Be Aware of Nuances When Using Phosphate Binders

You'll be asked how to manage hyperphosphatemia during transitions of care in patients with severe chronic kidney disease.

High phosphorus levels cause hypocalcemia...which triggers parathyroid hormone release. This can lead to fractures, vascular calcification, etc...and is linked to increased mortality.

Expect maintenance binders to be saved for persistently elevated phosphate levels. Any binder can lower phosphorus levels by about 1 to 2 mg/dL...but none is shown to improve outcomes.

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