Effects of Dietary Phosphate Restriction and Phosphate Binders on FGF23 Levels in CKD

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Effects of dietary phosphate restriction and phosphate binders on FGF23 levels in CKD.

BACKGROUND Elevated levels of fibroblast growth factor 23 (FGF23) are associated with increased risk of adverse outcomes in patients with CKD. Reducing dietary phosphate intake or absorption may decrease FGF23 levels, but data on the combined effects of dietary phosphate restriction and phosphate binders in CKD are limited. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS In this 2×2 factorial, ...

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Effects of phosphate binders in moderate CKD.

Some propose using phosphate binders in the CKD population given the association between higher levels of phosphorus and mortality, but their safety and efficacy in this population are not well understood. Here, we aimed to determine the effects of phosphate binders on parameters of mineral metabolism and vascular calcification among patients with moderate to advanced CKD. We randomly assigned ...

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Phosphate binders in CKD: bad news or good news?

Hyperphosphatemia has long been considered an important contributor to the mineral and bone disorder associated with CKD (CKD-MBD). Already 50 years ago, Slatopolsky et al. showed that as GFR decreased, fractional phosphate excretion rose because of inhibition of tubular phosphate reabsorption by parathyroid hormone (PTH), thus preventing serum phosphorus to rise. In the last 10 years, fibrobla...

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Impact of fractional phosphate excretion on the relation of FGF23 with outcome in CKD patients

BACKGROUND Cardiovascular risk is increased in patients with chronic kidney disease (CKD). Fibroblast growth factor 23 (FGF23) has emerged as an important, independent predictor of outcome in CKD patients. High FGF23 may, however, be a reflection of renal tissue resistance to its actions, reflected by low fractional excretion of phosphate (FePi). We evaluated the modifying effect of FePi on the...

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Rationale and Approaches to Phosphate and Fibroblast Growth Factor 23 Reduction in CKD.

Patients with CKD often progress to ESRD and develop cardiovascular disease (CVD), yet available therapies only modestly improve clinical outcomes. Observational studies report independent associations between elevated serum phosphate and fibroblast growth factor 23 (FGF23) levels and risks of ESRD, CVD, and death. Phosphate excess induces arterial calcification, and although elevated FGF23 hel...

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ژورنال

عنوان ژورنال: Clinical Journal of the American Society of Nephrology

سال: 2013

ISSN: 1555-9041,1555-905X

DOI: 10.2215/cjn.09250912