Journal article

Can we IMPROVE cardiovascular outcomes through phosphate lowering in CKD? Rationale and protocol for the IMpact of Phosphate Reduction on Vascular End-points in Chronic Kidney Disease (IMPROVE-CKD) study

N Lioufas, ND Toussaint, E Pedagogos, G Elder, SV Badve, E Pascoe, A Valks, C Hawley, GA Block, NC Boudville, K Campbell, JD Cameron, SSM Chen, RJ Faull, SG Holt, LS Hooi, D Jackson, MJ Jardine, DW Johnson, PG Kerr Show all

BMJ Open | BMJ PUBLISHING GROUP | Published : 2019

Abstract

Introduction Patients with chronic kidney disease (CKD) are at heightened cardiovascular risk, which has been associated with abnormalities of bone and mineral metabolism. A deeper understanding of these abnormalities should facilitate improved treatment strategies and patient-level outcomes, but at present there are few large, randomised controlled clinical trials to guide management. Positive associations between serum phosphate and fibroblast growth factor 23 (FGF-23) and cardiovascular morbidity and mortality in both the general and CKD populations have resulted in clinical guidelines suggesting that serum phosphate be targeted towards the normal range, although few randomised and placeb..

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University of Melbourne Researchers