Phosphate binders in chronic kidney disease: an updated narrative review of recent data

J Nephrol. 2020 Jun;33(3):497-508. doi: 10.1007/s40620-019-00689-w. Epub 2019 Dec 21.

Abstract

Chronic kidney disease (CKD) is frequently accompanied by hyperphosphatemia. High serum phosphate usually requires dietary measures, adequate dialysis prescription and/or phosphate binders. For this narrative review a PubMed searched was undertaken to identify new publications on phosphate binders that had been published between January 2015 and July 2019. The present review summarizes this most recent information on dietary measures and their problems in treating hyperphosphatemia in CKD patients, overall effects of phosphate binders on cardiovascular mortality and morbidity, adherence to phosphate binder therapy as well as new data on specific aspects of the various phosphate binders on the market: calcium-containing phosphate binders, polymeric phosphate binders (sevelamer, bixalomer, colestilan), magnesium-containing phosphate binders, lanthanum carbonate, ferric citrate, sucroferric oxyhydroxide, and new compounds in development, in particular drugs targeting intestinal phosphate transporters.

Keywords: Colestilan; Ferric citrate; Lanthanum carbonate; Sevelamer; Sucroferric oxyhydroxide.

Publication types

  • Review

MeSH terms

  • Chelating Agents / adverse effects
  • Humans
  • Hyperphosphatemia* / drug therapy
  • Hyperphosphatemia* / etiology
  • Lanthanum / therapeutic use
  • Phosphates
  • Renal Dialysis / adverse effects
  • Renal Insufficiency, Chronic* / complications
  • Renal Insufficiency, Chronic* / diagnosis
  • Renal Insufficiency, Chronic* / drug therapy
  • Sevelamer / therapeutic use

Substances

  • Chelating Agents
  • Phosphates
  • Lanthanum
  • Sevelamer