Multidisciplinary Perspectives of Current Approaches and Clinical Gaps in the Management of Hyperphosphatemia

References

• Jamal SA, Fitchett D, Lok CE, Mendelssohn DC, Tsuyuki RT. The effects of calcium-based versus non-calcium-based phosphate binders on mortality among patients with chronic kidney disease: a meta-analysis. Nephrol Dial Transplant. 2009;24(10):3168–3174. doi:10.1093/ndt/gfp350
   PubMed Web of Science ®Google Scholar
• Sekercioglu N, Thabane L, Díaz Martínez JP, et al. Comparative effectiveness of phosphate binders in patients with chronic kidney disease: a systematic review and network meta-analysis. PLoS One. 2016;11(6):e0156891. doi:10.1371/journal.pone.0156891
   PubMed Web of Science ®Google Scholar
• Habbous S, Przech S, Acedillo R, Sarma S, Garg AX, Martin J. The efficacy and safety of sevelamer and lanthanum versus calcium-containing and iron-based binders in treating hyperphosphatemia in patients with chronic kidney disease: a systematic review and meta-analysis. Nephrol Dial Transplant. 2017;32(1):111–125. doi:10.1093/ndt/gfw312
   PubMed Web of Science ®Google Scholar
• Ruospo M, Palmer SC, Natale P, et al. Phosphate binders for preventing and treating chronic kidney disease‐mineral and bone disorder (CKD‐MBD). Cochrane Database Syst Rev. 2018;(8). doi:10.1002/14651858.CD006023.pub3
   Web of Science ®Google Scholar
• Jamal SA, Vandermeer B, Raggi P, et al. Effect of calcium-based versus non-calcium-based phosphate binders on mortality in patients with chronic kidney disease: an updated systematic review and meta-analysis. Lancet. 2013;382(9900):1268–1277. doi:10.1016/S0140-6736(13)60897-1
   PubMed Web of Science ®Google Scholar
• Levin A, Bakris GL, Molitch M, et al. Prevalence of abnormal serum vitamin D, PTH, calcium, and phosphorus in patients with chronic kidney disease: results of the study to evaluate early kidney disease. Kidney Int. 2007;71(1):31–38. doi:10.1038/sj.ki.5002009
   PubMed Web of Science ®Google Scholar
• Kates DM, Sherrard DJ, Andress DL. Evidence that serum phosphate is independently associated with serum PTH in patients with chronic renal failure. Am J Kidney Dis. 1997;30(6):809–813. doi:10.1016/s0272-6386(97)90086-x
   Web of Science ®Google Scholar
• Kestenbaum B, Sampson JN, Rudser KD, et al. Serum phosphate levels and mortality risk among people with chronic kidney disease. J Am Soc Nephrol. 2005;16(2):520–528. doi:10.1681/ASN.2004070602
   PubMed Web of Science ®Google Scholar
• Waheed AA, Pedraza F, Lenz O, Isakova T. Phosphate control in end-stage renal disease: barriers and opportunities. Nephrol Dial Transplant. 2013;28(12):2961–2968. doi:10.1093/ndt/gft244
   PubMed Web of Science ®Google Scholar
• Block GA, Klassen PS, Lazarus JM, Ofsthun N, Lowrie EG, Chertow GM. Mineral metabolism, mortality, and morbidity in maintenance hemodialysis. J Am Soc Nephrol. 2004;15(8):2208–2218. doi:10.1097/01.ASN.0000133041.27682.A2
   PubMed Web of Science ®Google Scholar
• Tentori F, Blayney MJ, Albert JM, et al. Mortality risk for dialysis patients with different levels of serum calcium, phosphorus, and PTH: the Dialysis Outcomes and Practice Patterns Study (DOPPS). Am J Kidney Dis. 2008;52(3):519–530. doi:10.1053/j.ajkd.2008.03.020
   PubMed Web of Science ®Google Scholar
• Slinin Y, Foley RN, Collins AJ. Calcium, phosphorus, parathyroid hormone, and cardiovascular disease in hemodialysis patients: the USRDS waves 1, 3, and 4 study. J Am Soc Nephrol. 2005;16(6):1788–1793. doi:10.1681/ASN.2004040275
   PubMed Web of Science ®Google Scholar
• Block GA, Wheeler DC, Persky MS, et al. Effects of phosphate binders in moderate CKD. J Am Soc Nephrol. 2012;23(8):1407–1415. doi:10.1681/ASN.2012030223
   PubMed Web of Science ®Google Scholar
• St Peter WL, Liu J, Weinhandl E, Fan Q. A comparison of sevelamer and calcium-based phosphate binders on mortality, hospitalization, and morbidity in hemodialysis: a secondary analysis of the Dialysis Clinical Outcomes Revisited (DCOR) randomized trial using claims data. Am J Kidney Dis. 2008;51(3):445–454. doi:10.1053/j.ajkd.2007.12.002
   PubMed Web of Science ®Google Scholar
• Wald R, Rabbat CG, Girard L, et al. Two phosphAte taRGets in End-stage renal disease Trial (TARGET): a randomized controlled trial. Clin J Am Soc Nephrol. 2017;12(6):965–973. doi:10.2215/CJN.10941016
   Web of Science ®Google Scholar
• ClinicalTrials.gov. HiLo: pragmatic trial of higher vs lower serum phosphate targets in patients undergoing hemodialysis - full text view - ClinicalTrials.gov. Available from: https://clinicaltrials.gov/ct2/show/NCT04095039. Accessed November 26, 2020.
   Google Scholar
• ClinicalTrials.gov. Pragmatic randomised trial of high or standard PHosphAte targets in end-stage kidney disease (PHOSPHATE) - full text view - ClinicalTrials.gov. Available from: https://clinicaltrials.gov/ct2/show/NCT03573089. Accessed November 26, 2020.
   Google Scholar
• Barreto FC, Barreto DV, Massy ZA, Drüeke TB. Strategies for phosphate control in patients with CKD. Kidney Int Rep. 2019;4(8):1043–1056. doi:10.1016/j.ekir.2019.06.002
   PubMed Web of Science ®Google Scholar
• Cozzolino M, Ketteler M, Wagner CA. An expert update on novel therapeutic targets for hyperphosphatemia in chronic kidney disease: preclinical and clinical innovations. Expert Opin Ther Targets. 2020;24(5):477–488. doi:10.1080/14728222.2020.1743680
   PubMed Web of Science ®Google Scholar
• Umeukeje EM, Mixon AS, Cavanaugh KL. Phosphate-control adherence in hemodialysis patients: current perspectives. Patient Prefer Adherence. 2018;12:1175–1191. doi:10.2147/PPA.S145648
   PubMed Web of Science ®Google Scholar
• Vervloet MG, Sezer S, Massy ZA, Johansson L, Cozzolino M, Fouque D. The role of phosphate in kidney disease. Nat Rev Nephrol. 2017;13(1):27–38. doi:10.1038/nrneph.2016.164
   PubMed Web of Science ®Google Scholar
• Ikizler TA, Burrowes JD, Byham-Gray LD, et al. KDOQI clinical practice guideline for nutrition in CKD: 2020 update. Am J Kidney Dis. 2020;76(3):S1–S107. doi:10.1053/j.ajkd.2020.05.006
   PubMed Web of Science ®Google Scholar
• Ketteler M, Block GA, Evenepoel P, et al. Executive summary of the 2017 KDIGO chronic kidney disease–mineral and bone disorder (CKD-MBD) guideline update: what’s changed and why it matters. Kidney Int. 2017;92:26–36. doi:10.1016/j.kint.2017.10.001
   PubMed Web of Science ®Google Scholar
• Sullivan CM, Leon JB, Sehgal AR. Phosphorus-containing food additives and the accuracy of nutrient databases: implications for renal patients. J Ren Nutr. 2007;17(5):350–354. doi:10.1053/j.jrn.2007.05.008
   PubMed Web of Science ®Google Scholar
• Rufino M. Is it possible to control hyperphosphataemia with diet, without inducing protein malnutrition? Nephrol Dial Transplant. 1998;13(90003):65–67. doi:10.1093/ndt/13.suppl_3.65
   Web of Science ®Google Scholar
• Lynch KE, Lynch R, Curhan GC, Brunelli SM. Prescribed dietary phosphate restriction and survival among hemodialysis patients. Clin J Am Soc Nephrol. 2011;6(3):620–629. doi:10.2215/CJN.04620510
   PubMed Web of Science ®Google Scholar
• Shinaberger CS, Greenland S, Kopple JD, et al. Is controlling phosphorus by decreasing dietary protein intake beneficial or harmful in persons with chronic kidney disease? Am J Clin Nutr. 2008;88(6):1511–1518. doi:10.3945/ajcn.2008.26665
   PubMed Web of Science ®Google Scholar
• Moreira AC, Carolino E, Domingos F, Gaspar A, Ponce P, Camilo ME. Nutritional status influences generic and disease-specific quality of life measures in haemodialysis patients. Nutr Hosp. 2013;28(3):951–957. doi:10.3305/nh.2013.28.3.6454
   Web of Science ®Google Scholar
• D’Alessandro C, Piccoli GB, Cupisti A. The “phosphorus pyramid”: a visual tool for dietary phosphate management in dialysis and CKD patients. BMC Nephrol. 2015;16:9. doi:10.1186/1471-2369-16-9
   PubMed Web of Science ®Google Scholar
• Kuhlmann MK. Phosphate elimination in modalities of hemodialysis and peritoneal dialysis. BPU. 2010;29(2):137–144. doi:10.1159/000245640
   Web of Science ®Google Scholar
• Ramirez JA, Emmett M, White MG, et al. The absorption of dietary phosphorus and calcium in hemodialysis patients. Kidney Int. 1986;30(5):753–759. doi:10.1038/ki.1986.252
   PubMed Web of Science ®Google Scholar
• Gutzwiller J-P, Schneditz D, Huber AR, Schindler C, Gutzwiller F, Zehnder CE. Estimating phosphate removal in haemodialysis: an additional tool to quantify dialysis dose. Nephrol Dial Transplant. 2002;17(6):1037–1044. doi:10.1093/ndt/17.6.1037
   PubMed Web of Science ®Google Scholar
• Kalantar-Zadeh K. Patient education for phosphorus management in chronic kidney disease. Patient Prefer Adherence. 2013;7:379–390. doi:10.2147/PPA.S43486
   PubMed Web of Science ®Google Scholar
• Rastogi A, Bhatt N, Rossetti S, Beto J. Management of hyperphosphatemia in end-stage renal disease: a new paradigm. J Ren Nutr. 2021;31:21–34. doi:10.1053/j.jrn.2020.02.003
   PubMed Web of Science ®Google Scholar
• Locatelli F, Del Vecchio L, Violo L, Pontoriero G. Phosphate binders for the treatment of hyperphosphatemia in chronic kidney disease patients on dialysis: a comparison of safety profiles. Expert Opin Drug Saf. 2014;13(5):551–561. doi:10.1517/14740338.2014.907791
   PubMed Web of Science ®Google Scholar
• Daugirdas JT, Chertow GM, Larive B, et al. Effects of frequent hemodialysis on measures of CKD mineral and bone disorder. J Am Soc Nephrol. 2012;23(4):727–738. doi:10.1681/ASN.2011070688
   PubMed Web of Science ®Google Scholar
• Badve SV, Zimmerman DL, Knoll GA, Burns KD, McCormick BB. Peritoneal phosphate clearance is influenced by peritoneal dialysis modality, independent of peritoneal transport characteristics. Clin J Am Soc Nephrol. 2008;3(6):1711–1717. doi:10.2215/CJN.00190108
   PubMed Web of Science ®Google Scholar
• Locatelli F, Carfagna F, Del Vecchio L, La Milia V. Haemodialysis or haemodiafiltration: that is the question. Nephrol Dial Transplant. 2018;33(11):1896–1904. doi:10.1093/ndt/gfy035
   PubMed Web of Science ®Google Scholar
• Health Canada. Drug product database: access the database. March 18, 2001. Available from: https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database.html. Accessed November 3, 2020.
   Google Scholar
• Roxe DM, Mistovich M, Barch DH. Phosphate-binding effects of sucralfate in patients with chronic renal failure. Am J Kidney Dis. 1989;13(3):194–199. doi:10.1016/s0272-6386(89)80052-6
   Web of Science ®Google Scholar
• Shanahan CM, Crouthamel MH, Kapustin A, Giachelli CM. Arterial calcification in chronic kidney disease: key roles for calcium and phosphate. Circ Res. 2011;109(6):697–711. doi:10.1161/CIRCRESAHA.110.234914
   PubMed Web of Science ®Google Scholar
• London GM, Guérin AP, Marchais SJ, Métivier F, Pannier B, Adda H. Arterial media calcification in end-stage renal disease: impact on all-cause and cardiovascular mortality. Nephrol Dial Transplant. 2003;18(9):1731–1740. doi:10.1093/ndt/gfg414
   PubMed Web of Science ®Google Scholar
• Vemuri N, Michelis MF, Matalon A. Conversion to lanthanum carbonate monotherapy effectively controls serum phosphorus with a reduced tablet burden: a multicenter open-label study. BMC Nephrol. 2011;12:49. doi:10.1186/1471-2369-12-49
   PubMed Web of Science ®Google Scholar
• Wilson RJ, Keith MS, Preston P, Copley JB. The real-world dose-relativity of sevelamer hydrochloride and lanthanum carbonate monotherapy in patients with end-stage renal disease. Adv Ther. 2013;30(12):1100–1110. doi:10.1007/s12325-013-0077-5
   PubMed Web of Science ®Google Scholar
• Toida T, Fukudome K, Fujimoto S, et al. Effect of lanthanum carbonate vs. calcium carbonate on serum calcium in hemodialysis patients: a crossover study. Clin Nephrol. 2012;78(3):216–223. doi:10.5414/cn107257
   Web of Science ®Google Scholar
• Zhang C, Wen J, Li Z, Fan J. Efficacy and safety of lanthanum carbonate on chronic kidney disease-mineral and bone disorder in dialysis patients: a systematic review. BMC Nephrol. 2013;14:226. doi:10.1186/1471-2369-14-226
   PubMed Web of Science ®Google Scholar
• Takahara Y, Matsuda Y, Takahashi S, Shigematsu T, et al. Efficacy and safety of lanthanum carbonate in pre-dialysis CKD patients with hyperphosphatemia: a randomized trial. Clin Nephrol. 2014;82(3):181–190. doi:10.5414/cn108269
   Web of Science ®Google Scholar
• Black T, Philips G, Burbridge R. Pharmacobezoar in a patient on an oral phosphate binder. Gastrointest Endosc. 2013;77(3):511–512. doi:10.1016/j.gie.2012.11.002
   Web of Science ®Google Scholar
• Hutchison AJ, Barnett ME, Krause R, et al. Lanthanum carbonate treatment, for up to 6 years, is not associated with adverse effects on the liver in patients with chronic kidney disease Stage 5 receiving hemodialysis. Clin Nephrol. 2009;71(3):286–295.
   PubMed Web of Science ®Google Scholar
• Spasovski GB, Sikole A, Gelev S, et al. Evolution of bone and plasma concentration of lanthanum in dialysis patients before, during 1 year of treatment with lanthanum carbonate and after 2 years of follow-up. Nephrol Dial Transplant. 2006;21(8):2217–2224. doi:10.1093/ndt/gfl146
   PubMed Web of Science ®Google Scholar
• sanofi-aventis Canada Inc. PrRENAGEL®: sevelamer hydrochloride tablets product monograph. 2018.
   Google Scholar
• sanofi-aventis Canada Inc. PrRENVELA®: sevelamer carbonate tablets product monograph. 2019.
   Google Scholar
• Bleyer AJ, Burke SK, Dillon M, et al. A comparison of the calcium-free phosphate binder sevelamer hydrochloride with calcium acetate in the treatment of hyperphosphatemia in hemodialysis patients. Am J Kidney Dis. 1999;33(4):694–701. doi:10.1016/s0272-6386(99)70221-0
   PubMed Web of Science ®Google Scholar
• Qunibi WY, Hootkins RE, McDowell LL, et al. Treatment of hyperphosphatemia in hemodialysis patients: the Calcium Acetate Renagel Evaluation (CARE Study). Kidney Int. 2004;65(5):1914–1926. doi:10.1111/j.1523-1755.2004.00590.x
   PubMed Web of Science ®Google Scholar
• Evenepoel P, Selgas R, Caputo F, et al. Efficacy and safety of sevelamer hydrochloride and calcium acetate in patients on peritoneal dialysis. Nephrol Dial Transplant. 2009;24(1):278–285. doi:10.1093/ndt/gfn488
   PubMed Web of Science ®Google Scholar
• Chennasamudram SP, Noor T, Vasylyeva TL. Comparison of sevelamer and calcium carbonate on endothelial function and inflammation in patients on peritoneal dialysis. J Ren Care. 2013;39(2):82–89. doi:10.1111/j.1755-6686.2013.12009.x
   PubMedGoogle Scholar
• Gregório PC, Favretto G, Sassaki GL, et al. Sevelamer reduces endothelial inflammatory response to advanced glycation end products. Clin Kidney J. 2018;11(1):89–98. doi:10.1093/ckj/sfx074
   Web of Science ®Google Scholar
• Braunlin W, Zhorov E, Guo A, et al. Bile acid binding to sevelamer HCl. Kidney Int. 2002;62(2):611–619. doi:10.1046/j.1523-1755.2002.00459.x
   Web of Science ®Google Scholar
• Burke SK, Dillon MA, Hemken DE, Rezabek MS, Balwit JM. Meta-analysis of the effect of sevelamer on phosphorus, calcium, PTH, and serum lipids in dialysis patients. Adv Ren Replace Ther. 2003;10(2):133–145. doi:10.1053/jarr.2003.50016
   PubMedGoogle Scholar
• Spiegel DM, Farmer B, Smits G, Chonchol M. Magnesium carbonate is an effective phosphate binder for chronic hemodialysis patients: a pilot study. J Ren Nutr. 2007;17(6):416–422. doi:10.1053/j.jrn.2007.08.005
   PubMed Web of Science ®Google Scholar
• Sakaguchi Y, Hamano T, Obi Y, et al. A randomized trial of magnesium oxide and oral carbon adsorbent for coronary artery calcification in predialysis CKD. J Am Soc Nephrol. 2019;30(6):1073–1085. doi:10.1681/ASN.2018111150
   PubMed Web of Science ®Google Scholar
• de Francisco ALM, Leidig M, Covic AC, et al. Evaluation of calcium acetate/magnesium carbonate as a phosphate binder compared with sevelamer hydrochloride in haemodialysis patients: a controlled randomized study (CALMAG study) assessing efficacy and tolerability. Nephrol Dial Transplant. 2010;25(11):3707–3717. doi:10.1093/ndt/gfq292
   PubMed Web of Science ®Google Scholar
• Otsuka Canada Pharmaceutical Inc. Velphoro (sucroferric oxyhydroxide) product monograph. 2019.
   Google Scholar
• Sprague SM, Floege J. Sucroferric oxyhydroxide for the treatment of hyperphosphatemia. Expert Opin Pharmacother. 2018;19(10):1137–1148. doi:10.1080/14656566.2018.1491548
   PubMed Web of Science ®Google Scholar
• Floege J, Covic AC, Ketteler M, et al. A Phase III study of the efficacy and safety of a novel iron-based phosphate binder in dialysis patients. Kidney Int. 2014;86(3):638–647. doi:10.1038/ki.2014.58
   PubMed Web of Science ®Google Scholar
• Floege J, Covic AC, Ketteler M, et al. Long-term effects of the iron-based phosphate binder, sucroferric oxyhydroxide, in dialysis patients. Nephrol Dial Transplant. 2015;30(6):1037–1046. doi:10.1093/ndt/gfv006
   PubMed Web of Science ®Google Scholar
• Kendrick J, Parameswaran V, Ficociello LH, et al. One-year historical cohort study of the phosphate binder sucroferric oxyhydroxide in patients on maintenance hemodialysis. J Ren Nutr. 2019;29(5):428–437. doi:10.1053/j.jrn.2018.11.002
   PubMed Web of Science ®Google Scholar
• Coyne DW, Ficociello LH, Parameswaran V, et al. Sucroferric oxyhydroxide in maintenance hemodialysis: a retrospective, comparative cohort study. Kid Med. 2020;2(3):307–316. doi:10.1016/j.xkme.2020.01.009
   PubMedGoogle Scholar
• Labonté ED, Carreras CW, Leadbetter MR, et al. Gastrointestinal inhibition of sodium-hydrogen exchanger 3 reduces phosphorus absorption and protects against vascular calcification in CKD. J Am Soc Nephrol. 2015;26(5):1138–1149. doi:10.1681/ASN.2014030317
   PubMed Web of Science ®Google Scholar
• Knight Therapeutics Inc. Tenapanor product monograph; 2020. Available from: https://pdf.hres.ca/dpd_pm/00058277.PDF. Accessed December 17, 2020.
   Google Scholar
• Block GA, Rosenbaum DP, Leonsson-Zachrisson M, et al. Effect of tenapanor on serum phosphate in patients receiving hemodialysis. J Am Soc Nephrol. 2017;28(6):1933–1942. doi:10.1681/ASN.2016080855
   PubMed Web of Science ®Google Scholar
• Block GA, Rosenbaum DP, Yan A, Chertow GM. Efficacy and safety of tenapanor in patients with hyperphosphatemia receiving maintenance hemodialysis: a randomized phase 3 trial. J Am Soc Nephrol. 2019;30(4):641–652. doi:10.1681/ASN.2018080832
   PubMed Web of Science ®Google Scholar
• Chertow G, Yang Y, Rosenbaum D. Long-term safety and efficacy of tenapanor for the control of serum phosphorus in patients with CKD on dialysis. J Am Soc Nephrol. 2020. Available form: https://www.asn-online.org/education/kidneyweek/2020/program-abstract.aspx?controlId=3450189. Accessed August 3, 2021.
   Google Scholar
• Rosenbaum D, Yang Y. Efficacy of tenapanor for the control of serum phosphorus in patients with CKD on dialysis: novel mechanism of action allows for both monotherapy and dual-mechanism approach. Am J Kidney Dis. 2020;75:627.
   Web of Science ®Google Scholar
• Katai K, Tanaka H, Tatsumi S, et al. Nicotinamide inhibits sodium-dependent phosphate cotransport activity in rat small intestine. Nephrol Dial Transplant. 1999;14(5):1195–1201. doi:10.1093/ndt/14.5.1195
   PubMed Web of Science ®Google Scholar
• Takahashi Y, Tanaka A, Nakamura T, et al. Nicotinamide suppresses hyperphosphatemia in hemodialysis patients. Kidney Int. 2004;65(3):1099–1104. doi:10.1111/j.1523-1755.2004.00482.x
   PubMed Web of Science ®Google Scholar
• Cheng SC, Young DO, Huang Y, Delmez JA, Coyne DW. A randomized, double-blind, placebo-controlled trial of niacinamide for reduction of phosphorus in hemodialysis patients. Clin J Am Soc Nephrol. 2008;3(4):1131–1138. doi:10.2215/CJN.04211007
   PubMed Web of Science ®Google Scholar
• Lenglet A, Liabeuf S, El Esper N, et al. Efficacy and safety of nicotinamide in haemodialysis patients: the NICOREN study. Nephrol Dial Transplant. 2017;32(5):870–879. doi:10.1093/ndt/gfw042
   Web of Science ®Google Scholar
• Yeung WCG, Toussaint ND, Badve SV. Dual inhibition of gastrointestinal phosphate absorption: more questions than answers. J Am Soc Nephrol. 2019;30(6):909–910. doi:10.1681/ASN.2019040333
   Web of Science ®Google Scholar
• Ix JH, Isakova T, Larive B, et al. Effects of nicotinamide and lanthanum carbonate on serum phosphate and fibroblast growth factor-23 in CKD: the COMBINE trial. J Am Soc Nephrol. 2019;30(6):1096–1108. doi:10.1681/ASN.2018101058
   PubMed Web of Science ®Google Scholar
• Cupisti A, Comar F, Benini O, et al. Effect of boiling on dietary phosphate and nitrogen intake. J Ren Nutr. 2006;16(1):36–40. doi:10.1053/j.jrn.2005.10.005
   Web of Science ®Google Scholar
• Ando S, Sakuma M, Morimoto Y, Arai H. The effect of various boiling conditions on reduction of phosphorus and protein in meat. J Ren Nutr. 2015;25(6):504–509. doi:10.1053/j.jrn.2015.05.005
   Web of Science ®Google Scholar
• Massry SG, Coburn JW, Chertow GMet al. K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis. 2003;42(4 Suppl 3):i–S201.
   Web of Science ®Google Scholar
• Li J, Wang L, Han M, et al. The role of phosphate-containing medications and low dietary phosphorus-protein ratio in reducing intestinal phosphorus load in patients with chronic kidney disease. Nutr Diabetes. 2019;9(1):14. doi:10.1038/s41387-019-0080-2
   PubMed Web of Science ®Google Scholar
• Floege J. Phosphate binders in chronic kidney disease: a systematic review of recent data. J Nephrol. 2016;29(3):329–340. doi:10.1007/s40620-016-0266-9
   PubMed Web of Science ®Google Scholar
• Floege J. Phosphate binders in chronic kidney disease: an updated narrative review of recent data. J Nephrol. 2020;33(3):497–508. doi:10.1007/s40620-019-00689-w
   PubMed Web of Science ®Google Scholar
• Carfagna F, Del Vecchio L, Pontoriero G, Locatelli F. Current and potential treatment options for hyperphosphatemia. Expert Opin Drug Saf. 2018;17(6):597–607. doi:10.1080/14740338.2018.1476487
   PubMed Web of Science ®Google Scholar