Hyperphosphatemia in end-stage renal disease patients: pathophysiological consequences

A study of 6407 end-stage renal disease (ESRD) patients has shown that hyperphosphatemia is increasingly important as a risk for mortality. Half of the patients showed serum phosphorus levels of over 6.0 mg/dl; at the same time, an elevated calcium x phosphorus product indicated increased risk of mortality. These observations lead to questions regarding the mechanisms at work in both the observed phenomena and the way in which they affect mortality. To answer these questions, an understanding of the pathophysiological consequences of hyperphosphatemia is necessary.