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Journal of Nephrology

Erschienen in:

01.08.2015 | Review

Phosphate balance in ESRD: diet, dialysis and binders against the low evident masked pool

verfasst von: A. Galassi, A. Cupisti, A. Santoro, M. Cozzolino

Erschienen in: Journal of Nephrology | Ausgabe 4/2015

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Abstract

Phosphate metabolism is crucial in the pathophysiology of secondary hyperparathyroidism and vascular calcification. High phosphate levels have been consistently associated with unfavorable outcomes in dialysis patients, but several limitations are still hampering a resolutive definition of the optimal targets of phosphate serum levels to be achieved in this cohort. Nonetheless, hyperphosphatemia is a late marker of phosphate overload in humans. Clinical nephrologists routinely counteract the positive phosphate balance in dialysis patients through nutritional counseling, stronger phosphate removal by dialysis and prescription of phosphate binders. However, the superiority against placebo of phosphate control by diet, dialysis or binders in terms of survival has never been tested in dedicated randomized controlled trials. The present review discusses this conundrum with particular emphasis on the rationale supporting the value of a simultaneous intervention against phosphate overload in dialysis patients via the improvement of dietary intakes, dialysis efficiency and an individualized choice of phosphate binders.

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Titel: Phosphate balance in ESRD: diet, dialysis and binders against the low evident masked pool
verfasst von: A. Galassi
A. Cupisti
A. Santoro
M. Cozzolino
Publikationsdatum: 01.08.2015
Verlag: Springer International Publishing
Erschienen in: Journal of Nephrology / Ausgabe 4/2015
Print ISSN: 1121-8428
Elektronische ISSN: 1724-6059
DOI: https://doi.org/10.1007/s40620-014-0142-4

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