Hyperphosphatemia in patients with ESRD: assessing the current evidence linking outcomes with treatment adherence

BMC Nephrology

Anjay Rastogi²  Adrian Covic¹ 

[1] C.I. Parhon Hospital, Blvd Carol 1st Nr 50, Iasi 6600, Romania;University of California, Los Angeles, CA, USA

关键词: Pill burden;    Phosphate binder;    Hyperphosphatemia;    Chronic kidney disease;    Adherence;   

Others  :  1082886
DOI  :  10.1186/1471-2369-14-153

 received in 2013-01-29, accepted in 2013-07-12,  发布年份 2013

【 摘 要 】

In recent years, the imbalance in phosphate homeostasis in patients with end-stage renal disease (ESRD) has been the subject of much research. It appears that, while hyperphosphatemia may be a tangible indicator of deteriorating kidney function, lack of phosphate homeostasis may also be associated with the increased risk of cardiovascular events and mortality that has become a hallmark of ESRD. The need to maintain phosphorus concentrations within a recommended range is reflected in evidence-based guidelines. However, these do not reflect serum phosphorus concentrations achieved by most patients in clinical practice. Given this discrepancy, it is important to consider ways in which dietary restriction of phosphorus intake and, in particular, use of phosphate binders in patients with ESRD can be made more effective. Poor adherence is common in patients with ESRD and has been associated with inadequate control of serum phosphorus concentrations. Studies indicate that, among other factors, major reasons for poor adherence to phosphate binder therapy include high pill burden and patients’ lack of understanding of their condition and its treatment. This review examines available evidence, seeking to understand fully the reasons underlying poor adherence in patients with ESRD and consider possible strategies for improving adherence in clinical practice.

【 授权许可】

   
2013 Covic and Rastogi; licensee BioMed Central Ltd.

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