Evidence map›Paper›PMID 32917784›Full record

Trial reportJournal of the American Society of Nephrology : JASN2020

A Randomized Trial on the Effect of Phosphate Reduction on Vascular End Points in CKD (IMPROVE-CKD).

Nigel D Toussaint, Eugenia Pedagogos, Nicole M Lioufas, Grahame J Elder, Elaine M Pascoe, Sunil V Badve, Andrea Valks, Geoffrey A Block, Neil Boudville, James D Cameron and 21 more

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

Trial report in Journal of the American Society of Nephrology : JASN, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07676032 (The Impact of Body Composition on Setup Errors in Patients Undergoing Radiotherapy With Thermoplastic Mask Immobilization), which is not on this map. Cited by 45 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed, 3 pooled it
8.0field-weighted citation impact, top 2% 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.

NCT07676032 not yet recruitingnot on this mapstarted 2026, after this paper: background citation

The Impact of Body Composition on Setup Errors in Patients Undergoing Radiotherapy With Thermoplastic Mask Immobilization: A Single-Center Prospective Cohort Study

Typeobservational_patient_registrySponsorShijiazhuang People's HospitalRan2026 to 2027Enrolled150ConditionsMalignant Neoplasms
3 · Its place in the literature

Who cites it

45 citing papers in PubMed, 3 syntheses or guidelines pooled it, 81 citations in OpenAlex.

  1. Pooled it
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  3. Pooled it
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  5. Effect of lanthanum carbonate on serum calciprotein particles in patients with stage 3-4 CKD-results from a placebo-controlled randomized trial.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2023
    Trial
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  9. The effects of elevated phosphate on the kidney - damaging the gatekeeper.Pflugers Archiv : European journal of physiology · 2026
    Review
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  12. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

31 authors at 15 institutions in 6 countries.

Nigel D ToussaintDepartment of Nephrology, The Royal Melbourne Hospital, Parkville, Victoria, Australia Nigel.Toussaint@mh.org.au.
Eugenia PedagogosDepartment of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.
Nicole M LioufasDepartment of Nephrology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
Grahame J ElderSchool of Medicine, University of Notre Dame, Sydney, New South Wales, Australia.
Elaine M PascoeAustralasian Kidney Trials Network, The University of Queensland, Brisbane, Queensland, Australia.
Sunil V BadveSt. George Hospital, Sydney, New South Wales, Australia.
Andrea ValksAustralasian Kidney Trials Network, The University of Queensland, Brisbane, Queensland, Australia.
Geoffrey A BlockReata Pharmaceuticals, Plano, Texas.
Neil BoudvilleSir Charles Gairdner Hospital, Perth, Western Australia, Australia.
James D CameronMonash Cardiovascular Research Centre, Monash Heart, Monash Health, Clayton, Victoria, Australia.
Katrina L CampbellDepartment of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
Sylvia S M ChenEpworth Healthcare, Melbourne, Victoria, Australia.
Randall J FaullDepartment of Medicine, University of Adelaide, Adelaide, South Australia, Australia.
Stephen G HoltDepartment of Nephrology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
Dana JacksonMonash Health, Clayton, Victoria, Australia.
Meg J JardineConcord Repatriation and General Hospital, Concord, New South Wales, Australia.
David W JohnsonAustralasian Kidney Trials Network, The University of Queensland, Brisbane, Queensland, Australia.
Peter G KerrDepartment of Medicine, Monash University, Clayton, Victoria, Australia.
Kenneth K LauDepartment of Medicine, Monash University, Clayton, Victoria, Australia.
Lai-Seong HooiSultanah Aminah Hospital, Johor Bahru, Malaysia.
Om NarayanMonash Cardiovascular Research Centre, Monash Heart, Monash Health, Clayton, Victoria, Australia.
Vlado PerkovicRenal and Metabolic Division, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
Kevan R PolkinghorneDepartment of Medicine, Monash University, Clayton, Victoria, Australia.
Carol A PollockKolling Institute, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia.
Donna ReidlingerAustralasian Kidney Trials Network, The University of Queensland, Brisbane, Queensland, Australia.
Laura RobisonAustralasian Kidney Trials Network, The University of Queensland, Brisbane, Queensland, Australia.
Edward R SmithDepartment of Nephrology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.ORCID 0000-0002-2651-1787
Robert J WalkerDunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Angela Yee Moon WangQueen Mary Hospital, University of Hong Kong, Hong Kong.
Carmel M HawleyAustralasian Kidney Trials Network, The University of Queensland, Brisbane, Queensland, Australia.
IMPROVE-CKD Trial Investigators
Monash Health · AUThe Royal Melbourne Hospital · AUThe University of Queensland · AUThe University of Sydney · AUUNSW Sydney · AUConcord Repatriation General Hospital · AUEpworth Hospital · AUPrincess Alexandra Hospital · AUQueen Mary Hospital · CNReata Pharmaceuticals (United States) · USSultanah Aminah Hospital · MYThe University of Adelaide · AUThe University of Western Australia · AUTranslational Research Institute · AUUniversity of Otago · NZ

Funding

The Vanderbilt Institute for Clinical and Translational Research (VICTR)UL1TR000445 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BERNARD, GORDON RAPHAEL · 2012 to 2016
$41.4M
NCATS NIH HHS UL1 TR000445
6 · The paper itself

Abstract

backgroundHyperphosphatemia is associated with increased fibroblast growth factor 23 (FGF23), arterial calcification, and cardiovascular mortality. Effects of phosphate-lowering medication on vascular calcification and arterial stiffness in CKD remain uncertain.

methodsTo assess the effects of non-calcium-based phosphate binders on intermediate cardiovascular markers, we conducted a multicenter, double-blind trial, randomizing 278 participants with stage 3b or 4 CKD and serum phosphate >1.00 mmol/L (3.10 mg/dl) to 500 mg lanthanum carbonate or matched placebo thrice daily for 96 weeks. We analyzed the primary outcome, carotid-femoral pulse wave velocity, using a linear mixed effects model for repeated measures. Secondary outcomes included abdominal aortic calcification and serum and urine markers of mineral metabolism.

resultsA total of 138 participants received lanthanum and 140 received placebo (mean age 63.1 years; 69% male, 64% White). Mean eGFR was 26.6 ml/min per 1.73 m

conclusionsIn patients with stage 3b/4 CKD, treatment with lanthanum over 96 weeks did not affect arterial stiffness or aortic calcification compared with placebo. These findings do not support the role of intestinal phosphate binders to reduce cardiovascular risk in patients with CKD who have normophosphatemia. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER: Australian Clinical Trials Registry, ACTRN12610000650099.

Indexed as

AgedAorta, AbdominalDouble-Blind MethodFemaleFibroblast Growth Factor-23Fibroblast Growth FactorsGlomerular Filtration RateHumansHyperphosphatemiaLanthanumMaleMiddle AgedParathyroid HormonePhosphatesPulse Wave AnalysisRenal Insufficiency, ChronicFGF23 protein, humanFibroblast Growth Factor-23Fibroblast Growth FactorsLanthanumlanthanum carbonateParathyroid HormonePhosphatesarterial compliancecardiovascular diseaselanthanum carbonatephosphatephosphate bindersvascular calcification

Identifiers

PMID32917784
PMCPMC7608977
OpenAlexW3085534590

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.