Document Detail


Phosphate handling in CKD-MBD from stage 3 to dialysis and the three strengths of lanthanum carbonate.
MedLine Citation:
PMID:  23033914     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: High phosphate levels are associated with unfavorable outcomes in ESRD. Recent data suggested that phosphate levels within the normal range are equally associated with poor outcomes in the community and CKD stage 3 - 4. Several concept papers support the potential role of phosphate load as a first-line toxin in the beginning of CKD-MBD processes via the activation of FGF23 cascade. Phosphate load is thereafter involved in the progression of vascular calcification (VC) and bone disorder typical of CKD-MBD.
AREAS COVERED: Herein the authors cover the recent evidence on the pathophysiology of phosphate handling through the natural history of CKD, with particular emphasis on FGF23 cascade, its potential surrogate markers, VC and bone disorder. The major characteristics of lanthanum carbonate are therefore discussed, focusing on its potential advantages for the treatment of difficult cases in CKD-MBD.
EXPERT OPINION: Lanthanum carbonate, being the most potent calcium-free phosphate binder available in clinical practice, could be decisive for those cases where controlling phosphate load is complicated by poor compliance to medications, stubborn high phosphorus intake, extended VC and bone disorders.
Authors:
Mario Cozzolino; Elena Bruschetta; Daniele Cusi; Emanuele Montanari; Maria Enrica Giovenzana; Andrea Galassi
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Publication Detail:
Type:  Journal Article; Review     Date:  2012-10-04
Journal Detail:
Title:  Expert opinion on pharmacotherapy     Volume:  13     ISSN:  1744-7666     ISO Abbreviation:  Expert Opin Pharmacother     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-16     Completed Date:  2013-03-05     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  100897346     Medline TA:  Expert Opin Pharmacother     Country:  England    
Other Details:
Languages:  eng     Pagination:  2337-53     Citation Subset:  IM    
Affiliation:
Renal Division and Laboratory of Experimental Nephrology, Dipartimento di Scienze della Salute, Università di Milano,S. Paolo Hospita, Via A. di Rudinì 8, Milan, Italy. mario.cozzolino@unimi.it
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MeSH Terms
Descriptor/Qualifier:
Animals
Bone Diseases, Metabolic / drug therapy*,  metabolism
Fibroblast Growth Factors / metabolism
Humans
Lanthanum / administration & dosage*
Phosphates / metabolism*
Renal Dialysis
Renal Insufficiency, Chronic / drug therapy*,  metabolism
Chemical
Reg. No./Substance:
0/Phosphates; 0/fibroblast growth factor 23; 0/lanthanum carbonate; 62031-54-3/Fibroblast Growth Factors; 7439-91-0/Lanthanum

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