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Phosphate handling in CKD-MBD from stage 3 to dialysis and the three strengths of lanthanum carbonate.
Expert Opin Pharmacother. 2012 Nov; 13(16):2337-53.EO

Abstract

INTRODUCTION

High phosphate levels are associated with unfavorable outcomes in ESRD. Recent data suggested that phosphate levels within the normal range are equally associated with poor outcomes in the community and CKD stage 3 - 4. Several concept papers support the potential role of phosphate load as a first-line toxin in the beginning of CKD-MBD processes via the activation of FGF23 cascade. Phosphate load is thereafter involved in the progression of vascular calcification (VC) and bone disorder typical of CKD-MBD.

AREAS COVERED

Herein the authors cover the recent evidence on the pathophysiology of phosphate handling through the natural history of CKD, with particular emphasis on FGF23 cascade, its potential surrogate markers, VC and bone disorder. The major characteristics of lanthanum carbonate are therefore discussed, focusing on its potential advantages for the treatment of difficult cases in CKD-MBD.

EXPERT OPINION

Lanthanum carbonate, being the most potent calcium-free phosphate binder available in clinical practice, could be decisive for those cases where controlling phosphate load is complicated by poor compliance to medications, stubborn high phosphorus intake, extended VC and bone disorders.

Authors+Show Affiliations

Renal Division and Laboratory of Experimental Nephrology, Dipartimento di Scienze della Salute, Università di Milano,S. Paolo Hospita, Via A. di Rudinì 8, Milan, Italy. mario.cozzolino@unimi.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

23033914

Citation

Cozzolino, Mario, et al. "Phosphate Handling in CKD-MBD From Stage 3 to Dialysis and the Three Strengths of Lanthanum Carbonate." Expert Opinion On Pharmacotherapy, vol. 13, no. 16, 2012, pp. 2337-53.
Cozzolino M, Bruschetta E, Cusi D, et al. Phosphate handling in CKD-MBD from stage 3 to dialysis and the three strengths of lanthanum carbonate. Expert Opin Pharmacother. 2012;13(16):2337-53.
Cozzolino, M., Bruschetta, E., Cusi, D., Montanari, E., Giovenzana, M. E., & Galassi, A. (2012). Phosphate handling in CKD-MBD from stage 3 to dialysis and the three strengths of lanthanum carbonate. Expert Opinion On Pharmacotherapy, 13(16), 2337-53. https://doi.org/10.1517/14656566.2012.730520
Cozzolino M, et al. Phosphate Handling in CKD-MBD From Stage 3 to Dialysis and the Three Strengths of Lanthanum Carbonate. Expert Opin Pharmacother. 2012;13(16):2337-53. PubMed PMID: 23033914.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Phosphate handling in CKD-MBD from stage 3 to dialysis and the three strengths of lanthanum carbonate. AU - Cozzolino,Mario, AU - Bruschetta,Elena, AU - Cusi,Daniele, AU - Montanari,Emanuele, AU - Giovenzana,Maria Enrica, AU - Galassi,Andrea, Y1 - 2012/10/04/ PY - 2012/10/5/entrez PY - 2012/10/5/pubmed PY - 2013/3/6/medline SP - 2337 EP - 53 JF - Expert opinion on pharmacotherapy JO - Expert Opin Pharmacother VL - 13 IS - 16 N2 - INTRODUCTION: High phosphate levels are associated with unfavorable outcomes in ESRD. Recent data suggested that phosphate levels within the normal range are equally associated with poor outcomes in the community and CKD stage 3 - 4. Several concept papers support the potential role of phosphate load as a first-line toxin in the beginning of CKD-MBD processes via the activation of FGF23 cascade. Phosphate load is thereafter involved in the progression of vascular calcification (VC) and bone disorder typical of CKD-MBD. AREAS COVERED: Herein the authors cover the recent evidence on the pathophysiology of phosphate handling through the natural history of CKD, with particular emphasis on FGF23 cascade, its potential surrogate markers, VC and bone disorder. The major characteristics of lanthanum carbonate are therefore discussed, focusing on its potential advantages for the treatment of difficult cases in CKD-MBD. EXPERT OPINION: Lanthanum carbonate, being the most potent calcium-free phosphate binder available in clinical practice, could be decisive for those cases where controlling phosphate load is complicated by poor compliance to medications, stubborn high phosphorus intake, extended VC and bone disorders. SN - 1744-7666 UR - https://www.unboundmedicine.com/medline/citation/23033914/Phosphate_handling_in_CKD_MBD_from_stage_3_to_dialysis_and_the_three_strengths_of_lanthanum_carbonate_ L2 - https://www.tandfonline.com/doi/full/10.1517/14656566.2012.730520 DB - PRIME DP - Unbound Medicine ER -