title: Management of hyperphosphataemia in chronic kidney disease: summary of National Institute for Health and Clinical Excellence (NICE) guideline.
abstract: Bone disease and ectopic calcification are the two main consequences of hyperphosphataemia of chronic kidney disease (CKD). Observational studies have demonstrated that hyperphosphataemia in CKD is associated with increased mortality. Furthermore, the use of phosphate binders in dialysis patients is associated with significantly lower mortality. The UK Renal Registry data show significant underachievement of phosphate targets in dialysis patients. It is believed to be due to wide variation in how management interventions are used. The National Institute for Health and Clinical Excellence (NICE) has developed a guideline on the management of hyperphosphataemia in CKD. This is based on the evidence currently available using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. This review outlines the recommendations including research recommendations and discusses methodology, rationale and challenges faced in developing this guideline and the health economic model used to assess the cost-effectiveness of different phosphate binders.
authors.affiliation: Heartlands Hospital Birmingham, Birmingham, UK.
authors.forename: Indranil
authors.initials: I
authors.lastname: Dasgupta
authors.forename: Rukshana
authors.initials: R
authors.lastname: Shroff
authors.forename: David
authors.initials: D
authors.lastname: Bennett-Jones
authors.forename: Gary
authors.initials: G
authors.lastname: McVeigh
mesh_terms: D000085:Acetates / Q000191:economics / Q000592:standards / Q000627:therapeutic use; D002119:Calcium Carbonate / Q000191:economics / Q000592:standards / Q000627:therapeutic use; D017610:Calcium Compounds / Q000191:economics / Q000592:standards / Q000627:therapeutic use; D002614:Chelating Agents / Q000191:economics / Q000592:standards / Q000627:therapeutic use*; D015913:Chelation Therapy / Q000191:economics / Q000592:standards*; D004035:Diet Therapy / Q000191:economics / Q000592:standards*; D019317:Evidence-Based Medicine; D006801:Humans; D054559:Hyperphosphatemia / Q000191:economics / Q000209:etiology / Q000628:therapy*; D009398:Nephrology / Q000191:economics / Q000592:standards*; D017410:Practice Guidelines as Topic; D006435:Renal Dialysis / Q000009:adverse effects / Q000592:standards; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000191:economics / Q000628:therapy; D014481:United States
chemical_list: D000085:Acetates; D017610:Calcium Compounds; D002614:Chelating Agents; D002119:Calcium Carbonate; C120662:calcium acetate