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Calcium-based Phosphate Binder is Outdated in Current Era

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Dr Brig A Jairam, Kolkata    02 December 2019

  • Concerns of higher cardiovascular and all-cause mortality using calcium-based phosphate binders are based on studies that have methodological flaws. There is lot of heterogeneity in results of similar studies. Even analysis of the same data has yielded different conclusions.
  • Hence, even KDIGO guidelines of 2017 have suggested “restrict” use of calcium-based phosphate binders.
  • Use of non-calcium-based phosphate binders increases the cost of phosphate binder therapy by 20-fold and increases the financial burden on patients.
  • Till robust data is generated, it would be incorrect to conclude that calcium-based phosphate binders are outdated.
  • It would be prudent to continue use of calcium-based phosphate binder with adequate precaution, avoiding hypercalcemia and oversuppression of parathyroid hormone (PTH).

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