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Blood phosphate above ~5.5 mg/dL - a CKD mineral-bone disorder driver that accelerates vascular calcification and bone disease.
Hyperphosphatemia occurs when kidneys lose the ability to excrete phosphate. Persistently high phosphate drives vascular calcification (stiffening arteries and raising cardiovascular death risk), secondary hyperparathyroidism, and renal osteodystrophy. Management: dietary phosphate restriction (especially phosphate additives in processed foods, which are absorbed almost completely), phosphate binders taken with every meal, and adequate dialysis. The KDIGO goal is to keep phosphate in the normal range; the target is roughly 3.5-5.5 mg/dL for dialysis patients.
Overactive parathyroid glands caused by kidney failure — driven by low vitamin D, high phosphate, and low calcium — damaging bones and vessels if untreated.
Bone disease caused by chronic kidney disease — abnormal bone turnover from calcium, phosphate, vitamin D, and PTH disturbances.
A medication taken with meals that binds dietary phosphate in the gut so it is not absorbed - the cornerstone of phosphate control in advanced CKD.
A progressive condition characterized by gradual loss of kidney function over months or years, classified into 5 stages based on eGFR.
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