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Erschienen in: Clinical and Experimental Nephrology 3/2017

Open Access 12.07.2016 | Original article

Design and baseline characteristics of the LANDMARK study

verfasst von: Hiroaki Ogata, Masafumi Fukagawa, Hideki Hirakata, Hideaki Kaneda, Tatsuo Kagimura, Tadao Akizawa, On behalf of the LANDMARK Study Group

Erschienen in: Clinical and Experimental Nephrology | Ausgabe 3/2017

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Abstract

Background

Calcium (Ca)-based phosphate (P) binders, compared to non-Ca-based P binders, contribute to vascular calcification, which is associated with cardiovascular events.

Methods

The LANDMARK study is a multicenter, randomized, open-label, parallel comparative study of lanthanum carbonate (LC) and calcium carbonate (CC) in hemodialysis patients. Stable hemodialysis patients with intact parathyroid hormone ≤240 pg/mL meeting ≥1 of the following criteria (age >65 years, postmenopause, diabetes mellitus) were randomized into the LC and CC groups. LC group patients initially received LC 750 mg/day or the previously used dose and were titrated up to a maximum 2250 mg/day to achieve serum P levels of 3.5–6.0 mg/dL. CC group patients received CC 3 g/day or the previously used dose and were titrated to achieve the same P range. If the target serum P level was not achieved, non-Ca-based P binders (other than LC) could also be added. The primary endpoint is survival time free of cardiovascular events, including cardiovascular death, non-fatal myocardial infarction or stroke, and unstable angina.

Results

Overall, 2309 patients were allocated to the LC (N = 1154) or CC group (N = 1155). At baseline, the mean age was 68.4 years, 40.4 % were women, 55.9 % had diabetes, 18.3 % had a history of ischemic heart disease, and 13.9 % had cerebrovascular disease. A total of 184 patients (8.4 %) had undergone coronary intervention procedures. Baseline characteristics were well balanced between groups.

Conclusions

The LANDMARK study will determine whether LC, a non-Ca-based P binder, reduces cardiovascular mortality and morbidity in chronic hemodialysis patients.
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Metadaten
Titel
Design and baseline characteristics of the LANDMARK study
verfasst von
Hiroaki Ogata
Masafumi Fukagawa
Hideki Hirakata
Hideaki Kaneda
Tatsuo Kagimura
Tadao Akizawa
On behalf of the LANDMARK Study Group
Publikationsdatum
12.07.2016
Verlag
Springer Japan
Erschienen in
Clinical and Experimental Nephrology / Ausgabe 3/2017
Print ISSN: 1342-1751
Elektronische ISSN: 1437-7799
DOI
https://doi.org/10.1007/s10157-016-1310-8

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