Phosphate Binders, Past - Present - Future. A critical appraisal.
Expert Opin Pharmacother. 2015 Dec 17;
Authors: Malindretos P, Cozzolino M
Abstract
It has been shown, and it is now generally accepted that chronic kidney disease mineral bone disorder (CKD-MBD) is one of the main determinants responsible for increased cardiovascular morbidity and mortality. Multiple targets have been designated in our battle against CKD-MBD; for the time being, in the present manuscript we will try to approach the treatment itinerary of hyperphosphatemia. Half a century ago, aluminum-based phosphate binders, were already known for their effects, and were the first drugs used for this purpose. Some three decades later, calcium-based phosphate binders were adopted. A few years ago, sevelamer and shortly after that lanthanum were introduced in the treatment of hyperphosphatemia. Calcium-magnesium binders, also appeared relatively recently. Colestilan, nicotinamide and iron-based phosphate binders have also been proposed recently. Each phosphate-binder family has its own pros and contras, treating doctors are called to individualize their prescription according to their patient needs. "Practice two things in your dealings with disease: either help or do not harm the patient", this is the cornerstone of medical practice.
PMID: 26679256 [PubMed - as supplied by publisher]