Evidence map›Paper›PMID 22822075›Full record

Trial reportJournal of the American Society of Nephrology : JASN2012

Effects of phosphate binders in moderate CKD.

Geoffrey A Block, David C Wheeler, Martha S Persky, Bryan Kestenbaum, Markus Ketteler, David M Spiegel, Matthew A Allison, John Asplin, Gerard Smits, Andrew N Hoofnagle and 5 more

Registry-linked trialOpen access · bronzeAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Society of Nephrology : JASN, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03550534 (The Effectiveness and Safety of Calcium Carbonate in Chronic Kidney Disease With Normophosphatemia), which is not on this map. Cited by 236 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
236citing papers in PubMed, 10 pooled it
30.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03550534 nacompletednot on this mapstarted 2015, after this paper: background citation

The Effectiveness and Safety of Calcium Carbonate in Chronic Kidney Disease With Normophosphatemia: A Double Blind, Randomized Controlled Trial

TypeinterventionalSponsorIndonesia UniversityRan2015 to 2016Enrolled46ConditionsChronic Kidney DiseasesArmsCalcium Carbonate, Placebo oral capsule
3 · Its place in the literature

Who cites it

236 citing papers in PubMed, 10 syntheses or guidelines pooled it, 533 citations in OpenAlex.

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  15. One-year safety and efficacy of intravenous etelcalcetide in patients on hemodialysis with secondary hyperparathyroidism.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2020
    Trial
  16. Differential effects of phosphate binders on vitamin D metabolism in chronic kidney disease.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2020
    Trial
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  19. Effect of ferric citrate on serum phosphate and fibroblast growth factor 23 among patients with nondialysis-dependent chronic kidney disease: path analyses.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2019
    Trial
  20. Trial

176 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 9 institutions in 3 countries.

Geoffrey A BlockDenver Nephrology, 130 Rampart Way, Suite 300b, Denver, CO 80230, USA. gablock@denverneph.net
David C Wheeler
Martha S Persky
Bryan Kestenbaum
Markus Ketteler
David M Spiegel
Matthew A Allison
John Asplin
Gerard Smits
Andrew N Hoofnagle
Laura Kooienga
Ravi Thadhani
Michael Mannstadt
Myles Wolf
Glenn M Chertow
Colorado Kidney Care · USHarvard University Press · USUniversity of Washington · USKlinikum Coburg · DELeco Corporation (United States) · USStanford University · USUCL Australia · AUUniversity of California, San Diego · USUniversity of Colorado Denver · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Some propose using phosphate binders in the CKD population given the association between higher levels of phosphorus and mortality, but their safety and efficacy in this population are not well understood. Here, we aimed to determine the effects of phosphate binders on parameters of mineral metabolism and vascular calcification among patients with moderate to advanced CKD. We randomly assigned 148 patients with estimated GFR=20-45 ml/min per 1.73 m(2) to calcium acetate, lanthanum carbonate, sevelamer carbonate, or placebo. The primary endpoint was change in mean serum phosphorus from baseline to the average of months 3, 6, and 9. Serum phosphorus decreased from a baseline mean of 4.2 mg/dl in both active and placebo arms to 3.9 mg/dl with active therapy and 4.1 mg/dl with placebo (P=0.03). Phosphate binders, but not placebo, decreased mean 24-hour urine phosphorus by 22%. Median serum intact parathyroid hormone remained stable with active therapy and increased with placebo (P=0.002). Active therapy did not significantly affect plasma C-terminal fibroblast growth factor 23 levels. Active therapy did, however, significantly increase calcification of the coronary arteries and abdominal aorta (coronary: median increases of 18.1% versus 0.6%, P=0.05; abdominal aorta: median increases of 15.4% versus 3.4%, P=0.03). In conclusion, phosphate binders significantly lower serum and urinary phosphorus and attenuate progression of secondary hyperparathyroidism among patients with CKD who have normal or near-normal levels of serum phosphorus; however, they also promote the progression of vascular calcification. The safety and efficacy of phosphate binders in CKD remain uncertain.

Indexed as

AcetatesAgedAged, 80 and overBone DensityCalcium CompoundsChelating AgentsFemaleFibroblast Growth Factor-23Fibroblast Growth FactorsHumansHyperphosphatemiaLanthanumMaleMiddle AgedParathyroid HormonePhosphatesAcetatescalcium acetateCalcium CompoundsChelating AgentsFibroblast Growth Factor-23Fibroblast Growth FactorsLanthanumlanthanum carbonateParathyroid HormonePhosphatesPolyaminesSevelamer

Identifiers

PMID22822075
PMCPMC3402292
OpenAlexW2102734552

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.