Phosphate binders in chronic kidney disease. When should we start, what should we prescribe?

Abstract

It has been more than 2000 years since Hippocrates described renal disease and observed its progressive nature. Decreased survival and deteriorated health status of these patients' being is attributed to cardiovascular disease. There is increasing interest regarding the impact of non-traditional risk factors, including hyperphosphatemia, elevated calcium-phosphate (CaxPO₄) product, elevated parathyroid hormone levels and extensive use of calcium-containing phosphate binders on vascular calcification. There is a mounting body of evidence implying that a holistic and methodic approach should clearly suggest starting the battle against vascular calcification early in the course of chronic kidney disease. Type of phosphate binder used should be carefully selected, especially in the presence of vascular calcification.

Keywords::

• chronic kidney disease
• hyperphosphatemia
• lanthanum carbonate
• phosphate binders
• vascular calcification