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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...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2019
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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 |
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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 |