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Chronic Kidney Disease III: Interprofessional Care

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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
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Roles of Electrolytes: Calcium and Phosphate01:27

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Calcium and phosphate are essential electrolytes in the human body, with calcium being the most abundant mineral. Around 99% of the body's calcium is stored in the skeleton and teeth, forming a crystal lattice of mineral salts in combination with phosphates. Calcium plays crucial roles in various bodily functions such as blood clotting, neurotransmitter release, muscle tone maintenance, and nervous and muscle tissue excitability.
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The minerals contained in all of the food we consume are essential for our organ systems. However, certain essential minerals, such as calcium, phosphorus, magnesium, manganese, and fluoride, largely affect bone health.
Calcium and Phosphorus
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Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
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A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro
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[New Developments in CKD-MBD. New aspects in phosphate binders].

Keitaro Yokoyama1

  • 1Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Japan.

Clinical Calcium
|November 27, 2014
PubMed
Summary

Hyperphosphatemia in end-stage renal disease (ESRD) causes serious complications. Current phosphate binders have variable safety and efficacy, highlighting the need for improved treatments.

Area of Science:

  • Nephrology
  • Endocrinology
  • Pharmacology

Background:

  • Hyperphosphatemia is a common complication in end-stage renal disease (ESRD).
  • It contributes to secondary hyperparathyroidism, skeletal issues like fractures, and vascular calcification.
  • Existing phosphate binders (calcium carbonate, sevelamer hydrochloride, lanthanum carbonate) have limitations.

Purpose of the Study:

  • To review the current landscape of phosphate binders used in ESRD.
  • To discuss their varying safety profiles, potencies, and off-target effects.
  • To identify the unmet need for novel, safer, and more effective phosphate binders.

Main Methods:

  • Literature review of existing phosphate binders for ESRD.
  • Analysis of safety, efficacy, and off-target effects of current treatments.

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  • Evaluation of the clinical implications of these binders.

    • Main Results:

    • Phosphate binders effectively reduce oral phosphate absorption.
    • Agents like sevelamer offer potential benefits such as lowering LDL and uric acid.
    • Calcium-based binders may be associated with adverse effects like low turnover bone disease and vascular calcification.

    Conclusions:

    • Current phosphate binders present a trade-off between efficacy and safety/off-target effects.
    • There is a significant need for the development of new phosphate binders with improved safety and favorable side effect profiles.
    • Optimizing phosphate control in ESRD requires careful consideration of individual patient factors and binder characteristics.