[Phosphate metabolism and nutritional therapy in predialysis patients]

Phosphate metabolism is disordered in patients with chronic kidney disease (CKD). Although there is insufficient evidence in predialysis patients, hyperphosphatemia is closely connected with poor prognosis and cardiovascular disease. The standard approaches to management of elevated serum phosphate are dietary restriction and drug treatment using oral phosphate binders. Treatment of hyperphosphatemia is important in patients with CKD. On the other hand, it is possible that dietary restriction causes protein energy wasting (PEW). It is necessary to pay attention to both hyperphosphatemia and PEW in CKD patients.