Phosphate binders: new products and challenges.
Optimal phosphate control in dialysis patients is extremely challenging. A growing awareness of the deleterious effect of mineral metabolism imbalances together with the lack of a satisfactory explanation for the exaggerated mortality rate in patients undergoing renal replacement therapy has led to a renewed effort to refine our approach to hyperphosphatemia. However, despite the remarkable improvements in dialysis techniques, phosphate control has not substantially improved. Achieving normo-phosphatemia presents a multitude of practical and scientific challenges related to the optimal target level, cardiovascular health, and drug toxicities. It is the aim of the present review to summarize briefly the controversies associated with currently available phosphate binders, a cornerstone in the current management of hyperphosphatemia.
Bellasi
Antonio
A
Division of Nephrology, San Paolo Hospital, University of Milano, Milano, Italy.
Kooienga
Laura
L
Block
Geoffrey A
GA
D000535:Aluminum / Q000378:metabolism; D001647:Bile Acids and Salts / Q000494:pharmacology; D002118:Calcium / Q000378:metabolism; D006801:Humans; D007811:Lanthanum / Q000378:metabolism; D009536:Niacinamide / Q000494:pharmacology; D010710:Phosphates / Q000302:isolation & purification / Q000378:metabolism*; D010760:Phosphorus Metabolism Disorders / Q000188:drug therapy*; D011108:Polymers / Q000378:metabolism; D006435:Renal Dialysis
D001647:Bile Acids and Salts; D010710:Phosphates; D011108:Polymers; D009536:Niacinamide; D007811:Lanthanum; D000535:Aluminum; D002118:Calcium; C106574:cholebine