Trial reportJournal of the American Society of Nephrology : JASN2019
Effects of Nicotinamide and Lanthanum Carbonate on Serum Phosphate and Fibroblast Growth Factor-23 in CKD: The COMBINE Trial.
Trial report in Journal of the American Society of Nephrology : JASN, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 56 papers, 4 of them syntheses that pooled 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.
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.
The COMBINE Study: The CKD Optimal Management With BInders and NicotinamidE
Trial of Pirfenidone to Prevent Progression in Chronic Kidney Disease (TOP-CKD)
Who cites it
56 citing papers in PubMed, 4 syntheses or guidelines pooled it, 100 citations in OpenAlex.
- Phosphate binders for preventing and treating chronic kidney disease-mineral and bone disorder (CKD-MBD).The Cochrane database of systematic reviews · 2025Pooled it
- The impact of phosphate lowering agents on clinical and laboratory outcomes in chronic kidney disease patients: a systematic review and meta-analysis of randomized controlled trials.Journal of nephrology · 2022Pooled it
- Effectiveness of fibroblast growth factor 23 lowering modalities in chronic kidney disease: a systematic review and meta-analysis.International urology and nephrology · 2022Pooled it
- Effect of Nicotinamide in Skin Cancer and Actinic Keratoses Chemoprophylaxis, and Adverse Effects Related to Nicotinamide: A Systematic Review and Meta-Analysis.Journal of cutaneous medicine and surgeryPooled it
- Effect of Lanthanum Carbonate on Blood Pressure in CKD.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2021Trial
- A Randomized Trial on the Effect of Phosphate Reduction on Vascular End Points in CKD (IMPROVE-CKD).Journal of the American Society of Nephrology : JASN · 2020Trial
- Meta-analysis of the impact of serum phosphorus reduction on the prognosis of non-dialysis CKD patients: evidence based on clinical outcomes.International urology and nephrology · 2026Review
- The effects of elevated phosphate on the kidney - damaging the gatekeeper.Pflugers Archiv : European journal of physiology · 2026Review
- Protection against cisplatin-induced acute kidney injury by hellgrammite extract: insights from comprehensive metabolomics.Frontiers in pharmacology · 2026Article
- Elevated phosphate levels in CKD - a direct threat for the heart.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025Review
- Hyperphosphatemia in Kidney Failure: Pathophysiology, Challenges, and Critical Role of Phosphorus Management.Nutrients · 2025Review
- L-shaped association between dietary niacin intake and chronic kidney disease among adults in the USA: a cross-sectional study.Renal failure · 2024Article
- Impact of Pregnancy on the Pharmacokinetics and Metabolism of Nicotinamide in Humans.Clinical pharmacology and therapeutics · 2024Article
- FGF23 and klotho at the intersection of kidney and cardiovascular disease.Nature reviews. Cardiology · 2024Review
- Article
- The open system of FGF-23 at the crossroad between additional P-lowering therapy, anemia and inflammation: how to deal with the intact and the C-terminal assays?Clinical kidney journal · 2023Article
- [Diagnosis and treatment of osteoporosis in patients with chronic kidney disease : Joint guidelines of the Austrian Society for Bone and Mineral Research (ÖGKM), the Austrian Society of Physical and Rehabilitation Medicine (ÖGPMR) and the Austrian Society of Nephrology (ÖGN)].Wiener medizinische Wochenschrift (1946) · 2023Review
- Intact FGF23 predicts serum phosphate improvement after combined nicotinamide and phosphate binder treatment in hemodialysis patients.Clinical kidney journal · 2023Article
- Risk improvement and adverse kidney outcomes in patients with chronic kidney disease: findings from KNOW-CKD.Journal of nephrology · 2023Observational
- Roles of NADInternational journal of molecular sciences · 2022Review
Corrections and comments
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Authors and funding
13 authors at 9 institutions in 1 country.
Funding
Abstract
backgroundHigher serum phosphate and fibroblast growth factor-23 (FGF23) levels may be modifiable to prevent cardiovascular disease in CKD. Short-term studies have reported modest efficacy in phosphate and FGF23 reduction with intestinal phosphate binders in CKD.
methodsTo investigate effects of lanthanum carbonate (LC; a phosphate binder) and/or nicotinamide (NAM; an inhibitor of active intestinal phosphate transport) on serum phosphate and FGF23 in stage 3b/4 CKD, we conducted a randomized trial among individuals with eGFR 20-45 ml/min per 1.73 m
resultsMean eGFR for the 205 participants was 32ml/min per 1.73 m
conclusionsLC and/or NAM treatment did not significantly lower serum phosphate or FGF23 in stage 3b/4 CKD over 12 months. Although these agents appeared safe, intestinal symptoms limited adherence. Reducing phosphate and FGF23 in nondialysis CKD will require new approaches.
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What OpenQuestion holds
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.