The Effect of Lanthanum Carbonate on Fibroblast Growth Factor 23

Inclusion Criteria: * Age \> 18 years old * Chronic renal failure on maintenance hemodialysis 3 times a week for at least 3 months Serum calcium:8-10.5 mg/dL * Serum phosphate:3.5-6 mg/dL(before washout period) * Serum phosphate ≧6 mg/dL after washout period * Serum i-PTH: 150-600 pg/mL Exclusion Criteria: * Diabetes mellitus * Post parathyroidectomy * Life expectancy\< 6 months * Liver disease(hepatitis B,C or liver dysfunction) * Severe gastrointestinal disorders or other severe comorbidity * Poor compliance * Intolerance to lanthanum or calcium carbonate * Active infection * Malnutrition(serum albumin\<3 g/dL or clinical assessment) * Kt/V\< 1.2 (inadequate dialysis) * Serum phosphate\>7.5 mg/dL after washout period