The end-stage renal disease phosphorous dilemma

Published on Thursday, 18 December 2008 04:59PM CST by Michael Fraase in ESRD

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RenagelCo-morbidities of end-stage renal disease (permanent kidney failure) are one of the more complicated elements of the disease. One of the first things medical professionals tell kidney failure patients—usually right after telling them that the disease is incurable—is that they’re unlikely to die from kidney failure, but highly likely to die from something else; one of the many co-morbidities. As I’ve said before, Robert Hunter was more correct than he knew when he wrote, “if the thunder don’t get you, then the lightning will.”

Hyperphosphataemia—high levels of phosphorous in the blood chemistry—is one of those co-morbidities. Hyperphosphataemia is a known contributory factor for increased risk of cardiac problems and death in kidney failure patients. Specifically, it’s responsible for vascular calcification, cardiac interstitial fibrosis, and arterial thickening. And yes, they’re as bad as they sound; they all “highly increase the risk of cardiac death.”

Cardiac death is to be avoided if at all possible.

Hyperphosphataemia is also a contributory factor of bone loss.

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