects in animal studies. This suggests potential use in tumor hyperthermia, a cancer treatment method using heat.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

20.

Lanthanum carbonate versus sevelamer hydrochloride: improvement of metabolic acidosis and hyperkalemia in hemodialysis patients.

Author: FiliopoulosVassilis, KoutisIoannis, TrompoukiSofia, HadjiyannakosDimitrios, LazarouDimitrios, VlassopoulosDimosthenis

Hyperkalemia treatment
Metabolic acidosis treatment
Gastrointestinal side effects

This study compared the effects of sevelamer hydrochloride (SH) and lanthanum carbonate (LC) on acid-base status and serum potassium in hemodialysis patients. LC improved metabolic acidosis and hyperkalemia compared to SH. However, LC had more gastrointestinal side effects and difficulties in chewing the tablet, potentially leading to decreased compliance.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

22.

Clinical usefulness of lanthanum carbonate for serum phosphate control in difficult patients.

Author: AlmirallJ, BetancourtL, EsteveV, ValenzuelaM P, LópezT, RuizA, Martínez-OcañaJ C, CalvetX

Phosphataemia control

This study will evaluate the effectiveness of lanthanum carbonate, a new phosphate binder, in treating uncontrolled high phosphate levels in patients with end-stage renal disease.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

23.

Precocious puberty and unlicensed paediatric drugs for severe hyperparathyroidism.

Author: BacchettaJustine, PlottonIngrid, RanchinBruno, VialThierry, NicolinoMarc, MorelYves, CochatPierre

Hypotestosteronaemia
Precocious puberty

A 5-year-old boy with chronic kidney disease experienced precocious puberty after starting cinacalcet and lanthanum carbonate. The cause remains unclear, but monitoring plasma testosterone in patients receiving these drugs is recommended.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

24.

Oral phosphate binders.

Author: HutchisonAlastair J

Phosphate reduction
Hypercalcemia
Vascular calcification

Hyperphosphatemia is a common complication of end-stage chronic kidney disease. Phosphate binders are used to control serum phosphate levels in dialysis patients. While conventional binders have limitations and side effects, newer agents such as lanthanum carbonate appear to be well-tolerated and effective.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

25.

Oral phosphate binders for the management of serum phosphate levels in dialysis patients.

Author: MohammedIsmail, HutchisonAlastair J

Cardiovascular mortality
Hypercalcemia
Vascular calcification

Hyperphosphatemia is a common consequence of end-stage chronic kidney disease and affects the majority of dialysis patients. It is statistically linked to increased cardiovascular mortality in this population. Dietary restriction and current dialysis modalities are not sufficiently effective to maintain serum phosphate levels within the recommended range, leading most dialysis patients to require oral phosphate binders. However, the benefits of achieving the recommended range have not been demonstrated prospectively. Traditional phosphate binders have limitations and side effects. Aluminium-containing agents, while highly efficient, are no longer widely used due to established toxicity. Calcium-based salts are inexpensive, effective, and most widely used but are now associated with hypercalcemia and vascular calcification. Sevelamer hydrochloride and lanthanum carbonate, non-aluminum, calcium-free phosphate binders, are effective and generally well-tolerated but do not control phosphate levels in all patients. Patient education programs have been shown to be effective in improving serum phosphate target achievement.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

28.

[Is lanthanum carbonate a safe drug?].

Author: KazamaJunichiro James

Hyperphosphatemia control
Lanthanum accumulation

Lanthanum carbonate, a new phosphate binder, is gaining attention for its effectiveness. While it is absorbed and accumulates in the body, no toxicity has been reported. However, long-term effects require further investigation as metal toxicity may take years to manifest.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : Japanese

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