Phosphate binder use was associated with lower mortality riskbut a higher risk of end-stage renal disease (ESRD) among patients withchronic kidney disease (CKD) andhigh phosphorus levels, accordingto study findings presented at theNational Kidney Foundation’s 2015Spring Clinical Meetings in Dallas.

In a retrospective longitudinal cohortstudy, Ardeshir Khosraviani, MD, andcolleagues at Kaiser PermanenteSouthern California compared phosphatebinder use and non-use among3,026 non-dialysis CKD patients withhyperphosphatemia (phosphorus levels5.5 mg/dL or higher). Comparedwith patients who did not use phosphatebinders, those who did had a15% decreased mortality risk and anearly 3-fold increased risk of ESRD,the investigators reported. 

“These findings underscore theneed to better understand whetherearlier phosphorus management mayimpact morbidity and mortality inadvanced CKD,” the authors concludedin a poster presentation.Of the 3,026 subjects, 596 usedbinders and 2,430 did not. Studysubjects had a mean age was 65.5years; 49% were female, 49% werewhite, 24% were Hispanic, 17.3%were black, and 8.5% were Asian.The binder group had higher rates ofdiabetes, hypertension, and coronary artery disease

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“Our study raises the question ofwhether earlier management andcontrol of hyperphosphatemia in theCKD population with binder therapymay improve patient survival interms of mortality prior to and after[transition to ESRD],” Dr. Khosravianitold Renal & Urology News

He said he and his colleaguesbelieve their study adds to the literatureon the topic because it lookedat a real-world practice environmentusing a large and heterogeneousCKD population, and the results provideinsights into CKD mineral-bonemanagement strategies as patientstransition to ESRD.