[Use of phosphate binder in predialysis patients]

Recently, it is evident that sevelamer hydrochloride is superior to calcium carbonate in the anti-phosphorus therapy for the dialysis patients, from the viewpoints of vascular calcification and mortality. The efficacy of sevelamer hydrochloride was also suggested in predialysis patients. Although, in Japan, calcium carbonate, but not sevelamer, is only approved to the treatment in predialysis patients. It should be discussed about lanthanum carbonate. In this review, the management of phosphorus and the administration of phosphate binder in predialysis patients are extrapolated.