Pediatric Nephrology

, Volume 25, Issue 3, pp 385–394

Phosphate binders in CKD: chalking out the differences

Review

DOI: 10.1007/s00467-009-1329-0

Cite this article as:
Rees, L. & Shroff, R.C. Pediatr Nephrol (2010) 25: 385. doi:10.1007/s00467-009-1329-0

Abstract

Plasma phosphate levels are important in the evolution of hyperparathyroidism and ectopic calcification in chronic kidney disease (CKD). Although dietary management may be adequate to control plasma phosphate in its early stages, most patients develop hyperphosphataemia by CKD stages 3−4 and require the addition of a phosphate binder. Calcium-containing phosphate binders are the most used and cheapest binders but have fallen out of favour because of the potential for positive calcium balance and calcium toxicity. This problem may be attenuated by newer phosphate binders such as sevelamer hydrochloride and lanthanum carbonate. In this review, the role of phosphate as a uraemic toxin and the advantages and disadvantages of the currently available phosphate binders are discussed.

Keywords

ChildrenPhosphateCalciumPhosphate bindersCalcium carbonateCalcium acetateSevelamerLanthanum

Copyright information

© IPNA 2009

Authors and Affiliations

  1. 1.Department of NephrologyGreat Ormond Street Hospital for Children NHS TrustLondonUK
  2. 2.Renal OfficeGreat Ormond Street Hospital for ChildrenLondonUK