Hyperphosphatemia Medication Choices

Question 1

What kind of medications should be used to treat hyperphosphatemia in ESRD patients?

Answer 1

Phosphate binders

Question 2

How do phosphate binders work?

Answer 2

Bind dietary phosphate ingested in food to prevent it from being absorbed by the body, and then are eliminated in the feces.

Question 3

When should phosphate binders be taken?

Answer 3

WITH MEALS

Question 4

What are the two calcium containing phosphate binders?

Answer 4

Calcium carbonate (TUMS)
Calcium acetate (PhosLo)

Question 5

What is the dosing of Calcium carbonate (TUMS)?

Answer 5

500mg of elemental Ca three times daily with meals

Question 6

What is the dosing of Calcium acetate (PhosLo)?

Answer 6

2-3 tablets three times daily with meals

Question 7

What is the maximum amount of Ca that should be given per day?

Answer 7

1500mg/day

Question 8

What is the issue with using calcium containing phosphate binders?

Answer 8

They contribute to the soft-tissue calcification problem since they add more calcium into the blood where it is able to interact with phosphorus

Question 9

What is the preferred non-calcium containing phosphate binder?

Answer 9

Sevelamer carbonate (Renvela)

Question 10

What are some of the benefits to using Sevelamer?

Answer 10

-Decreases uric acid!
-Decreases LDL by 15-30%
-Has been tested at high doses and is shown to be safe
-No calcium

Question 11

What is the dosing of sevelamer?

Answer 11

If phos > 5.5 but < 7.5 mg/dL : 800mg tid
If phos > or = 7.5mg/dL: 1600mg tid

Question 12

What are the two iron containing phosphate binders?

Answer 12

-Sucroferric oxyhydroxide (Velphoro)
-Auryxia (Ferric citrate)

Question 13

Which iron-containing phosphate binder DOES have an effect on iron stores in the blood?

Answer 13

Auryxia (ferric citrate)