Hyperphosphatemia News Archive

Intensive Phosphate Control May Reduce FGF23 in HD

Intensive Phosphate Control May Reduce FGF23 in HD

A serum phosphate control target of 4.5 mg/dL or below in hemodialysis patients was accompanied by a decline in fibroblast growth factor 23.

Phosphate Binders Do Not Interfere With Vitamin D Therapy

Phosphate Binders Do Not Interfere With Vitamin D Therapy

Mean 25-hydroxyvitamin D levels did not differ significantly among groups receiving phosphate binders or dietary therapy.

Intensive Phosphorus-Lowering May Reduce PTH

Intensive Phosphorus-Lowering May Reduce PTH

In a study, intact parathyroid hormone levels fell by nearly 10% over 6 months in hemodialysis patients who received intensive treatment for hyperphosphatemia.

Dialysis Patients Exhibit Abnormal Postprandial Mineral Handling

Dialysis Patients Exhibit Abnormal Postprandial Mineral Handling

Excess calcium following a meal may be deposited in soft tissue and blood vessels, researchers hypothesize.

Iron-Based Binder May Have Advantages Over Sevelamer

Iron-Based Binder May Have Advantages Over Sevelamer

Sucroferric oxyhydroxide and sevelemer are similarly effective in lower phosphorus levels in dialysis patients, but the former is associated with less toxicity and lower pill burden.

Sucroferric Oxyhydroxide Improves Phosphorus Control in PD

Sucroferric Oxyhydroxide Improves Phosphorus Control in PD

In addition, average phosphate binder pill burden decreased by more than half.

CKD-MBD Guideline Synopsis Issued

CKD-MBD Guideline Synopsis Issued

Panel focuses on diagnosing and testing of CKD-MBD and treatment of the CKD-MBD that emphasizes decreasing phosphate, maintaining calcium, and addressing elevated PTH in adults with CKD stage G3a to G5.

Coronary Artery Calcification Risk Factors in CKD Identified

Coronary Artery Calcification Risk Factors in CKD Identified

Abnormal calcium-phosphate metabolism appears to be an important pathogenic factor in the development of vascular calcification in patients with chronic kidney disease.

Phosphorus Content Higher in Packaged Meats Listing Phosphate Additives

Phosphorus Content Higher in Packaged Meats Listing Phosphate Additives

Additives in packaged meat, poultry, and fish can contribute significantly to the dietary phosphorus and potassium loads in CKD patients, researchers say.

Phosphorus Control by Dietary Restriction May Lead to Malnutrition

Phosphorus Control by Dietary Restriction May Lead to Malnutrition

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.

Sucroferric Oxyhydroxide Efficacy Similar to That of Sevelamer

Sucroferric Oxyhydroxide Efficacy Similar to That of Sevelamer

Serum phosphorus fell to similar levels in two-thirds of peritoneal dialysis patients, but sucroferric oxyhdroxide recipients had a lower pill burden.

Niacin's Phosphate-Lowering Ability Modest

Niacin's Phosphate-Lowering Ability Modest

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 Tied With Better Survival

Phosphate Binder Use Tied With Better Survival

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.

Reducing Phosphorus Improves Survival

Reducing Phosphorus Improves Survival

Achieving a phosphate value of 1.4 mmol/L seemed optimal.

Phosphate Binder Reduces FGF23 in CKD Patients

Phosphate Binder Reduces FGF23 in CKD Patients

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.

In-Hospital Mortality Linked to High, Low Phosphorus

In-Hospital Mortality Linked to High, Low 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.

Sucroferric Oxyhydroxide Improves Phosphorus Control

Sucroferric Oxyhydroxide Improves Phosphorus Control

After switching to sucroferric oxyhydroxide, a higher proportion of patients achieved in-range serum phosphorus levels.

Distinct Phosphate Targets Feasible, Pilot Study Shows

Distinct Phosphate Targets Feasible, Pilot Study Shows

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.

High Phosphorus Ups Risk of Kidney Transplant Failure, Death

High Phosphorus Ups Risk of Kidney Transplant Failure, Death

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.

Sevelamer Carbonate Improves Pediatric Hyperphosphatemia

Sevelamer Carbonate Improves Pediatric Hyperphosphatemia

Phase 2 randomized placebo-controlled trial demonstrated the safety and efficacy of sevelamer in lowering serum phosphorus levels in children and adolescents.

Sodium Phosphate Enemas Do Not Worsen Renal Function

Sodium Phosphate Enemas Do Not Worsen Renal Function

Creatinine, phosphorus, and electrolyte levels were not significantly different for exposed and unexposed hospitalized patients.

Nutritional Status Affects Phosphorus-Mortality Link in Hemodialysis

Nutritional Status Affects Phosphorus-Mortality Link in Hemodialysis

New findings suggest that nutritional index should be considered in the management of phosphorus level in HD patients, researchers conclude.

Researchers: Iron-based Binders Best for Hyperphosphatemia

Researchers: Iron-based Binders Best for Hyperphosphatemia

Of 7 phosphate binders, iron-based agents were optimal when efficacy and safety are considered.

Adynamic Bone Disease Prevalent in Type 2 Diabetes Patients With CKD

Adynamic Bone Disease Prevalent in Type 2 Diabetes Patients With CKD

Almost 40% of pre-dialysis patients with stage 4-5 CKD patients and type 2 diabetes had lab results suggesting low turnover bone disease.

Short-term Interleukin Inhibition Ineffective in CKD-MBD

Short-term Interleukin Inhibition Ineffective in CKD-MBD

Serum phosphorus and intact parathyroid hormone levels were not reduced with 12 weeks of rilonacept therapy.

Hyperphosphatemia May Predict Diastolic Dysfunction in CKD

Hyperphosphatemia May Predict Diastolic Dysfunction in CKD

CKD patients with and without diastolic dysfunction had average serum phosphate levels of 7.3 and 5.5 mg/dL, respectively.

Iron-based Binder Improves Phosphorus Levels in Dialysis Patients

Iron-based Binder Improves Phosphorus Levels in Dialysis Patients

The proportion of patients with serum phosphorus levels within target range rose from 22% to 65% within 6 months of starting ferric citrate treatment.

Add-on Sevelamer Therapy May Improve Hemodialysis Patient Survival

Add-on Sevelamer Therapy May Improve Hemodialysis Patient Survival

Use of sevelamer was associated with a 14% decreased risk of death compared with non-use.

Guidelines for CKD Mineral and Bone Disorder Updated

Guidelines for CKD Mineral and Bone Disorder Updated

Among other changes, the new KDIGO guidelines highlight the potential dangers of hypercalcemia.

Hip Fracture Rates Falling Among ESRD Patients

Hip Fracture Rates Falling Among ESRD Patients

From 2003 to 2011 there was a 26.7% decrease in in-hospital mortality rate after hip fracture.

Education Can Improve Phosphate Control

Education Can Improve Phosphate Control

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.

Switch to an Iron-Based Binder Found to Improve Phosphorus Lowering

Switch to an Iron-Based Binder Found to Improve Phosphorus Lowering

Converting hemodialysis patient to sucroferric oxyhydroxide from a previous binder increased the proportion of patients achieving target serum phosphorus levels.

Reducing Serum Phosphorus to Safer Target Range Ups Survival

Reducing Serum Phosphorus to Safer Target Range Ups Survival

Survival improved by 12% when serum phosphate levels approached a safer target range.

Residual Kidney Function Predicts Mortality in CKD-MBD

Residual Kidney Function Predicts Mortality in CKD-MBD

In a study of hemodialysis patients, mortality risk increased along with phosphorus level, particularly among patients with higher residual renal urea clearance.

Initial Low-Dose Etelcalcetide Feasible for SHPT Patients

Initial Low-Dose Etelcalcetide Feasible for SHPT Patients

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.

Sucroferric Oxyhydroxide Ups Phosphorus Control in SHPT

Sucroferric Oxyhydroxide Ups Phosphorus Control in SHPT

Nearly twice as many patients achieved the target phosphorus range after a year of taking the phosphate binder, regardless of iPTH level.

Eliminating Phosphorus Food Additives Does Not Compromise Nutrition

Eliminating Phosphorus Food Additives Does Not Compromise Nutrition

Replacing foods containing phosphorus-based additives with similar foods not containing these additives can control hyperphospatemia without interfering with nutritional status.

ALP Predicts Mortality in Peritoneal Dialysis Patients With CKD-MBD

ALP Predicts Mortality in Peritoneal Dialysis Patients With CKD-MBD

Alkaline phosphatase was more strongly linked to mortality compared with other biomarkers of chronic kidney disease-mineral and bone disorder.

Elemental Calcium Intake High With Calcium-Based Binder Use

Elemental Calcium Intake High With Calcium-Based Binder Use

In a study, 25.8% and 37.8% of calcium acetate and calcium carbonate users, respectively, exceeded the maximum recommended daily intake.

Iron-Based Phosphate Binder Safely Treats Anemia in CKD Patients

Iron-Based Phosphate Binder Safely Treats Anemia in CKD Patients

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.

Dialysis Patient Age May Affect Hyperphosphatemia Management

Dialysis Patient Age May Affect Hyperphosphatemia Management

Younger patients are less likely to respond to treatment with sucroferric oxyhydroxide or sevelamer.

Phosphate Enemas Can Cause Hyperphosphatemia

Phosphate Enemas Can Cause Hyperphosphatemia

Purgative products introduce 10 times the normal daily amount of phosphorus into the body.

Prescribed Meds May Up Phosphate Burden in Hemodialysis Patients

Prescribed Meds May Up Phosphate Burden in Hemodialysis Patients

Study implicates amlodipine, lisinopril, clonidine, acetaminophen, and omeprazole.

Sucroferric Oxyhydroxide Helps More Hyperphosphatemia Pts Reach Target

Sucroferric Oxyhydroxide Helps More Hyperphosphatemia Pts Reach Target

Patients also needed fewer phosphate binder pills over time.

Phosphate Binder Switch Found to Benefit Peritoneal Dialysis Patients

Phosphate Binder Switch Found to Benefit Peritoneal Dialysis Patients

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.

ESRD Linked to Diet Soda Consumption

ESRD Linked to Diet Soda Consumption

The risk of end-stage renal disease was 83% higher for those who drank more than 7 glasses of diet soft drinks weekly.

Intensive Hemodialysis Effective for Treating Hyperphosphatemia

Intensive Hemodialysis Effective for Treating Hyperphosphatemia

It can sharply lower serum phosphorus levels and reduce dependence on phosphate binders.

Cutting Phosphorus Additives Reduces Hyperphosphatemia

Cutting Phosphorus Additives Reduces Hyperphosphatemia

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.

Dietary Management May Aid Transition to Incremental HD

Dietary Management May Aid Transition to Incremental HD

A low protein, low phosphorus diet plays an important role in the nutritional management of patients transitioning to once-weekly incremental hemodialysis.

Hyperphosphatemia Linked With Mortality in Septic AKI

Hyperphosphatemia Linked With Mortality in Septic AKI

Hyperphosphatemia was associated with more than double the risk of death from any cause.

Teaching Low Phosphorus Cooking May Improve Hyperphosphatemia

Teaching Low Phosphorus Cooking May Improve Hyperphosphatemia

Patients reduced dietary phosphorus without compromising protein intake.

Nutritional Databases Underreport Phosphorus Content

Nutritional Databases Underreport Phosphorus Content

The USDA Standard Nutrient Reference Database, for example, listed phosphorus amounts for just 5 of 46 beverages.

Serum Phosphorus Linked With Left Ventricular Remodeling

Serum Phosphorus Linked With Left Ventricular Remodeling

For each 1 mmol/L increase in serum phosphorus, the odds of left ventricular hypertrophy more than doubled.

Study: Phosphate Binders Do Not Lower Death Risk

Study: Phosphate Binders Do Not Lower Death Risk

Calcium-based binders, however, are associated with greater odds of all-cause mortality versus sevelamer.

Uncontrolled Phosphorus Linked to Poor Binder Adherence

Uncontrolled Phosphorus Linked to Poor Binder Adherence

In a study, 61% of hemodialysis patients reported accidentally forgetting to take their medication or otherwise skipping doses unintentionally.

Natural Vitamin D Supplement Effective for Nondialysis CKD-MBD

Natural Vitamin D Supplement Effective for Nondialysis CKD-MBD

Over 33 months, the 25-hydroxyvitamin D level of ergocalciferol recipients increased significantly from 15.14 to 37.32 ng/mL.

Low-Dose Niacin Helps Lower Phosphorus Levels

Low-Dose Niacin Helps Lower Phosphorus Levels

Researchers evaluated the efficacy of 100 mg/day of niacin in hemodialysis patients.

Sucroferric Oxyhydroxide Exhibits a Dose-Dependent Effect

Sucroferric Oxyhydroxide Exhibits a Dose-Dependent Effect

The phosphate binder is a useful treatment for hyperphosphatemia with a relatively low pill burden, researchers say.

Study: Minimal Risk of Iron Overload With Sucroferric Oxyhydroxide

Study: Minimal Risk of Iron Overload With Sucroferric Oxyhydroxide

Patients may need no more than routine evaluation of iron.

Even High-Normal Phosphorus May Be an ESRD Risk Factor, Study Finds

Even High-Normal Phosphorus May Be an ESRD Risk Factor, Study Finds

Phosphorus targets in patients with chronic kidney disease stage 3 to 4 should be below 4.3 mg/dL, researchers report.

Young Patients Often Misperceive Adherence to Phosphorus Control

Young Patients Often Misperceive Adherence to Phosphorus Control

Hyperphosphatemia is present in many who say following diets and binder schedules is easy.

Patient Autonomy May Improve Phosphate Binder Adherence

Patient Autonomy May Improve Phosphate Binder Adherence

Autonomy support could be an appropriate target for culturally informed strategies to optimize mineral bone health.

Calcium-based Phosphate Binders Linked to Higher Mortality

Calcium-based Phosphate Binders Linked to Higher Mortality

A mortality rate increase of 43 cases per 1000 patients was found for calcium-based phosphate binders.

When Blood Is Sampled Affects Dialysis Patients' Phosphorus Values

When Blood Is Sampled Affects Dialysis Patients' Phosphorus Values

Phosphorus levels are higher when blood specimens are collected after weekends.

Proposed Regimen May Cut Hypercalcemia Risk in CKD Patients

Proposed Regimen May Cut Hypercalcemia Risk in CKD Patients

Paricalcitol-based protocol includes limited use of calcium-based phosphate binders.

Why SHPT Remains Difficult to Treat

Why SHPT Remains Difficult to Treat

The control of phosphorus is underappreciated, for example.

Niacin's Phosphorus-Lowering Effect Confirmed

Niacin's Phosphorus-Lowering Effect Confirmed

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).

Iron-Based Binder Found to Improve Phosphorus Control, Cut Pill Burden

Iron-Based Binder Found to Improve Phosphorus Control, Cut Pill Burden

Researchers observe an 81% increase in dialysis patients achieving recommended phosphorus levels after switching to sucroferric oxyhydroxide.

Multimodal Therapy for Calciphylaxis Shows Favorable Results

Multimodal Therapy for Calciphylaxis Shows Favorable Results

Small case series also confirmed that the diagnosis of calciphylaxis is rarely made in the nodular, non-ulcerative phase.

Fixed-Dose Phosphate Binder Schedules May Be Less Than Ideal

Fixed-Dose Phosphate Binder Schedules May Be Less Than Ideal

Study of peritoneal dialysis patients showed that they do not adjust binders to match the phosphate content of meals and snacks.

Personalized Diet Improves CKD-Related Risks

Personalized Diet Improves CKD-Related Risks

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.

Individual Variability Overlooked in Uncontrolled Hyperphosphatemia

Individual Variability Overlooked in Uncontrolled Hyperphosphatemia

Expert suggests factors beyond poor adherence to a low phosphorus diet and binder therapy may contribute to hyperphosphatemia.

Phosphate Binders Show Similar Efficacy in African Americans

Phosphate Binders Show Similar Efficacy in African Americans

Study compared sucroferric oxyhydroxide and sevelamer carbonate.

CKD Severity Linked to Low BMD, Hip Fracture, and Mortality

CKD Severity Linked to Low BMD, Hip Fracture, and Mortality

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.

CKD-MBD May Play Role in Restless Legs Syndrome in Dialysis Patients

CKD-MBD May Play Role in Restless Legs Syndrome in Dialysis Patients

Phosphate and vitamin D deficiency were linked with RLS severity.

High Phosphate Increases Mortality Risk in CKD Patients

High Phosphate Increases Mortality Risk in CKD Patients

Meta-analysis finds that each 1 mg/dL increase in serum phosphate increases the risk of death by 23%.

High Phosphorus, Cerebral Hemorrhage Linked in HD Patients

High Phosphorus, Cerebral Hemorrhage Linked in HD Patients

Researchers observe a 2.2-fold increased risk in patients with serum phosphate levels of 6.0 mg/dL or higher.

Sucroferric Oxyhydroxide Reduces Phosphorus, Binder Pill Burden

Sucroferric Oxyhydroxide Reduces Phosphorus, Binder Pill Burden

Researchers observe a significant mean decrease in binder pills from 8.4 to 3.8 pills per day.

HD Patients with Lowest FGF-23 Level Have Lowest Survival Rate

HD Patients with Lowest FGF-23 Level Have Lowest Survival Rate

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.

Stopping Cinacalcet for Non-Medical Reasons Ups Death Risk

Stopping Cinacalcet for Non-Medical Reasons Ups Death Risk

About 3 additional deaths per 100 persons occur when the drug is discontinued due to non-medical versus medical reasons during the first year.

Ferric Citrate Reduces Hyperphosphate, EPO Requirement

Ferric Citrate Reduces Hyperphosphate, EPO Requirement

Significant decreases in serum phosphate and erythropoietin dose in hemodialysis patients observed after 6 months of treatment.

Restricting Dietary Protein and Phosphorus May Improve CKD-MBD

Restricting Dietary Protein and Phosphorus May Improve CKD-MBD

Very low protein intake was not superior to traditional low protein diets, however.

Nocturnal Dialysis Linked with Reduced Left Ventricular Mass

Nocturnal Dialysis Linked with Reduced Left Ventricular Mass

Recipients of in-hospital nighttime dialysis experienced a 14.2 gram reduction in left ventricle thickening.

Phosphorus-Based Food Additives May Impact Bone Metabolism

Phosphorus-Based Food Additives May Impact Bone Metabolism

Even healthy adults show evidence of abnormal bone metabolism.

Higher Phosphorus Ups Anemia Risk

Higher Phosphorus Ups Anemia Risk

Researchers find link in the non-dialysis population.

Elevated Phosphorus Predicts Mortality in Men

Elevated Phosphorus Predicts Mortality in Men

Large South Korean study demonstrates the association in individuals with normal kidney function.

Abnormal Mineral, Bone Markers in Dialysis Patients Hike Mortality

Abnormal Mineral, Bone Markers in Dialysis Patients Hike Mortality

Large European study identifies ranges of phosphorus, calcium, and parathyroid hormone levels with the lowest death risk.

Serum Phosphorus Levels Not Affected by Race, Income

Serum Phosphorus Levels Not Affected by Race, Income

African-American patients, however, had significantly higher intact parathyroid hormone levels, possibly due to lower 25-hydroxyvitamin D levels.

High Phosphorus Levels Predict CKD Progression, Early Death

High Phosphorus Levels Predict CKD Progression, Early Death

Every 1 mg/dL increase in serum phosphorus level was linked with 36% greater odds of kidney failure among non-dialysis CKD patients.

Hyperphosphatemia Increases Mortality in Critically Ill Patients

Hyperphosphatemia Increases Mortality in Critically Ill Patients

High phosphate levels are associated with 3.3-fold increased odds of 28-day in-hospital mortality.

Phosphate Binder Adherence Challenging for Dialysis Patients

Phosphate Binder Adherence Challenging for Dialysis Patients

In a study, 45% of hemodialysis patients internationally reported skipping phosphate binder pills at least once in the prior month.

Coaching and Financial Incentives May Reduce Phosphorus

Coaching and Financial Incentives May Reduce Phosphorus

Patients with hyperphosphatemia lowered their phosphorus levels with a dietitian's guidance or cash incentive.

Study Probes Boiling Methods for Cutting Phosphorus in Meat

Study Probes Boiling Methods for Cutting Phosphorus in Meat

Boiling sliced meat in a pressure cooker filled with soft water may be a promising way for dialysis patients to reduce phosphorus intake.

Food Additives Found to Raise Serum Phosphorus

Food Additives Found to Raise Serum Phosphorus

Study implicates dairy products, cereals, and grains containing inorganic phosphate additives.

Medications Contribute to Phosphate Intake

Medications Contribute to Phosphate Intake

Among the phosphate-containing medicinal products prescribed to chronic kidney disease patients, 76% may contain absorbable phosphate.

Study: 30% Decline in eGFR Over 2 Years Strongly Predicts ESRD

Study: 30% Decline in eGFR Over 2 Years Strongly Predicts ESRD

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.

Risk Factors for CKD Progression ID'd

Risk Factors for CKD Progression ID'd

Proteinuria, hyperphosphatemia, anemia linked more rapid annual decline in eGFR.

Dietary Interventions Improve Hyperphosphatemia Treatment

Dietary Interventions Improve Hyperphosphatemia Treatment

Cutting back on dietary phosphorus in addition to taking phosphate binders achieved greater decreases in serum phosphate in PD patients.

Many Beverages Contain Hidden Phosphorus

Many Beverages Contain Hidden Phosphorus

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.

Phosphorus, Calcium Decreases Linked to Improved HD Patient Survival

Phosphorus, Calcium Decreases Linked to Improved HD Patient Survival

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.

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