Progress in pharmacotherapy for the treatment of hyperphosphatemia in renal failure

Cernaro, Valeria; Longhitano, Elisa; Calabrese, Vincenzo; Casuscelli, Chiara; Di Carlo, Silvia; Spinella, Claudia; Gembillo, Guido; Santoro, Domenico

doi:10.1080/14656566.2023.2243817

Cited by 5 publications

(6 citation statements)

References 91 publications

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“…As CKD progresses, dietary restrictions alone may become insufficient, 34 hence phosphate binders emerge as pivotal components of the therapeutic strategy. 35 These medications operate within the gastrointestinal tract, binding dietary phosphorus and impeding its absorption. 36 While calcium-based binders like calcium carbonate or calcium acetate are conventionally employed, the choice may shift towards non-calcium-based alternatives, such as sevelamer or lanthanum carbonate, particularly in patients with hypercalcaemia or those at risk for vascular calcification.…”

Section: Currently Available Drugs In the Treatment Of Hyperphosphata...mentioning

confidence: 99%

“…39,40 An emerging and promising class of phosphate binders involves iron-based compounds devoid of calcium, namely sucroferric oxyhydroxide and ferric citrate. 35 These binders not only effectively control phosphate levels but also address concurrent issues of anaemia and iron deficiency frequently encountered in CKD patients. 41 Main potential adverse effects of the iron-based phosphate-lowering agents are discoloured tools and mild and transitory diarrhoea.…”

Section: Currently Available Drugs In the Treatment Of Hyperphosphata...mentioning

confidence: 99%

“…41 Main potential adverse effects of the iron-based phosphate-lowering agents are discoloured tools and mild and transitory diarrhoea. 35 The landscape of phosphate binder efficacy is complex and influenced by various factors. Comparative studies have produced diverse results, with some indicating potential benefits of non-calcium-based binders, like lanthanum carbonate, especially concerning coronary artery calcification and cardiovascular outcomes.…”

Section: Currently Available Drugs In the Treatment Of Hyperphosphata...mentioning

confidence: 99%

Section: Currently Available Drugs In the Treatment Of Hyperphosphata...mentioning

confidence: 99%

“… 41 Main potential adverse effects of the iron-based phosphate-lowering agents are discoloured tools and mild and transitory diarrhoea. 35 …”

Section: Currently Available Drugs In the Treatment Of Hyperphosphata...mentioning

confidence: 99%

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Hyperphosphatemia in Chronic Kidney Disease: The Search for New Treatment Paradigms and the Role of Tenapanor

Cernaro,

Longhitano,

Casuscelli

et al. 2024

IJNRD

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Hyperphosphataemia represents a significant challenge in the management of chronic kidney disease, exerting a pronounced influence on the pathogenesis of cardiovascular complications and mineral bone disorders. Traditional approaches to address hyperphosphataemia involve implementing dietary phosphate restrictions, administering phosphate binders, and, in cases of end-stage renal disease, resorting to dialysis. Unfortunately, these interventions frequently prove inadequate in maintaining phosphate levels within recommended ranges. Additionally, commonly employed pharmacological agents are not immune to eliciting adverse events, thereby limiting their prescription and therapeutic adherence. There is a growing focus on exploring novel therapeutic strategies in this context. The current discussion centres on tenapanor, a pharmacological agent predominantly acting as a selective inhibitor of sodium/hydrogen exchanger isoform 3 (NHE3). Its mechanism of action involves modulating tight junctions, resulting in reduced sodium absorption and intestinal paracellular permeability to phosphate. Furthermore, tenapanor downregulates sodiumdependent phosphate 2b transport protein (NaPi2b) expression, thereby impeding active transcellular phosphate transport. Clinical trials have elucidated the efficacy and safety profile of tenapanor. This evidence hints at a potential paradigm shift in the management of hyperphosphataemia. However, the burgeoning optimism surrounding tenapanor warrants tempered enthusiasm, as further research remains indispensable. The imperative lies in meticulously delineating its efficacy and safety contours within the crucible of clinical practice. In this review, we synthesize the intricate interplay between hyperphosphataemia and Chronic Kidney Disease-Mineral Bone Disorder, and we discuss the existing pharmacological interventions for hyperphosphataemia and explore emerging treatment paradigms that offer novel perspectives in managing elevated phosphate levels in CKD patients.

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Section: Currently Available Drugs In the Treatment Of Hyperphosphata...mentioning

confidence: 99%

Section: Currently Available Drugs In the Treatment Of Hyperphosphata...mentioning

confidence: 99%

Section: Currently Available Drugs In the Treatment Of Hyperphosphata...mentioning

confidence: 99%

Section: Currently Available Drugs In the Treatment Of Hyperphosphata...mentioning

confidence: 99%

“… 41 Main potential adverse effects of the iron-based phosphate-lowering agents are discoloured tools and mild and transitory diarrhoea. 35 …”

Section: Currently Available Drugs In the Treatment Of Hyperphosphata...mentioning

confidence: 99%

See 3 more Smart Citations

Hyperphosphatemia in Chronic Kidney Disease: The Search for New Treatment Paradigms and the Role of Tenapanor

Cernaro,

Longhitano,

Casuscelli

et al. 2024

IJNRD

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Role of osteokines in atherosclerosis

Liu,

Tian,

Chen

et al. 2024

Cell Biochemistry & Function

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Despite their diverse physiologies and roles, the heart, skeletal muscles, and smooth muscles all derive from a common embryonic source as bones. Moreover, bone tissue, skeletal and smooth muscles, and the heart share conserved signaling pathways. The maintenance of skeletal health is precisely regulated by osteocytes, osteoblasts, and osteoclasts through coordinated secretion of bone‐derived factors known as osteokines. Increasing evidence suggests the involvement of osteokines in regulating atherosclerotic vascular disease. Therefore, this review aims to examine the evidence for the role of osteokines in atherosclerosis development and progression comprehensively. Specifically discussed are extensively studied osteokines in atherosclerosis such as osteocalcin, osteopontin, osteoprotegerin, and fibroblast growth factor 23. Additionally, we highlighted the effects of exercise on modulating these key regulators derived from bone tissue metabolism. We believe that gaining an enhanced understanding of how osteocalcin contributes to the process of atherosclerosis will enable us to develop targeted and comprehensive therapeutic strategies against diseases associated with its progression.

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Efficacy and safety of tenapanor vs placebo in treating CKD patients on dialysis and with hyperphosphatemia: a systematic review and meta-analysis of 2251 patients

Abo Elnaga,

Serag,

Alsaied

et al. 2024

Int Urol Nephrol

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Progress in pharmacotherapy for the treatment of hyperphosphatemia in renal failure

Cited by 5 publications

References 91 publications

Hyperphosphatemia in Chronic Kidney Disease: The Search for New Treatment Paradigms and the Role of Tenapanor

Hyperphosphatemia in Chronic Kidney Disease: The Search for New Treatment Paradigms and the Role of Tenapanor

Role of osteokines in atherosclerosis

Efficacy and safety of tenapanor vs placebo in treating CKD patients on dialysis and with hyperphosphatemia: a systematic review and meta-analysis of 2251 patients

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