Lanthanum therapy

Last revised by Daniel J Bell on 10 Aug 2020

Lanthanum therapy is used to treat hyperphosphatemia in end-stage renal disease 1. It is taken as oral tablets (usually in the chemical form lanthanum carbonate) which dissociate in the acidic environment of the stomach. The released trivalent lanthanum cation has a high affinity for dietary phosphate. As lanthanum is poorly absorbed in the gut, the phosphate is excreted rectally 5.

Lanthanum is a naturally occurring rare earth element with atomic number 57, one atomic number higher than barium. Lanthanum strongly absorbs x-rays and has contrast medium-like properties 6

Clinical presentation

Abdominal pain and constipation are common complications 5. It has been proposed that abdominal radiographs can be used to assess patient compliance 2,8.

Radiographic features

Radiography will demonstrate radiopaque deposits within the entire gastrointestinal tract, particularly the colon 1,2,6. This can be mistaken for retained barium or geophagia. Lanthanum is known to cause beam hardening on CT 7.

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