scholarly journals Phosphate binders and management of hyperphosphataemia in end-stage renal disease

2006 ◽  
Vol 21 (8) ◽  
pp. 2065-2068 ◽  
Author(s):  
Vincenzo Savica ◽  
Lorenzo A. Calò ◽  
Pietro Monardo ◽  
Domenico Santoro ◽  
Guido Bellinghieri
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Phosphate Binders ◽  
Stage Renal Disease ◽  
End Stage

The Use of Magnesium-Containing Phosphate Binders in Patients with End-Stage Renal Disease on Maintenance Hemodialysis

Nephron ◽  
1982 ◽  
Vol 30 (2) ◽  
pp. 114-117 ◽  
Author(s):  
Ann P. Guillot ◽  
Virginia L. Hood ◽  
Carl F. Runge ◽  
John Gennari
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Phosphate Binders ◽  
Maintenance Hemodialysis ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Cardiovascular Outcomes of Calcium-Free vs Calcium-Based Phosphate Binders in Patients 65 Years or Older With End-stage Renal Disease Requiring Hemodialysis

2019 ◽  
Vol 179 (6) ◽  
pp. 741 ◽  
Author(s):  
Julia Spoendlin ◽  
Julie M. Paik ◽  
T. Tsacogianis ◽  
Seoyoung C. Kim ◽  
Sebastian Schneeweiss ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Cardiovascular Outcomes ◽  
Phosphate Binders ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Iron parameters in patients with end-stage renal disease receiving lanthanum carbonate or other non-iron-based phosphate binders: Results from a phase 3, randomized open-label study

2018 ◽  
Vol 6 ◽  
pp. 205031211878616
Author(s):  
Rosamund J Wilson ◽  
Beverly Jones ◽  
Claudio Marelli
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Standard Therapy ◽  
Transferrin Saturation ◽  
Lanthanum Carbonate ◽  
Phosphate Binders ◽  
Iron Parameters ◽  
Iron Based ◽  
Stage Renal Disease ◽  
End Stage

Objectives: The recent availability of iron-based phosphate binders has raised some concerns about iron overload in patients with end-stage renal disease. This study evaluated iron parameters in patients with end-stage renal disease receiving lanthanum carbonate or other non-iron-based phosphate binders. Methods: This analysis used 2-year follow-up data from an open-label, multicentre, randomized, active-controlled, parallel-group, phase 3 trial of lanthanum carbonate (SPD405-307). After a washout period, if patients’ serum phosphate levels exceeded 5.9 mg/dL, they were randomized 1:1 to receive lanthanum carbonate (375–3000 mg/day) or non-iron-based standard therapy during a 6-week dose titration period. Patients achieving control of serum phosphate levels (⩽5.9 mg/dL) received maintenance therapy with lanthanum carbonate or standard therapy for up to 24 months. Results: No clinically relevant changes in mean (standard deviation) iron parameters between the treatment groups (lanthanum carbonate, n = 682; standard therapy, n = 677) from baseline to month 24/final visit were observed: iron (µg/dL), −1.1 (41.8) versus 1.0 (38.7); ferritin (ng/mL), 208.4 (445.1) versus 262.4 (505.5); transferrin saturation (%), 2.8 (18.0) versus 2.8 (17.3); and haemoglobin (g/dL), 0.4 (1.9) versus 0.3 (1.7), respectively (all, p > 0.1). There were no clinically relevant changes in the percentage of patients receiving any anti-anaemic preparation in either treatment group (pre- vs post-randomization: lanthanum carbonate, 94.9% vs 97.8%; standard therapy, 95.1% vs 98.8%, respectively). This is in contrast to the study by Lewis and colleagues, which found significant increases in ferritin and transferrin saturation levels in patients receiving ferric citrate versus active control (calcium acetate and/or sevelamer carbonate) after 52 weeks of therapy. Although serum ferritin and transferrin saturation are the recommended iron indices by the Kidney Disease Outcome Quality Initiative, they are indirect indicators of iron status. Longer-term studies are required to understand fully the potential risks associated with iron overload. Conclusion: No evidence of iron accumulation was found in patients with end-stage renal disease receiving lanthanum carbonate or other non-iron-based binders.

Secondary Hyperparathyroidism in End-Stage Renal Disease: No Longer a Matter for Surgeons?

2016 ◽  
Vol 42 (1) ◽  
pp. 44-48 ◽  
Author(s):  
Mario Cozzolino ◽  
Francesca Elli ◽  
Stefano Carugo ◽  
Paola Ciceri
Keyword(s):  
Vitamin D ◽  
Renal Disease ◽  
Secondary Hyperparathyroidism ◽  
End Stage Renal Disease ◽  
Fibroblast Growth Factor 23 ◽  
Phosphate Binders ◽  
High Turnover ◽  
Skeletal Resistance ◽  
Stage Renal Disease ◽  
End Stage

Hyperphosphatemia, hypocalcemia and vitamin D deficiency are the main factors involved in the pathogenesis of secondary hyperparathyroidism (SHPT). Moreover, the skeletal resistance to parathyroid hormone is not only a high-turnover bone accompanying SHPT, but may also play a crucial role in the onset of low-turnover bone disease in uremia. However, a growing body of evidence suggests that other hormones play a key role in this disease, such as fibroblast growth factor 23, Klotho and sclerostin. SHPT causes both bone-associated and non-skeletal consequences, including cardiovascular calcifications. Furthermore, vitamin D and calcium (Ca)-containing phosphate binders may increase Ca load. Anyway, the rate of parathyroidectomy in end-stage renal disease has greatly decreased during the last decade. Is there any room left for surgeons?

scholarly journals Secondary and Tertiary Hyperparathyroidism: A Narrative Review

2019 ◽  
Vol 109 (4) ◽  
pp. 271-278 ◽  
Author(s):  
W. Y. van der Plas ◽  
M. E. Noltes ◽  
T. M. van Ginhoven ◽  
S. Kruijff
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Treatment Options ◽  
Phosphate Binders ◽  
Tertiary Hyperparathyroidism ◽  
Increased Risk ◽  
Vitamin D Supplements ◽  
The Individual ◽  
Stage Renal Disease ◽  
End Stage

End-stage renal disease is often complicated by the occurrence of secondary and eventually tertiary hyperparathyroidism, characterized by increased parathormone, calcium, and phosphate concentrations. Related symptoms include pruritus and osteodynia, concentration difficulties, and feelings of depression may be present. In the long-term, end-stage renal disease patients with hyperparathyroidism have an increased risk of all-cause and cardiovascular mortality. Among treatment options are vitamin D supplements, phosphate binders, calcimimetics, and surgical parathyroidectomy. Determining the optimal treatment for the individual patient is challenging for nephrologists and endocrine surgeons. This review resumes the pathogenesis of hyperparathyroidism, clinical presentation, required diagnostic work-up, and discusses indications for the available treatment options for patients with secondary and tertiary hyperparathyroidism.

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