What does the research indicate about hyperphosophatemia in chronic kidney disease? (2001 CD)
Hyperphosphatemia and the associated conditions begin to appear as GFR declines <60 ml/min. Hyperphosphatemia, elevated parathyroid hormone (PTH), secondary hyperparathyroidism with depressed serum calcium and vitamin D deficiency are metabolic disturbances that require early detection and treatment to prevent bone disease of chronic hyperparathryoidism, and to minimize the increased risk for cardiovascular disease. Evaluating, preventing and monitoring hyperparathyroidism requires data on serum calcium, serum phosphate and intact-PTH. Treatment needs to be individualized and may include dietary phosphate restriction and/or phosphate binders and calcium and vitamin D supplementation and self-management training. Dietary phosphorus intakes are correlated with dietary protein intakes; therefore diets restricted in protein are also lower in phosphorus.
- Grade I means there is Good/Strong evidence supporting the statement;
- Grade II is Fair;
- Grade III is Limited/Weak;
- Grade IV is Expert Opinion Only;
- Grade V is Not Assignable.
- High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
- Moderate (B) means we are moderately confident in the effect estimate;
- Low (C) means our confidence in the effect estimate is limited;
- Very Low (D) means we have very little confidence in the effect estimate.
- Ungraded means a grade is not assignable.