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Phosphate homeostasis in CKD: report of a scientific symposium sponsored by the National Kidney Foundation.

Publication ,  Journal Article
Block, GA; Ix, JH; Ketteler, M; Martin, KJ; Thadhani, RI; Tonelli, M; Wolf, M; Jüppner, H; Hruska, K; Wheeler, DC
Published in: Am J Kidney Dis
September 2013

Chronic kidney disease (CKD)-mineral and bone disorder is associated with diverse metabolic and endocrine disturbances that ultimately may contribute to further loss of kidney function, bone demineralization, and fatal or nonfatal cardiovascular events. Recent insights into the pathophysiology of the events that unfold during the development of this disorder suggest that disturbances in phosphate metabolism are pivotal. The consequences of abnormal phosphate homeostasis are evident at estimated glomerular filtration rates <70 mL/min/1.73 m(2), long before serum phosphate levels increase. Healthy individuals with blood phosphate levels in the top quartile of the normal range have an increased risk of developing CKD, reaching end-stage renal disease, and experiencing cardiovascular events. Substantial public health consequences may be related to increased dietary phosphorus exposure from additives that contain phosphate in the food supply and from modest increases in serum phosphate levels; however, it remains to be established whether interventions aimed at these targets can impact on the development of adverse clinical outcomes. Current approaches involving dietary intervention and intestinal phosphate binders are based on principles and assumptions that need to be examined more rigorously. Compelling animal, observational, and clinical data indicate that interventions directed at lowering phosphate exposure and serum phosphate levels should be subject to rigorous clinical trials that use appropriate placebo comparators and focus on key clinical outcomes, such as cardiovascular events, progression of CKD, fractures, quality of life, and mortality.

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Published In

Am J Kidney Dis

DOI

EISSN

1523-6838

Publication Date

September 2013

Volume

62

Issue

3

Start / End Page

457 / 473

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Research Report
  • Renal Insufficiency, Chronic
  • Phosphates
  • Humans
  • Homeostasis
  • Foundations
  • Congresses as Topic
  • Clinical Trials as Topic
  • 3202 Clinical sciences
 

Citation

APA
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Block, G. A., Ix, J. H., Ketteler, M., Martin, K. J., Thadhani, R. I., Tonelli, M., … Wheeler, D. C. (2013). Phosphate homeostasis in CKD: report of a scientific symposium sponsored by the National Kidney Foundation. Am J Kidney Dis, 62(3), 457–473. https://doi.org/10.1053/j.ajkd.2013.03.042
Block, Geoffrey A., Joachim H. Ix, Markus Ketteler, Kevin J. Martin, Ravi I. Thadhani, Marcello Tonelli, Myles Wolf, Harald Jüppner, Keith Hruska, and David C. Wheeler. “Phosphate homeostasis in CKD: report of a scientific symposium sponsored by the National Kidney Foundation.Am J Kidney Dis 62, no. 3 (September 2013): 457–73. https://doi.org/10.1053/j.ajkd.2013.03.042.
Block GA, Ix JH, Ketteler M, Martin KJ, Thadhani RI, Tonelli M, et al. Phosphate homeostasis in CKD: report of a scientific symposium sponsored by the National Kidney Foundation. Am J Kidney Dis. 2013 Sep;62(3):457–73.
Block, Geoffrey A., et al. “Phosphate homeostasis in CKD: report of a scientific symposium sponsored by the National Kidney Foundation.Am J Kidney Dis, vol. 62, no. 3, Sept. 2013, pp. 457–73. Pubmed, doi:10.1053/j.ajkd.2013.03.042.
Block GA, Ix JH, Ketteler M, Martin KJ, Thadhani RI, Tonelli M, Wolf M, Jüppner H, Hruska K, Wheeler DC. Phosphate homeostasis in CKD: report of a scientific symposium sponsored by the National Kidney Foundation. Am J Kidney Dis. 2013 Sep;62(3):457–473.
Journal cover image

Published In

Am J Kidney Dis

DOI

EISSN

1523-6838

Publication Date

September 2013

Volume

62

Issue

3

Start / End Page

457 / 473

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Research Report
  • Renal Insufficiency, Chronic
  • Phosphates
  • Humans
  • Homeostasis
  • Foundations
  • Congresses as Topic
  • Clinical Trials as Topic
  • 3202 Clinical sciences