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The clinical management of hyperphosphatemia.

Abstract

As renal function declines in patients with end-stage renal disease (ESRD), excess dietary phosphorus accumulates in the bloodstream. Routine dialysis removes up to 70% of absorbed phosphorus; therefore, hyperphosphatemia is found in the majority of patients with ESRD. The consequences of this imbalance include secondary hyperparathyroidism and osteodystrophy. Recent studies have also documented that hyperphosphatemia can lead to soft-tissue and vascular calcification; the latter is strongly associated with cardiovascular disease and, thus, increased mortality and morbidity. The reduction of phosphorus levels is, therefore, an important therapeutic target in this patient group. Management of hyperphosphatemia using conventional phosphate binders is not always successful. However, emerging therapies aim to reduce the incidence of hyperparathyroidism, bone disease, and calcification in this patient population. In this article, the consequences of hyperphosphatemia are reviewed, and recent developments in the treatment of the condition are discussed.

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  • Authors+Show Affiliations

    Klinikum der Universitat Heidelberg, Heidelberg, Germany. E.Ritz@t-online.de

    Source

    Journal of nephrology 18:3 pg 221-8

    MeSH

    Aluminum Hydroxide
    Antacids
    Calcium Carbonate
    Epoxy Compounds
    Humans
    Kidney Failure, Chronic
    Lanthanum
    Phosphates
    Phosphorus Metabolism Disorders
    Polyamines
    Polyethylenes
    Practice Guidelines as Topic
    Renal Dialysis
    Sevelamer

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    16013007

    Citation

    Ritz, Eberhard. "The Clinical Management of Hyperphosphatemia." Journal of Nephrology, vol. 18, no. 3, 2005, pp. 221-8.
    Ritz E. The clinical management of hyperphosphatemia. J Nephrol. 2005;18(3):221-8.
    Ritz, E. (2005). The clinical management of hyperphosphatemia. Journal of Nephrology, 18(3), pp. 221-8.
    Ritz E. The Clinical Management of Hyperphosphatemia. J Nephrol. 2005;18(3):221-8. PubMed PMID: 16013007.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The clinical management of hyperphosphatemia. A1 - Ritz,Eberhard, PY - 2005/7/14/pubmed PY - 2005/10/26/medline PY - 2005/7/14/entrez SP - 221 EP - 8 JF - Journal of nephrology JO - J. Nephrol. VL - 18 IS - 3 N2 - As renal function declines in patients with end-stage renal disease (ESRD), excess dietary phosphorus accumulates in the bloodstream. Routine dialysis removes up to 70% of absorbed phosphorus; therefore, hyperphosphatemia is found in the majority of patients with ESRD. The consequences of this imbalance include secondary hyperparathyroidism and osteodystrophy. Recent studies have also documented that hyperphosphatemia can lead to soft-tissue and vascular calcification; the latter is strongly associated with cardiovascular disease and, thus, increased mortality and morbidity. The reduction of phosphorus levels is, therefore, an important therapeutic target in this patient group. Management of hyperphosphatemia using conventional phosphate binders is not always successful. However, emerging therapies aim to reduce the incidence of hyperparathyroidism, bone disease, and calcification in this patient population. In this article, the consequences of hyperphosphatemia are reviewed, and recent developments in the treatment of the condition are discussed. SN - 1121-8428 UR - https://www.unboundmedicine.com/medline/citation/16013007/full_citation L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=16013007.ui DB - PRIME DP - Unbound Medicine ER -