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Early initiation of phosphate lowering dietary therapy in non-dialysis chronic kidney disease: a critical review.
J Ren Care. 2009 Mar; 35 Suppl 1:71-8.JR

Abstract

Dietary management of hyperphosphatemia and hyperparathyroidism have long been important elements in the clinical management of CKD stage 4 and 5 for the prevention of mineral bone disease. The rationale for phosphate lowering has been further justified, given the accumulating data to support the association of phosphate with vascular damage, in this population who are at high risk of cardiovascular (CV) death. Phosphate is a novel CV risk factor in both CKD and in the general population, and a growing body of literature suggests that high normal serum phosphate may be a risk factor for progression of CKD. Few studies have examined hard outcomes after phosphate lowering. Nonetheless, given the balance of data both in cell, animal and human studies, the use of phosphate lowering strategies at earlier stages of CKD, perhaps even prior to serum phosphate level rising, may well be justified. This review will discuss the complications associated with higher serum phosphate, the potential benefits of early phosphate intervention, practical considerations of low phosphate diets and novel strategies for evaluating these strategies in clinical practice.

Authors+Show Affiliations

University of British Columbia, St. Paul's Hospital, Vancouver, Canada. msigrist@providencehealth.bc.caNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

19222735

Citation

Sigrist, M K., et al. "Early Initiation of Phosphate Lowering Dietary Therapy in Non-dialysis Chronic Kidney Disease: a Critical Review." Journal of Renal Care, vol. 35 Suppl 1, 2009, pp. 71-8.
Sigrist MK, Chiarelli G, Lim L, et al. Early initiation of phosphate lowering dietary therapy in non-dialysis chronic kidney disease: a critical review. J Ren Care. 2009;35 Suppl 1:71-8.
Sigrist, M. K., Chiarelli, G., Lim, L., & Levin, A. (2009). Early initiation of phosphate lowering dietary therapy in non-dialysis chronic kidney disease: a critical review. Journal of Renal Care, 35 Suppl 1, 71-8. https://doi.org/10.1111/j.1755-6686.2009.00064.x
Sigrist MK, et al. Early Initiation of Phosphate Lowering Dietary Therapy in Non-dialysis Chronic Kidney Disease: a Critical Review. J Ren Care. 2009;35 Suppl 1:71-8. PubMed PMID: 19222735.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early initiation of phosphate lowering dietary therapy in non-dialysis chronic kidney disease: a critical review. AU - Sigrist,M K, AU - Chiarelli,G, AU - Lim,L, AU - Levin,A, PY - 2009/2/19/entrez PY - 2009/2/19/pubmed PY - 2009/7/8/medline SP - 71 EP - 8 JF - Journal of renal care JO - J Ren Care VL - 35 Suppl 1 N2 - Dietary management of hyperphosphatemia and hyperparathyroidism have long been important elements in the clinical management of CKD stage 4 and 5 for the prevention of mineral bone disease. The rationale for phosphate lowering has been further justified, given the accumulating data to support the association of phosphate with vascular damage, in this population who are at high risk of cardiovascular (CV) death. Phosphate is a novel CV risk factor in both CKD and in the general population, and a growing body of literature suggests that high normal serum phosphate may be a risk factor for progression of CKD. Few studies have examined hard outcomes after phosphate lowering. Nonetheless, given the balance of data both in cell, animal and human studies, the use of phosphate lowering strategies at earlier stages of CKD, perhaps even prior to serum phosphate level rising, may well be justified. This review will discuss the complications associated with higher serum phosphate, the potential benefits of early phosphate intervention, practical considerations of low phosphate diets and novel strategies for evaluating these strategies in clinical practice. SN - 1755-6678 UR - https://www.unboundmedicine.com/medline/citation/19222735/Early_initiation_of_phosphate_lowering_dietary_therapy_in_non_dialysis_chronic_kidney_disease:_a_critical_review_ L2 - https://doi.org/10.1111/j.1755-6686.2009.00064.x DB - PRIME DP - Unbound Medicine ER -