title: Nicotinamide and phosphate homeostasis in chronic kidney disease.
abstract: Higher serum phosphate concentration is a central driver of the chronic kidney disease (CKD) mineral bone disorder (MBD). Although phosphate binders are commonly used to lower phosphate, they are minimally effective in CKD. Nicotinamide (vitamin B3) decreases intestinal phosphate transport in animals. Its efficacy and safety in CKD is uncertain.
  
  
  
  We review data differentiating nicotinamide from nicotinic acid (niacin) and compare the metabolism and side-effect profile of each. Several recent studies have tested the safety and efficacy of nicotinamide in patients with CKD and the general population. Available data on efficacy and safety, gaps in knowledge, and ongoing studies to address them are described.
  
  
  
  Nicotinamide is a novel potential tool to treat hyperphosphatemia in patients with CKD, but additional data on safety and efficacy are required before widespread clinical use.
authors.affiliation: aDivision of Nephrology-Hypertension, Department of Medicine, University of California San Diego bNephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, California cDivision of Preventive Medicine, Department of Family Medicine and Public Health, University of California San Diego, San Diego, California, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Ginsberg
authors.forename: Joachim H
authors.initials: JH
authors.lastname: Ix
mesh_terms: D000818:Animals; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D006706:Homeostasis; D006801:Humans; D054559:Hyperphosphatemia / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D009536:Niacinamide / Q000627:therapeutic use*; D010710:Phosphates / Q000097:blood; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D014803:Vitamin B Complex / Q000627:therapeutic use*
chemical_list: D010710:Phosphates; D014803:Vitamin B Complex; D009536:Niacinamide