Category Archives: Phosphorus
Phosphorus and risk of renal failure in subjects with normal renal function
Hemodialysis.com Author Interview: John J. Sim, MD
Area Research Chair
Director of Continuing Medical Education
Division of Nephrology and Hypertension
Kaiser Permanente Los Angeles Medical Center
Los Angeles, CA 90027
Hemodialysis.com: What are the main findings of the study?
Dr. Sim: This study on individuals with no significant kidney disease and relatively intact kidney function (eGFR>/=60ml/ml) demonstrated that higher serum phosphorus levels were association with greater risk for developing end stage renal disease (ESRD). Every 0.5mg/dl increase in serum phosphorus was associated with 40% increase risk for ESRD. Additionally, every 0.5mg/dl higher level of phosphorus increased the risk of death by 9% during the 11 year observation period.
Marie Benz, MD on Google+Importance of Understanding Phosphate Binding Capacity of Sevelamer and Lanthanum in Relation to Dietary Protein and Phosphate Intake in Chronic Hemodialysis Patients
Hemodialysis.com Interview with: William F. Finn, MD
Professor of Medicine (Ret)
University of North Carolina
School of Medicine
Hemodialysis.com: What are the main findings of the study?
Dr. Finn: Published reports were examined that detailed changes in the urinary excretion of phosphorus that followed the administration of various doses of either sevelamer hydrochloride/carbonate (SHC) or lanthanum carbonate (LC).
From these data, dose-response curves were developed.
These data demonstrated that the relative binding capacity of each agent decreased as doses was increased. That is, the respective dose-response curves are non-linear. At the upper limits of the clinically recommended doses, the phosphorus binding capacities plateau. This has important implications for the management of hyperphosphatemia in dialysis patients for it places an upper limit on the amount of phosphorus that can be bound. On the basis of these dose-response curves, it would require 18.4 g of SHC or 4.6 g of LC to bind 350 mg of phosphorus. This helps to explain the persistent hyperphosphatemia among many patients whose required dietary protein intake exceeds the ability to maintain phosphorus intake at or below 1000 mg per day.
THE “PHOSPHORUS OLYMPICS”: A Self-Management Approach for Enhancing Phosphorus Education in a Multi-Site Dialysis Program
Hemodialysis.com Authors’ Interview:
Rachel Linzon, Josie Caruso-Ditta, Marla McKerracher, York Region Chronic Kidney Disease Program – Mackenzie Health, Richmond Hill, Ontario, Canada.
Objective:
The “Phosphorus Olympics” initiative was created to test whether a self-management approach to phosphorus education would improve patients’ decisions impacting dietary phosphorus intake, phosphate-binders usage and serum phosphorus levels.
Hemodialysis.com: What are the main findings of the study?
The “Phosphorous Olympics” was a continuous quality improvement (CQI) initiative which used a fun innovative approach to learning about dietary phosphorus and binder usage. The goal was to empower 229 (50%) dialysis patients recruited to improve their ability to self-manage dietary phosphorus intake and phosphate-binder usage. Participants’ serum phosphorus levels subsequently improved by 3.6%.
