Phosphatbinder
Tóm tắt
Hyperphosphatämie ist ein typischer Befund im Endstadium chronischer Nierenerkrankungen („chronic kidney disease“, CKD). Präklinische und Beobachtungsstudien weisen überzeugend und nachdrücklich darauf hin, dass die Hyperphosphatämie unmittelbar pathogenetisch bedeutsam ist für kardiovaskuläre Komplikationen, insbesondere für das Auftreten progressiver Gefäß- und Weichteilverkalkungen, sowie für die Gesamt- und die kardiovaskuläre Mortalität dieser Population. Insofern spielt das adäquate Management des Phosphathaushalts derzeit eine zentrale Rolle bei der Behandlung von CKD-Patienten. Neben diätetischer Phosphatrestriktion und Modifikationen des Dialyseregimes kommen hier in erster Linie Phosphatbinder zum Einsatz. Diese Übersichtsarbeit fokussiert auf die Therapierationale der Hyperphosphatämie, auf die Stärken und Limitationen der verfügbaren Phosphatbinder, auf neue Erkenntnisse zur Phosphatregulation und auf deren Konsequenzen für zukünftige Therapiestrategien sowie auf potenziell neue Behandlungsansätze.
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