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KMID : 0359920140330010003
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Korean Journal of Nephrology
2014 Volume.33 No. 1 p.3 ~ p.8
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Treatment of phosphate retention: The earlier the better?
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Biggar Patrick
Fung Samuel K.S.
Ketteler Markus
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Abstract
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Over the last 15 years, our knowledge and understanding of the underlying mechanisms involved in the regulation of calcium and phosphate homeostasis in chronic kidney disease have advanced dramatically. Contrary to general opinion in the 20th century that moderate hypercalcemia and hyperphosphatemia were acceptable in treating secondary hyperparathyroidism, the calcium and phosphate load is increasingly perceived to be a major trigger of vascular and soft tissue calci?cation. The current treatment options are discussed in view of historical developments and the expectations of the foreseeable future, focusing on the early treatment of hyperphosphatemia. At present, we lack indisputable evidence that active intervention using currently available drugs is of bene?t to patients in chronic kidney disease stages 3 and 4.
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KEYWORD
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Calcification, Chronic kidneydisease, FGF-23, Hyperphosphatemia, Phosphate binders, Prognosis
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