[Phosphorus binders: trigger for intestinal diverticula formation in an ADPKD patient]

Area of Science:

• Nephrology
• Gastroenterology

Background:

• Hyperphosphatemia is prevalent in chronic kidney disease (CKD) patients.
• Elevated phosphate levels are a significant risk factor for adverse outcomes in CKD.
• Phosphate binders are a primary therapeutic strategy for managing hyperphosphatemia.

Observation:

• Phosphate binders can cause gastrointestinal side effects, including gastritis, diarrhea, and constipation.
• A case report details a hemodialysis-dependent patient with stage V CKD secondary to autosomal dominant polycystic kidney disease.
• This patient developed diverticulosis, which progressed to acute diverticulitis, during treatment with phosphate binders.

Findings:

• Phosphate binder therapy in a CKD patient was associated with the development of diverticulosis.
• The diverticulosis subsequently evolved into acute diverticulitis, a serious gastrointestinal complication.
• This case highlights a potential link between phosphate binder use and the manifestation of diverticular disease.

Implications:

• Further investigation into the gastrointestinal safety profile of phosphate binders is warranted.
• Clinicians should consider the risk of diverticular complications in CKD patients treated with phosphate binders.
• This case underscores the importance of monitoring for gastrointestinal adverse events in patients with hyperphosphatemia.