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Modifying Phosphate Toxicity in Chronic Kidney Disease

Department of Nephrology and Amsterdam Cardiovascular Sciences, Amsterdam University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
Received: 4 August 2019 / Revised: 29 August 2019 / Accepted: 5 September 2019 / Published: 9 September 2019
(This article belongs to the Special Issue The Chronic Kidney Disease - Mineral Bone Disorder (CKD-MBD))
Phosphate toxicity is a well-established phenomenon, especially in chronic kidney disease (CKD), where hyperphosphatemia is a frequent occurrence when CKD is advanced. Many therapeutic efforts are targeted at phosphate, and comprise dietary intervention, modifying dialysis schemes, treating uncontrolled hyperparathyroidism and importantly, phosphate binder therapy. Despite all these interventions, hyperphosphatemia persists in many, and its pathological influence is ongoing. In nephrological care, a somewhat neglected aspect of treatment—when attempts fail to lower exposure to a toxin like phosphate—is to explore the possibility of “anti-dotes”. Indeed, quite a long list of factors modify, or are mediators of phosphate toxicity. Addressing these, especially when phosphate itself cannot be sufficiently controlled, may provide additional protection. In this narrative overview, several factors are discussed that may qualify as either such a modifier or mediator, that can be influenced by other means than simply lowering phosphate exposure. A wider scope when targeting phosphate-induced comorbidity in CKD, in particular cardiovascular disease, may alleviate the burden of disease that is the consequence of this potentially toxic mineral in CKD. View Full-Text
Keywords: chronic kidney disease; CKD-MBD; phosphate chronic kidney disease; CKD-MBD; phosphate
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MDPI and ACS Style

Vervloet, M. Modifying Phosphate Toxicity in Chronic Kidney Disease. Toxins 2019, 11, 522.

AMA Style

Vervloet M. Modifying Phosphate Toxicity in Chronic Kidney Disease. Toxins. 2019; 11(9):522.

Chicago/Turabian Style

Vervloet, Marc. 2019. "Modifying Phosphate Toxicity in Chronic Kidney Disease" Toxins 11, no. 9: 522.

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