Episode Description:
Phosphorus, essential for bone mineralization, energy production, and cellular signaling, becomes problematic in CKD as kidney function declines, leading to hyperphosphatemia. Elevated phosphorus levels stimulate parathyroid hormone (PTH) production, causing increased bone resorption and further phosphorus release. Additionally, the role of fibroblast growth factor 23 (FGF23) in phosphorus regulation and its reduced effectiveness in advanced CKD is discussed.
The episode highlights the adverse outcomes of hyperphosphatemia, including vascular calcification, arterial stiffness, and cardiovascular disease. Bone disorders, such as osteitis fibrosa cystica and adynamic bone disease, resulting from high phosphorus levels, are also covered.
Strategies for managing phosphorus levels include dietary modifications, phosphate binders, and pharmacological treatments. The use of calcium-based binders, non-calcium-based binders, and iron-based binders, as well as activated vitamin D analogues and calcimimetics like cinacalcet, are examined.
For advanced CKD patients, the importance of dialysis—both hemodialysis and peritoneal dialysis—in removing excess phosphorus is emphasized. The multifaceted approach to phosphorus management aims to improve outcomes for CKD patients by mitigating the risks associated with hyperphosphatemia.
Renes Care Radio is a podcast designed for nephrology professionals, offering in-depth scientific explorations of key topics. It equips kidney care providers with the essential knowledge needed for advanced patient care.
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This podcast is for informational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment.