Hyperphosphatemia News Archive
The use of phosphate binders to manage hyperphosphatemia in maintenance hemodialysis patients might allow diets less restricted in protein and calories, according to a study.
Serum phosphorus fell to similar levels in two-thirds of peritoneal dialysis patients, but sucroferric oxyhdroxide recipients had a lower pill burden.
In a study of patients with chronic kidney disease and cardiovascular disease, niacin therapy lowered serum phosphate by just 0.25 mg/dL over 3 years compared with placebo.
Phosphate binder use is associated with a 25% and 37% decreased risk of death from infection-related causes and all-causes, respectively, compared with non-users.
Achieving a phosphate value of 1.4 mmol/L seemed optimal.
Patients with non-dialysis chronic kidney disease and iron deficiency anemia treated with ferric citrate experienced significant declines in FGF23 regardless of change in serum phosphorus.
Admission serum phosphorus levels below 2.5 and 4.9 mg/dL and above are associated with increased odds of dying in the hospital.
After switching to sucroferric oxyhydroxide, a higher proportion of patients achieved in-range serum phosphorus levels.
A randomized controlled pilot study demonstrated the feasibility and safety of performing a large clinical trial that is powered to establish whether phosphate lowering reduces fatal and nonfatal cardiovascular events.
Each 1-mg/dL increase in serum phosphorus among kidney transplant recipients is associated with 36% and 21% increased risk in graft failure and death, respectively.
Phase 2 randomized placebo-controlled trial demonstrated the safety and efficacy of sevelamer in lowering serum phosphorus levels in children and adolescents.
Creatinine, phosphorus, and electrolyte levels were not significantly different for exposed and unexposed hospitalized patients.
New findings suggest that nutritional index should be considered in the management of phosphorus level in HD patients, researchers conclude.
Of 7 phosphate binders, iron-based agents were optimal when efficacy and safety are considered.
Almost 40% of pre-dialysis patients with stage 4-5 CKD patients and type 2 diabetes had lab results suggesting low turnover bone disease.
Serum phosphorus and intact parathyroid hormone levels were not reduced with 12 weeks of rilonacept therapy.
CKD patients with and without diastolic dysfunction had average serum phosphate levels of 7.3 and 5.5 mg/dL, respectively.
The proportion of patients with serum phosphorus levels within target range rose from 22% to 65% within 6 months of starting ferric citrate treatment.
Use of sevelamer was associated with a 14% decreased risk of death compared with non-use.
Among other changes, the new KDIGO guidelines highlight the potential dangers of hypercalcemia.
From 2003 to 2011 there was a 26.7% decrease in in-hospital mortality rate after hip fracture.
Patients receiving educational or behavioral interventions aimed at controlling hyperphosphatemia had an average reduction in phosphate of 0.23 mmol/L more than standard care patients.
Converting hemodialysis patient to sucroferric oxyhydroxide from a previous binder increased the proportion of patients achieving target serum phosphorus levels.
Survival improved by 12% when serum phosphate levels approached a safer target range.
In a study of hemodialysis patients, mortality risk increased along with phosphorus level, particularly among patients with higher residual renal urea clearance.
At 18 months, PTH levels were within target for 67% and 68% of participants who initiated etelcalcetide at 2.5 mg and 5 mg, respectively.
Nearly twice as many patients achieved the target phosphorus range after a year of taking the phosphate binder, regardless of iPTH level.
Replacing foods containing phosphorus-based additives with similar foods not containing these additives can control hyperphospatemia without interfering with nutritional status.
Alkaline phosphatase was more strongly linked to mortality compared with other biomarkers of chronic kidney disease-mineral and bone disorder.
In a study, 25.8% and 37.8% of calcium acetate and calcium carbonate users, respectively, exceeded the maximum recommended daily intake.
In a study 52.1% of patients receiving ferric citrate attained a 1.0 g/dL or greater increase in hemoglobin compared with just 19.1% receiving placebo.
Younger patients are less likely to respond to treatment with sucroferric oxyhydroxide or sevelamer.
Purgative products introduce 10 times the normal daily amount of phosphorus into the body.
Study implicates amlodipine, lisinopril, clonidine, acetaminophen, and omeprazole.
Patients also needed fewer phosphate binder pills over time.
The percentage of patients with serum phosphorus levels of 5.5 mg/dL and below more than doubled to 37.8% after 6 months of treatment with sucroferric oxyhydroxide.
The risk of end-stage renal disease was 83% higher for those who drank more than 7 glasses of diet soft drinks weekly.
It can sharply lower serum phosphorus levels and reduce dependence on phosphate binders.
In a study, 69.7% of intervention patients attained serum phosphorus levels below 5.5 mg/dL, compared with just 18.5% of control patients.
A low protein, low phosphorus diet plays an important role in the nutritional management of patients transitioning to once-weekly incremental hemodialysis.
Hyperphosphatemia was associated with more than double the risk of death from any cause.
Patients reduced dietary phosphorus without compromising protein intake.
The USDA Standard Nutrient Reference Database, for example, listed phosphorus amounts for just 5 of 46 beverages.
For each 1 mmol/L increase in serum phosphorus, the odds of left ventricular hypertrophy more than doubled.
Calcium-based binders, however, are associated with greater odds of all-cause mortality versus sevelamer.
In a study, 61% of hemodialysis patients reported accidentally forgetting to take their medication or otherwise skipping doses unintentionally.
Over 33 months, the 25-hydroxyvitamin D level of ergocalciferol recipients increased significantly from 15.14 to 37.32 ng/mL.
Researchers evaluated the efficacy of 100 mg/day of niacin in hemodialysis patients.
The phosphate binder is a useful treatment for hyperphosphatemia with a relatively low pill burden, researchers say.
Patients may need no more than routine evaluation of iron.
Phosphorus targets in patients with chronic kidney disease stage 3 to 4 should be below 4.3 mg/dL, researchers report.
Hyperphosphatemia is present in many who say following diets and binder schedules is easy.
Autonomy support could be an appropriate target for culturally informed strategies to optimize mineral bone health.
A mortality rate increase of 43 cases per 1000 patients was found for calcium-based phosphate binders.
Phosphorus levels are higher when blood specimens are collected after weekends.
Paricalcitol-based protocol includes limited use of calcium-based phosphate binders.
The control of phosphorus is underappreciated, for example.
Average 6-month serum phosphorus level was significantly lower in CKD patients who received niacin than those who did not (3.4 vs. 4.2 mg/dL).
Researchers observe an 81% increase in dialysis patients achieving recommended phosphorus levels after switching to sucroferric oxyhydroxide.
Small case series also confirmed that the diagnosis of calciphylaxis is rarely made in the nodular, non-ulcerative phase.
Study of peritoneal dialysis patients showed that they do not adjust binders to match the phosphate content of meals and snacks.
A low protein diet of vegetable proteins along with reduced intake of specific micronutrients should be recommended to stage 3-4 CKD patients, researchers say.
Expert suggests factors beyond poor adherence to a low phosphorus diet and binder therapy may contribute to hyperphosphatemia.
Study compared sucroferric oxyhydroxide and sevelamer carbonate.
The risk of dying following a hip fracture was 6.5 times higher for patients with severe CKD than for those with normal kidney function or mild CKD.
Phosphate and vitamin D deficiency were linked with RLS severity.
Meta-analysis finds that each 1 mg/dL increase in serum phosphate increases the risk of death by 23%.
Researchers observe a 2.2-fold increased risk in patients with serum phosphate levels of 6.0 mg/dL or higher.
Researchers observe a significant mean decrease in binder pills from 8.4 to 3.8 pills per day.
Cumulative 2-year survival rate was 65.4%, 78.9%, 85.1%, and 80.6% among patients in the 1st, 2nd, 3rd, and 4th quartiles.
About 3 additional deaths per 100 persons occur when the drug is discontinued due to non-medical versus medical reasons during the first year.
Significant decreases in serum phosphate and erythropoietin dose in hemodialysis patients observed after 6 months of treatment.
Very low protein intake was not superior to traditional low protein diets, however.
Recipients of in-hospital nighttime dialysis experienced a 14.2 gram reduction in left ventricle thickening.
Even healthy adults show evidence of abnormal bone metabolism.
Researchers find link in the non-dialysis population.
Large South Korean study demonstrates the association in individuals with normal kidney function.
Large European study identifies ranges of phosphorus, calcium, and parathyroid hormone levels with the lowest death risk.
African-American patients, however, had significantly higher intact parathyroid hormone levels, possibly due to lower 25-hydroxyvitamin D levels.
Every 1 mg/dL increase in serum phosphorus level was linked with 36% greater odds of kidney failure among non-dialysis CKD patients.
High phosphate levels are associated with 3.3-fold increased odds of 28-day in-hospital mortality.
In a study, 45% of hemodialysis patients internationally reported skipping phosphate binder pills at least once in the prior month.
Patients with hyperphosphatemia lowered their phosphorus levels with a dietitian's guidance or cash incentive.
Boiling sliced meat in a pressure cooker filled with soft water may be a promising way for dialysis patients to reduce phosphorus intake.
Study implicates dairy products, cereals, and grains containing inorganic phosphate additives.
Among the phosphate-containing medicinal products prescribed to chronic kidney disease patients, 76% may contain absorbable phosphate.
Baseline eGFR, higher phosphorus, proteinuria, and male gender, also are associated with an elevated risk of end-stage renal disease in patients with chronic kidney disease.
Proteinuria, hyperphosphatemia, anemia linked more rapid annual decline in eGFR.
Cutting back on dietary phosphorus in addition to taking phosphate binders achieved greater decreases in serum phosphate in PD patients.
A study found that 78% of popular drinks, from flavored waters to lemonades to iced teas, contain far more phosphorus than listed in nutritional databases.
Lowest relative risk of death observed in patients with serum phosphorus and calcium levels of 4.4 mg/dL and 8.8 mg/dL, respectively.
Patients who use the supplements should have their kidney function and electrolytes monitored, researchers say.
In a study, the incidence of hyperphosphatemia, ionized hypocalcemia, and ionized hypercalcemia was 44%, 22%, and 23%, respectively.
It had a phosphorus-lowering effect similar to that of sevelamer, but had a lower pill burden.
One-third of patients who missed clinical targets for phosphorus, calcium and/or parathormone remained untreated.
Strategies to overcome motivational barriers may improve mineral bone health.
These findings underscore the need to better understand whether earlier phosphorus management influences morbidity and mortality in advanced CKD, according to researchers.
Individuals who perceived the benefits of a low-phosphorus diet and demonstrated self-efficacy were more likely to make strides against hyperphosphatemia.
Reducing dietary phosphorus is challenging, so researchers have developed a food pyramid for CKD and dialysis patients.
The findings generally support KDOQI guidelines for dialysis patients, which recommend maintaining serum phosphorus levels between 3.5 and 5.5 mg/dL.
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