The continuous challenge of cardiovascular and bone and bone disease in uremic patients: clinical consequences of hyperphosphatemia and advanced therapeutic approaches

This review focuses on a series of risk factors involved in the pathogenesis of cardiovascular complications in patients undergoing Regular Dialysis Treatment (RDT). Many of them are not modifiable by any pharmacological strategies or dialysis therapy, others - such as phosphate overload - can be corrected successfully, thus slowing progression of vascular calcification. Another important reason to control serum phosphate is that its accumulation in the body plays a key role in triggering, directly or indirectly, PTH secretion with important metabolic consequences, mainly in the bone. The need to control serum phosphate levels relies mostly on the use of phosphate binders and in this review the procon analysis of several P binders (Calcium Salts, Sevelamer, Lanthanum Carbonate) is presented in terms of safety and efficacy.