5th April 2024

Management

In normal renal function, intravenous saline can facilitate renal elimination of excess phosphate. Dietary phosphate restriction and phosphate binders are used to avoid high phosphate levels in chronic hyperphosphatemia. Examples of phosphate binders include Sevelamer, Lanthanum carbonate, calcium carbonate and calcium acetate. 

Calcium based phosphate binders are most commonly prescribed as they also address hypocalcaemia which often accompanies hyperphosphataemia. However, the main concern is hypercalcaemia and accelerated vascular calcification, particularly when combined with vitamin D therapy. Non calcium based binders include Sevelamer and Lanthanum carbonate. A common side effect of phosphate binders is constipation. 

Haemodialysis may be indicated in severe cases of hyperphosphatemia with symptomatic hypocalcemia and impaired renal function.