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Effect of calcium-based versus non-calcium-based phosphate binders on mortality in patients with chronic kidney disease: an updated systematic review and meta-analysis

The Lancet (British edition), 2013-10, Vol.382 (9900), p.1268-1277 [Peer Reviewed Journal]

Elsevier Ltd ;2013 Elsevier Ltd ;2014 INIST-CNRS ;Copyright © 2013 Elsevier Ltd. All rights reserved. ;Copyright Elsevier Limited Oct 12, 2013 ;ISSN: 0140-6736 ;EISSN: 1474-547X ;DOI: 10.1016/S0140-6736(13)60897-1 ;PMID: 23870817 ;CODEN: LANCAO

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Title:
Effect of calcium-based versus non-calcium-based phosphate binders on mortality in patients with chronic kidney disease: an updated systematic review and meta-analysis
Author: Jamal, Sophie A, Dr ; Vandermeer, Ben, MSc ; Raggi, Paolo, Prof ; Mendelssohn, David C, Prof ; Chatterley, Trish, MLIS ; Dorgan, Marlene, MLS ; Lok, Charmaine E, MD ; Fitchett, David, MD ; Tsuyuki, Ross T, Prof
Subjects: Acetates - therapeutic use ; Aged ; Biological and medical sciences ; blood serum ; Calcium Carbonate - therapeutic use ; Calcium Compounds - therapeutic use ; Cause of Death ; Chelating Agents - therapeutic use ; Diabetes ; Epidemiology ; Female ; General aspects ; Hemodialysis ; Humans ; Hyperphosphatemia - etiology ; Hyperphosphatemia - mortality ; Hyperphosphatemia - prevention & control ; Internal Medicine ; kidney diseases ; Kidneys ; Male ; Medical sciences ; Medical treatment ; meta-analysis ; Middle Aged ; Mortality ; Nephrology. Urinary tract diseases ; patients ; Phosphates - therapeutic use ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Randomized Controlled Trials as Topic ; relative risk ; Renal Dialysis - adverse effects ; Renal Dialysis - mortality ; Renal Insufficiency, Chronic - complications ; Renal Insufficiency, Chronic - mortality ; risk reduction ; Systematic review ; Urinary system involvement in other diseases. Miscellaneous ; Womens health
Is Part Of: The Lancet (British edition), 2013-10, Vol.382 (9900), p.1268-1277
Description: Summary Background Phosphate binders (calcium-based and calcium-free) are recommended to lower serum phosphate and prevent hyperphosphataemia in patients with chronic kidney disease, but their effects on mortality and cardiovascular outcomes are unknown. We aimed to update our meta-analysis on the effect of calcium-based versus non-calcium-based phosphate binders on mortality in patients with chronic kidney disease. Methods We did a systematic review of articles published in any language after Aug 1, 2008, up until Oct 22, 2012, by searching Medline, Embase, International Pharmaceutical Abstracts, Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing and Allied Health Literature. We included all randomised and non-randomised trials that compared outcomes between patients with chronic kidney disease taking calcium-based phosphate binders with those taking non-calcium-based binders. Eligible studies, determined by consensus with predefined criteria, were reviewed, and data were extracted onto a standard form. We combined data from randomised trials to assess the primary outcome of all-cause mortality using the DerSimonian and Laird random effects model. Findings Our search identified 847 reports, of which eight new studies (five randomised trials) met our inclusion criteria and were added to the ten (nine randomised trials) included in our previous meta-analysis. Analysis of the 11 randomised trials (4622 patients) that reported an outcome of mortality showed that patients assigned to non-calcium-based binders had a 22% reduction in all-cause mortality compared with those assigned to calcium-based phosphate binders (risk ratio 0·78, 95% CI 0·61–0·98). Interpretation Non-calcium-based phosphate binders are associated with a decreased risk of all-cause mortality compared with calcium-based phosphate binders in patients with chronic kidney disease. Further studies are needed to identify causes of mortality and to assess whether mortality differs by type of non-calcium-based phosphate binder. Funding None.
Publisher: Kidlington: Elsevier Ltd
Language: English
Identifier: ISSN: 0140-6736
EISSN: 1474-547X
DOI: 10.1016/S0140-6736(13)60897-1
PMID: 23870817
CODEN: LANCAO
Source: ProQuest One Psychology
MEDLINE
ProQuest Central

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Effect of calcium-based versus non-calcium-based phosphate binders on mortality in patients with chronic kidney disease: an updated systematic review and meta-analysis

Elsevier Ltd ;2013 Elsevier Ltd ;2014 INIST-CNRS ;Copyright © 2013 Elsevier Ltd. All rights reserved. ;Copyright Elsevier Limited Oct 12, 2013 ;ISSN: 0140-6736 ;EISSN: 1474-547X ;DOI: 10.1016/S0140-6736(13)60897-1 ;PMID: 23870817 ;CODEN: LANCAO

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