Chronic kidney disease (CKD) is characterized by phosphorus retention and, in more advanced stages, by high serum phosphorus (P) levels. During the last decade, it has been elucidated the central role of P in the pathogenesis of CKD mineral bone disorder (CKD-MBD), determining both renal osteodystrophy and cardiovascular disease. Unfortunately, at least one third of patients on chronic dialysis have high serum P levels, with a consequent higher serum PTH levels, commonly associated with vitamin D deficiency, increased vascular calcification and the highest ratios of morbidity and mortality. In patients with CKD stage 5 on dialysis, therapeutic approaches to reduce serum P levels should include restriction of dietary phosphate intake, optimal dialysis treatment, and use of P binders. In this context, the use of P binders appears to be an essential treatment to control P overload in CKD patients. In this review, we analyzed the use of calcium-based and calcium-free P binders in peritoneal dialysis patients.
Phosphate control in peritoneal dialysis / M. Cozzolino, A. Stucchi, M.A. Rizzo, I. Brenna, F. Elli, P. Ciceri, J. Bover, D. Cusi, M. Gallieni. - In: CONTRIBUTIONS TO NEPHROLOGY. - ISSN 0302-5144. - 178:(2012 May), pp. 116-123. (Intervento presentato al convegno International Vicenza Course on Peritoneal Dialysis tenutosi a Vicenza nel 2012) [10.1159/000337831].
Phosphate control in peritoneal dialysis
M. CozzolinoPrimo
;A. StucchiSecondo
;F. Elli;P. Ciceri;D. CusiPenultimo
;M. GallieniUltimo
2012
Abstract
Chronic kidney disease (CKD) is characterized by phosphorus retention and, in more advanced stages, by high serum phosphorus (P) levels. During the last decade, it has been elucidated the central role of P in the pathogenesis of CKD mineral bone disorder (CKD-MBD), determining both renal osteodystrophy and cardiovascular disease. Unfortunately, at least one third of patients on chronic dialysis have high serum P levels, with a consequent higher serum PTH levels, commonly associated with vitamin D deficiency, increased vascular calcification and the highest ratios of morbidity and mortality. In patients with CKD stage 5 on dialysis, therapeutic approaches to reduce serum P levels should include restriction of dietary phosphate intake, optimal dialysis treatment, and use of P binders. In this context, the use of P binders appears to be an essential treatment to control P overload in CKD patients. In this review, we analyzed the use of calcium-based and calcium-free P binders in peritoneal dialysis patients.File | Dimensione | Formato | |
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