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Phosphatbinder

Phosphate binders

  • Leitthema
  • Published:
Der Nephrologe Aims and scope

Zusammenfassung

Die Hyperphosphatämie stellt eine der häufigsten Sekundärfolgen bei fortgeschrittener chronischer Niereninsuffizienz dar. Neben diätetischen Maßnahmen und ggf. einer adäquaten Dialyse sind häufig Phosphatbinder notwendig, um das Serumphosphat zu senken. Die vorliegende Übersicht fasst jüngere Daten aus den Jahren 2010 bis 2016 zusammen mit speziellem Fokus auf den jüngsten KDIGO-Leitlinien zu diesem Thema, der Therapieadhärenz sowie Daten zu einzelnen Substanzen (Kalziumacetat bzw. -karbonat, kalzium-/magnesiumaltige Phosphatbinder, Polymere (Sevelamer, Bixalomer, Colestilan), Lanthankarbonat, Eisenzitrat, Sucroferric Oxyhydroxid, aluminiumhaltige Phosphatbinder) sowie Substanzen, die sich in Entwicklung befinden. Zusätzlich wird kurz auf neue Entwicklungen, v. a. auf Hemmer des intestinalen Phosphattransports, eingegangen.

Abstract

Hyperphosphatemia is one of the most frequent secondary consequences of advanced chronic renal failure. In addition to dietary measures and possibly adequate dialysis, phosphate binders are often necessary to reduce serum phosphate levels. This review article summarizes recent data from 2010–2016 with special emphasis on the latest Kidney Disease: Improving Global Outcomes (KDIGO) guidelines on this topic, therapy adherence and data on individual substances, e.g. calcium acetate and calcium carbonate, phosphate binders containing calcium amd magnesium, polymers (e.g. sevelamer, bixalomer and colestilan), lanthanum carbonate, ferric citrate, sucroferric oxyhydroxide and phosphate binders containing aluminium as well as substances that are in the developmental stage. In addition, new developments and particularly inhibitors of intestinal phosphate transport are also discussed.

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  1. Medizinische Klinik II, RWTH Aachen, Pauwelsstr. 30, 52057, Aachen, Deutschland

    J. Floege

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J. Floege hat Vortrags- und/oder Beraterhonorare der folgenden Firmen erhalten: Fresenius, Sanofi, Shire, Vifor.

Alle beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethik-Kommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor.

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J. Floege, Aachen

M. Ketteler, Coburg

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Floege, J. Phosphatbinder. Nephrologe 12, 183–191 (2017). https://doi.org/10.1007/s11560-017-0149-7

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