Hyperphosphataemia as an important complication of chronic renal insufficiency and chronic renal failure, part 2 – treatment

Authors: J. Smržová
Authors‘ workplace: Dialyzační a nefrologické oddělení Interní gastroenterologické kliniky Lékařské fakulty MU a FN Brno, pracoviště Bohunice přednosta prof. MUDr. Petr Dítě, DrSc.
Published in: Vnitř Lék 2005; 51(3): 337-344
Category: Reviews


Hyperphosphataemia is a commonly found complication of severe renal insufficiency. However, minor disturbances of calcium-phosphate metabolism are encountered in mild to moderate renal insufficiency and, as a result, can be found in up to 5% of population. They lead not only to renal bone disease but also to extraosseal calcifications (including the vascular ones) and increase in mortality rate. Their impact on the patients’ quality of life is very significant, too. The treatment of hyperphosphataemia is closely associated with the therapy of renal bone disease. It consists in dietary restrictions, the use of a constantly widening range of phosphate binders, active metabolites of vitamin D and their analogues, therapy of metabolic acidosis, customising dialysis regimen in dialysed patients and surgical treatment atadvanced stages of secondary hyperparathyreoidism. This represents a long-term treatment that should be conducted by nephrologists in patients with moderate to severe renal insufficiency and by internists in patients with mild renal insufficiency. This paper gives details pertaining to all the kinds of hyperphosphataemia treatment including the concrete medication available. Finally, therapeutic recommendations for all the types of calcium-phosphate metabolism disturbances are given. These recommendations are based on the up-to-date treatment standards as well as the author’s own clinical experience.

Key words:
hyperphosphataemia – renal bone disease – hyperparathyroidism – renal insufficiency – haemodialysis – phosphate binders


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