Consequences of hyperphosphatemia and elevated levels of the calcium-phosphorus product in dialysis patients.
Control of serum phosphorus levels is a central goal in the management of patients with chronic renal failure. Inadequate control of serum phosphorus leads to elevated levels of the calcium-phosphorus product. This plays a pivotal role in vascular calcification, cardiovascular disease, calciphylaxis, and death. Elevated phosphorus and elevated levels of the calcium-phosphorus product are both significant predictors of cardiovascular mortality, at phosphorus and calcium-phosphorus product levels that were considered safe until recently. A lowering of levels such that phosphorus is maintained between 2.2 and 5.5 mg/dl, calcium-phosphorus product is below 55 mg(2)/dl(2), and serum calcium is at 9.2-9.6 mg/dl, respectively, might well be the goal of therapeutic management strategies.
Levin
N W
NW
Renal Research Institute, New York, New York 10128, USA. nlevin@rriny.com
Hoenich
N A
NA
D001842:Bone and Bones / Q000378:metabolism; D002114:Calcinosis / Q000209:etiology; D002118:Calcium / Q000097:blood*; D002318:Cardiovascular Diseases / Q000209:etiology; D006439:Hemodynamics; D006801:Humans; D010758:Phosphorus / Q000097:blood*; D010760:Phosphorus Metabolism Disorders / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D017582:Renal Replacement Therapy
D010758:Phosphorus; D002118:Calcium