Expanding Horizons in Renal Disease

A patient with end-stage renal disease (ESRD) is defined as one who has developed chronic renal failure and required kidney replacement therapy, either by dialysis or transplantation.1 ESRD affects over 400,000 individuals in the United States,2 and this number is growing. Growing evidence suggests that the risk of cardiovascular morbidity and mortality in patients with ESRD undergoing dialysis may be related in part to high levels of phosphorus in the blood (hyperphosphatemia).3-8 Phosphorus is a key element in a variety of cellular processes, and its deregulation in ESRD may lead to serious complications.

Awareness of the risks of hyperphosphatemia has led to increased attempts to identify more effective management strategies for this condition (reviewed in Malluche et al.9). Pharmaceutical treatments have involved the use of calcium- and aluminum-salt-based phosphate binders, and more recently sevelamer (Renagel®; Genzyme Corp, Cambridge, MA), which work by binding dietary phosphorus in the gut, preventing its absorption. However, these products are associated with a number of limitations and potential side effects. Even with the availability of phosphate-binding agents, uncontrolled phosphorus levels can lead to morbidity and mortality in patients with kidney disease. This emphasizes the need for new therapeutic approaches to improve the management of hyperphosphatemia in this patient population.

On this web site, you'll find a wealth of information relating to the control of serum phosphorus levels in patients with renal diseases. You can find detailed material on:

• Role of Phosphorus
• Hyperphosphatemia
• Non-Pharmaceutical Treatment Options
• Pharmaceutical Treatment Options
• Patient Treatment
• Resources