Academic Journal
Novel therapeutic approaches for phosphate regulation.
| Τίτλος: | Novel therapeutic approaches for phosphate regulation. |
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| Συγγραφείς: | Alzyood L; Department of Medicine, Nephrology Division, Montefiore Medical Center., Chen W; Department of Medicine, Nephrology Division, Montefiore Medical Center.; Department of Medicine, Nephrology Division, Albert Einstein College of Medicine.; Department of Developmental and Molecular Biology, Albert Einstein College of Medicine.; Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, Bronx, New York, USA. |
| Πηγή: | Current opinion in nephrology and hypertension [Curr Opin Nephrol Hypertens] 2026 Sep 01; Vol. 35 (5), pp. 491-497. Date of Electronic Publication: 2026 May 15. |
| Τύπος έκδοσης: | Journal Article; Review |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Lippincott Williams & Wilkins Country of Publication: England NLM ID: 9303753 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1473-6543 (Electronic) Linking ISSN: 10624821 NLM ISO Abbreviation: Curr Opin Nephrol Hypertens Subsets: MEDLINE |
| Imprint Name(s): | Publication: London : Lippincott Williams & Wilkins Original Publication: Philadelphia, Pa : Current Science, c1992- |
| Ιατρικοί όροι (MeSH): | Hyperphosphatemia*/drug therapy , Hyperphosphatemia*/blood , Hyperphosphatemia*/etiology , Phosphates*/blood , Renal Insufficiency, Chronic*/blood , Renal Insufficiency, Chronic*/complications , Renal Insufficiency, Chronic*/therapy , Chelating Agents*/therapeutic use , Chelating Agents*/adverse effects, Lanthanum/therapeutic use ; Biomarkers/blood ; Isoquinolines/therapeutic use ; Isoquinolines/adverse effects ; Intestinal Absorption/drug effects ; Humans ; Animals ; Treatment Outcome ; Sulfonamides |
| Περίληψη: | Purpose of Review: Hyperphosphatemia in chronic kidney disease (CKD) is associated with vascular calcification and increased mortality. Despite widespread use of phosphate binders, treatment of hyperphosphatemia remains challenging and controversy persists regarding the optimal serum phosphate targets. This review summarizes recent clinical and experimental studies of phosphate-lowering therapies in CKD. Recent Findings: To define the optimal phosphate target, the Pragmatic Trial of Higher vs. Lower Serum Phosphate Targets in Patients Undergoing Hemodialysis (HiLo) trial was conducted but was terminated early and underpowered. Oxylanthanum carbonate is a new lanthanum-based agent with phosphate-binding efficacy equivalent to lanthanum carbonate but smaller in pill size. Tenapanor, an inhibitor of paracellular phosphate transport, effectively lowers serum phosphate and reduces pill burden. AP306, formerly known as EOS789, an inhibitor of active transcellular phosphate transporters, lowers serum phosphate more effectively compared to sevelamer carbonate. As with existing phosphate binders, gastrointestinal side effects are common with these new phosphate-lowering agents. Lastly, synbiotic therapy modulates gut microbiota and reduces intestinal phosphate absorption in rats with CKD. Summary: Combining phosphate binders with agents that inhibit paracellular and transcellular intestinal phosphate absorption may improve the treatment of hyperphosphatemia while reducing pill burden in CKD. Defining optimal serum phosphate targets and the mortality benefits of phosphate lowering is essential to minimize treatment-related adverse effects. (Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved.) |
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| Grant Information: | R01 HL172073 United States HL NHLBI NIH HHS |
| Contributed Indexing: | Keywords: AP306; chronic kidney disease; hyperphosphatemia; oxylanthanum carbonate; phosphate binders; phosphate-lowering therapies; tenapanor |
| Substance Nomenclature: | 0 (Phosphates) 0 (Chelating Agents) 6I3K30563S (Lanthanum) WYD79216A6 (tenapanor) 0 (Biomarkers) 0 (Isoquinolines) 490D9F069T (lanthanum carbonate) 0 (Sulfonamides) |
| Entry Date(s): | Date Created: 20260514 Date Completed: 20260730 Latest Revision: 20260730 |
| Update Code: | 20260730 |
| DOI: | 10.1097/MNH.0000000000001191 |
| PMID: | 42130236 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1473-6543 |
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| DOI: | 10.1097/MNH.0000000000001191 |