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Current and potential treatment options for hyperphosphatemia.

Fabio Carfagna1, Lucia Del Vecchio1, Giuseppe Pontoriero1

  • 1a Department of Nephrology and Dialysis , A. Manzoni Hospital ASST Lecco , Lecco , Italy.

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|May 23, 2018
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Summary
This summary is machine-generated.

Hyperphosphatemia in chronic kidney disease (CKD) management is challenging. Current phosphate binders have limitations, necessitating exploration of new treatments like intestinal phosphate transport inhibitors for better patient outcomes.

Keywords:
Chronic kidney diseasehyperphosphatemianon-calcium phosphate bindersphosphate bindersafetytolerability

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Area of Science:

  • Nephrology
  • Pharmacology
  • Internal Medicine

Background:

  • Hyperphosphatemia is prevalent in advanced chronic kidney disease (CKD).
  • It is linked to adverse outcomes including bone disease, calcification, and mortality.
  • Existing oral phosphate binders present safety, tolerability, and compliance challenges.

Purpose of the Study:

  • To review established treatments for hyperphosphatemia in CKD patients.
  • To focus on novel inhibitors of active intestinal phosphate absorption.

Main Methods:

  • Literature review of established and emerging phosphate binders.
  • Analysis of safety, efficacy, and tolerability profiles.
  • Evaluation of novel phosphate absorption inhibitors.

Main Results:

  • Aluminum binders carry toxic risks.
  • Calcium-based binders risk hypercalcemia and calcification.
  • Sevelamer and lanthanum show promise with gastrointestinal or minimal adverse effects.
  • Iron binders offer effective phosphate binding.
  • Phosphate transport inhibitors show potential but may require combination therapy.

Conclusions:

  • Current hyperphosphatemia management in CKD remains suboptimal.
  • A variety of phosphate binders exist, each with distinct risk-benefit profiles.
  • Novel phosphate transport inhibitors represent a promising therapeutic avenue, though further research is needed.