Abstract

NEGRI, Armando Luis. New therapeutic strategies to treat hyperphosphatemia in CRF: focus on intestinal absorption. Rev. nefrol. dial. traspl. [online]. 2023, vol.43, n.1, pp.8-8. ISSN 2346-8548.

Management of hyperphosphatemia in patients with chronic renal failure on dialysis remains challenging. Despite using a multifaceted approach that includes dietary restriction, phosphorus removal by dialysis, and phosphate binders, these multiple strategies fail to reduce phosphorus levels by more than 2 mg/dL. Phosphorus control in dialysis patients is essential due to the monotonic relationship between serum phosphate levels and increased cardiovascular risk. Therefore, there is a need to explore new strategies to reduce serum phosphate levels to normal levels. Recent advances in understanding the mechanisms underlying phosphorus homeostasis suggest that the gastrointestinal transport of phosphorus could be a target. Inhibitors of intestinal sodium phosphate cotransporters recently developed, and using of nicotinamide, in its prolonged release formulation, which would also act by this mechanism, has been revalued. There have also been drugs such as tenapanor, which, by inhibiting the isoform three sodium/hydrogen exchanger of the enterocyte, decreases the paracellular absorption of phosphorus.

Keywords : hyperphosphatemia; intestinal absorption of phosphorus; nicotinamide; tenapanor; Sodium/phosphate cotransporter.

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