IMpact of Phosphate Reduction On Vascular End-points in Chronic Kidney Disease

Principal Investigator: Dr Nigel Toussaint and Dr Eugenie Pedagogos
Project Officer: Andrea Valks (AKTN)
Trial Number: AKTN 10.01

Population: CKD stage 3b/4 patients
Intervention: Lanthanum carbonate (1500-3000mg) vs placebo, daily
Follow-up: 24 months
Primary outcome: Arterial compliance (PWV)
Status: Trial completed

Recruitment end date: 31 December 2016
Follow-up end date: December 2018
Recruitment: 278/488

Trial Results
The IMPROVE-CKD study ran across 18 hospitals in Australia, New Zealand and Malaysia, with 278 patients taking part in the trial. The study was the largest trial of its kind to look at the effect of lanthanum carbonate, a phosphate binder medication, in people with chronic kidney disease.  High phosphate levels are a common problem in kidney disease and are linked to the onset and degree of cardiovascular disease.

The IMPROVE-CKD trial found lanthanum carbonate does not reduce the risk of cardiovascular disease developing in patients with chronic kidney disease.  The drug is routinely prescribed to help reduce the risk of both bone disease and cardiovascular disease, the latter being the most common complication and cause of death in people with chronic kidney disease. Determining that phosphate binding medication is not effective to reduce cardiovascular disease is an important finding because of the pill burden and cost related to this medication.

The results of the trial have been published in the Journal of the American Society of Nephrology.

Click here to view the Statistical Analysis Plan.

Read the full publications via the links below.
IMPROVE-CKD Full Paper – Journal of the American Society of Nephrology (JASN)
IMPROVE-CKD Editorial – Journal of the American Society of Nephrology (JASN)
IMPROVE Dietary Phosphate Study Baseline Characteristics – Journal of Renal Nutrition 2020
IMPROVE Baseline Characteristics – American Journal of Nephrology 2020
IMPROVE Protocol – BMJ Open 2019

Download a copy of the IMROVE-CKD Results Infographic for your reference.

Watch the IMROVE-CKD trial outcomes on You Tube