Cargando…

Modifying Phosphate Toxicity in Chronic Kidney Disease

Phosphate toxicity is a well-established phenomenon, especially in chronic kidney disease (CKD), where hyperphosphatemia is a frequent occurrence when CKD is advanced. Many therapeutic efforts are targeted at phosphate, and comprise dietary intervention, modifying dialysis schemes, treating uncontro...

Descripción completa

Detalles Bibliográficos
Autor principal: Vervloet, Marc
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6784221/
https://www.ncbi.nlm.nih.gov/pubmed/31505780
http://dx.doi.org/10.3390/toxins11090522
_version_ 1783457720234409984
author Vervloet, Marc
author_facet Vervloet, Marc
author_sort Vervloet, Marc
collection PubMed
description Phosphate toxicity is a well-established phenomenon, especially in chronic kidney disease (CKD), where hyperphosphatemia is a frequent occurrence when CKD is advanced. Many therapeutic efforts are targeted at phosphate, and comprise dietary intervention, modifying dialysis schemes, treating uncontrolled hyperparathyroidism and importantly, phosphate binder therapy. Despite all these interventions, hyperphosphatemia persists in many, and its pathological influence is ongoing. In nephrological care, a somewhat neglected aspect of treatment—when attempts fail to lower exposure to a toxin like phosphate—is to explore the possibility of “anti-dotes”. Indeed, quite a long list of factors modify, or are mediators of phosphate toxicity. Addressing these, especially when phosphate itself cannot be sufficiently controlled, may provide additional protection. In this narrative overview, several factors are discussed that may qualify as either such a modifier or mediator, that can be influenced by other means than simply lowering phosphate exposure. A wider scope when targeting phosphate-induced comorbidity in CKD, in particular cardiovascular disease, may alleviate the burden of disease that is the consequence of this potentially toxic mineral in CKD.
format Online
Article
Text
id pubmed-6784221
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-67842212019-10-16 Modifying Phosphate Toxicity in Chronic Kidney Disease Vervloet, Marc Toxins (Basel) Review Phosphate toxicity is a well-established phenomenon, especially in chronic kidney disease (CKD), where hyperphosphatemia is a frequent occurrence when CKD is advanced. Many therapeutic efforts are targeted at phosphate, and comprise dietary intervention, modifying dialysis schemes, treating uncontrolled hyperparathyroidism and importantly, phosphate binder therapy. Despite all these interventions, hyperphosphatemia persists in many, and its pathological influence is ongoing. In nephrological care, a somewhat neglected aspect of treatment—when attempts fail to lower exposure to a toxin like phosphate—is to explore the possibility of “anti-dotes”. Indeed, quite a long list of factors modify, or are mediators of phosphate toxicity. Addressing these, especially when phosphate itself cannot be sufficiently controlled, may provide additional protection. In this narrative overview, several factors are discussed that may qualify as either such a modifier or mediator, that can be influenced by other means than simply lowering phosphate exposure. A wider scope when targeting phosphate-induced comorbidity in CKD, in particular cardiovascular disease, may alleviate the burden of disease that is the consequence of this potentially toxic mineral in CKD. MDPI 2019-09-09 /pmc/articles/PMC6784221/ /pubmed/31505780 http://dx.doi.org/10.3390/toxins11090522 Text en © 2019 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Vervloet, Marc
Modifying Phosphate Toxicity in Chronic Kidney Disease
title Modifying Phosphate Toxicity in Chronic Kidney Disease
title_full Modifying Phosphate Toxicity in Chronic Kidney Disease
title_fullStr Modifying Phosphate Toxicity in Chronic Kidney Disease
title_full_unstemmed Modifying Phosphate Toxicity in Chronic Kidney Disease
title_short Modifying Phosphate Toxicity in Chronic Kidney Disease
title_sort modifying phosphate toxicity in chronic kidney disease
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6784221/
https://www.ncbi.nlm.nih.gov/pubmed/31505780
http://dx.doi.org/10.3390/toxins11090522
work_keys_str_mv AT vervloetmarc modifyingphosphatetoxicityinchronickidneydisease