Is serum phosphate a useful target in patients with chronic kidney disease and what is the role for dietary phosphate restriction?
Nigel D Toussaint, Stephen G Holt
NEPHROLOGY | WILEY | Published : 2017
A complex system of endocrine and paracrine signals exists to control phosphate balance. Dysregulation of these systems in patients with chronic kidney disease has serious clinical consequences. Whilst observational studies have shown associations between higher serum phosphate levels and poor clinical outcomes, the direction of causality has not been demonstrated. Whether there is a target level of serum phosphate remains controversial and no randomized trials to date have proved that strategies to lower extracellular phosphate actually improve clinical outcomes. Serum phosphate provides only a partial measure of overall phosphate balance and, importantly, calcification risk. Changes in die..View full abstract