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Nephrol Dial Transplant (2000) 15: 1738-1742
© 2000 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

Managing phosphate retention: is a change necessary?

Editor's note Please see also Letter to the Editor by F. Eifinger et al. pp. 1892–1894.

Isidro B. Salusky1, and William G. Goodman2

1 Department of Pediatrics and 2 Department of Medicine, UCLA School of Medicine, Los Angeles, California, USA

Introduction

Cardiovascular disease accounts for half the deaths in adults treated with maintenance dialysis, and mortality from cardiovascular causes is far higher than that in the general population [1,2]. Contributing factors include sodium and water overload, hypertension, diabetes mellitus, alterations in lipid metabolism and elevated levels of homocysteine in serum [3–8]. Despite considerable progress over the last two decades in the management of these and other traditional cardiovascular risks, the mortality rate from cardiovascular causes has not diminished in patients with end-stage renal disease (ESRD) [9]. Indeed, cardiovascular mortality for those treated with dialysis continues to far exceed that predicted from the combined risks attributable to age, sex, systolic blood pressure, left ventricular hypertrophy, serum total and HDL cholesterol, cigarette smoking and diabetes mellitus [10]. Other factors are likely, therefore, to account for the high incidence of cardiovascular death . . . [Full Text of this Article]

Disturbances of calcium and phosphate metabolism and cardiovascular morbidity

Soft-tissue calcifications in patients with renal failure

Calcification of atherosclerotic plaques

Arterial calcifications in dialysis patients and the role of oral calcium intake

Importance of controlling phosphate retention

The use of phosphate-binding agents

Potential value of new aluminium- and calcium-free phosphate binding agents and vitamin D derivatives

Acknowledgments

Notes

References


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