Pharmacological interactions of phosphate binders.

Abstract

The use of phosphate binders is one of basic elements in the treatment of CKD-MBD (“Chronic Kidney Disease-Mineral and Bone Disorder”). It has been well known for decades that phosphate reten tion through direct and indirect mechanisms, contributes to the generation and progression of secondary hyperparathy roidism (SHP) and renal osteodystrophy in chronic kidney disease (CKD).1,2 In fact, phosphate retention blocks all DOI of original article: https://doi.org/10.1016/j.nefro.2018.05.003. ∗ Corresponding author. E-mail address: jbover@fundacio-puigvert.es (J. Bover Sanjuán). hormonal counter-regulatory mechanisms, increases skeletal resistance to PTH and is considered a central factor in the and systemic alterations such as the decrease in calcitriol, increase in fibroblast growth factor-23 (FGF-23), cardiovascular calcifications, premature aging and the high morbi-mortality of these patients.2,3 For all this, phosphate has been considered as “the silent killer” of patients with CKD