[Phosphate binder up to date]

It has become clear that hyperphosphatemia is the major risk factor on the patients' survival undergoing regular renal replacement therapy. One of the mechanism of this impact on survival is ectopic calcification like vascular calcification. The standard therapy for hyperphosphatemia is phosphate removal by renal replacement therapy. However, since the amount of phosphate removal with today's hemodialysis procedure is not enough, the phosphate binder as depressant of phosphate absorption is still essential. Aluminum compound had been prohibited from 1992 due to serious adverse effect like aluminum encephalopathy and osteomalacia.Calcium carbonate and sevelamer hydrochloride are common phosphate binder. The combination therapy of both phosphate binders is recommended to avoid involvement in adverse effects of the both drugs. Lanthanum carbonate is developing compound as a new and powerful phosphate binder. It is expected as a new non-calcium and non-aluminum phosphate binder with powerful phosphate binding effect. However, the adverse effect of the Lanthanum carbonate is still obscure. Further investigation is acquired.