Hyperphosphatemia and secondary hyperparathyroidism are common complications of ESRD (chronic kidney disease stage 5) that, when untreated, may result in increased morbidity and mortality. Hyperphosphatemia and hypercalcemia have been associated with increased coronary artery calcification. Achieving control of serum phosphorus without increasing serum calcium is an important goal for patients ...

      Calcium acetate is used as an oral phosphate binder to control hyperphosphatemia in patients with chronic renal failure. Compared to calcium carbonate, control of hyperphosphatemia can be achieved at lower calcium administration with calcium acetate which likely reduces the risk of hypercalcemia. In this study, various formulations of calcium acetate tablets were prepared and their disint...

The abnormalities in bone and mineral metabolism in chronic kidney disease patients are associated with an increased risk of fractures, vascular calcifications and cardiovascular diseases. A few decades ago hyperphosphatemia and the common development of secondary hyperparathyroidism were thought to be the main problem to deal with. Since dietary phosphate restriction and haemodialysis were not...

Chronic kidney disease with hyperphosphatemia is associated with accelerated atherosclerosis and endothelial dysfunction. However, the contribution of high serum phosphate levels to endothelial injury is incompletely understood. The aim of this work was to evaluate the responses of endothelial cells to elevated levels of extracellular phosphate in vitro. High phosphate in concentrations similar...

Elevated serum phosphorus, calcium, and fibroblast growth factor 23 (FGF23) levels are associated with cardiovascular disease in chronic renal disease. This study evaluated the effects of sucroferric oxyhydroxide (PA21), a new iron-based phosphate binder, versus lanthanum carbonate (La) and sevelamer carbonate (Se), on serum FGF23, phosphorus, calcium, and intact parathyroid hormone (iPTH) conc...

Diabetic nephropathy is the leading cause of end-stage renal disease (ESRD) in Japan and other Westernized countries. Over 50% of the ESRD patients die from cardiovascular events. Cardiovascular disease (CVD) in ESRD patients with diabetes mellitus (DM) are implicated in the endothelial dysfunction caused by hyperglycemia, hyperlipidemia, and hypertension, and in the vascular calcification of i...

Hyperphosphatemia is a common complication in advanced chronic kidney disease and contributes to cardiovascular morbidity mortality. The present narrative review focuses on the management of phosphatemia uremic patients receiving peritoneal dialysis. These frequently develop hyperphosphatemia since phosphate anion behaves as middle-size molecule despite its low molecular weight. Accordingly, pa...

Prem K.G. Chandran, MD, Iowa Methodist Medical Center, and Iowa Lutheran Hospital, 1215 Pleasant Suite 100, Des Moines, IA 50309 (USA) Dear Sir, Metabolic consequences of chronic irreversible renal failure include hyperphosphatemia, hypocalcemia, and secondary hyperparathyroidism. Persistent hyperphosphatemia not only contributes to abnormal vitamin D balance, but is also responsible for metast...

We established a rat model of hyperphosphatemia and investigated the systemic effects of high phosphorus (P). Sprague Dawley rats were randomly divided into high (HP), low (LP), and normal (NP) P groups (N = 12 each), which received injections of fructose diphosphate sodium, or were fed self-manufactured low phosphorus or normal diets, respectively. In each group, 4 rats were sacrificed at the ...

Sevelamer carbonate is an anion exchange pharmaceutical, developed to improve on the performance of the non-absorbable, non-calcium, and metal-free phosphate binder sevelamer hydrochloride. Sevelamer carbonate is expected not to worsen metabolic acidosis, as previously reported during long-term treatment with sevelamer hydrochloride in hemodialysis (HD) patients. Carbonate is the alternate coun...