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Management of hyperphosphatemia in chronic kidney disease

Michael Berkoben, MD
L Darryl Quarles, MD
Section Editor
Jeffrey S Berns, MD
Deputy Editor
Alice M Sheridan, MD


The tendency toward phosphate retention develops early in chronic kidney disease (CKD) due to the reduction in the filtered phosphate load. Overt hyperphosphatemia develops when the estimated glomerular filtration rate (eGFR) falls below 25 to 40 mL/min/1.73 m2 [1-3].

Hyperphosphatemia has been associated with increased mortality and morbidity [4-10].

This topic reviews recommendations regarding target phosphate concentration and treatment options for hyperphosphatemia for CKD patients.

Recommended goals for serum parathyroid hormone (PTH) concentration for patients with CKD are discussed elsewhere. (See "Management of secondary hyperparathyroidism in dialysis patients", section on 'Treat high parathyroid hormone'.)

Mechanisms underlying the physiologic response to phosphate retention are discussed elsewhere. (See "Overview of chronic kidney disease-mineral and bone disorder (CKD-MBD)".)

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Literature review current through: Dec 2017. | This topic last updated: Dec 06, 2017.
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