Phosphate binders in CKD: chalking out the differences.
Plasma phosphate levels are important in the evolution of hyperparathyroidism and ectopic calcification in chronic kidney disease (CKD). Although dietary management may be adequate to control plasma phosphate in its early stages, most patients develop hyperphosphataemia by CKD stages 3-4 and require the addition of a phosphate binder. Calcium-containing phosphate binders are the most used and cheapest binders but have fallen out of favour because of the potential for positive calcium balance and calcium toxicity. This problem may be attenuated by newer phosphate binders such as sevelamer hydrochloride and lanthanum carbonate. In this review, the role of phosphate as a uraemic toxin and the advantages and disadvantages of the currently available phosphate binders are discussed.
Rees
Lesley
L
Department of Nephrology, Great Ormond Street Hospital for Children NHS Trust, London, UK. Reesl@gosh.nhs.uk
Shroff
Rukshana C
RC
D002118:Calcium / Q000378:metabolism; D002119:Calcium Carbonate / Q000627:therapeutic use; D002648:Child; D004032:Diet; D006801:Humans; D006961:Hyperparathyroidism / Q000378:metabolism / Q000473:pathology; D054559:Hyperphosphatemia / Q000178:diet therapy / Q000188:drug therapy* / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000178:diet therapy / Q000188:drug therapy*; D007811:Lanthanum / Q000627:therapeutic use; D010710:Phosphates / Q000097:blood / Q000378:metabolism*; D011073:Polyamines / Q000627:therapeutic use; D006435:Renal Dialysis; D000069603:Sevelamer; D014652:Vascular Diseases / Q000378:metabolism / Q000473:pathology
D010710:Phosphates; D011073:Polyamines; C119467:lanthanum carbonate; D007811:Lanthanum; D000069603:Sevelamer; D002119:Calcium Carbonate; D002118:Calcium