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Should we be using calcium-containing phosphate binders in patients on dialysis?

Nature Clinical Practice Nephrology volume 4, pages 118–119 (2008)Cite this article

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Few areas related to the care of patients on dialysis have generated more controversy than the use of phosphate binders. The current debate regarding use of calcium-based versus non-calcium-based phosphate binders has arisen because of the lack of definitive randomized trials in this setting, coupled with the expense of newer therapies relative to the accepted standard of care. In this Viewpoint, we hope to frame this subject in a new way that might help guide clinical practice.

Proof of efficacy and safety is required before a new therapy can replace standard practice. In general, such proof requires randomized controlled trials; observational or animal studies are never adequate to dictate a change in therapy. Even studies measuring surrogate end points must be viewed with caution, as improvements in such end points often fail to translate into improvements in actual clinical outcomes.

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Author information

Authors and Affiliations

  1. DM Spiegel is Professor of Medicine in the Division of Renal Diseases and Hypertension at the University of Colorado Health Sciences Center, Denver, CO, USA.,

    David M Spiegel

  2. GA Block is Director of Research at Denver Nephrologists, Denver, CO, USA.,

    Geoffrey A Block

Authors
  1. David M Spiegel
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  2. Geoffrey A Block
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Corresponding author

Correspondence to David M Spiegel.

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Competing interests

DM Spiegel has received grant support from Genzyme and is on the speakers' bureau for Genzyme. GA Block has received grant support from Genzyme and is an advisor and consultant to Genzyme.

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Spiegel, D., Block, G. Should we be using calcium-containing phosphate binders in patients on dialysis?. Nat Rev Nephrol 4, 118–119 (2008). https://doi.org/10.1038/ncpneph0710

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  • DOI: https://doi.org/10.1038/ncpneph0710

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