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Please read carefully, as you will be asked questions regarding the following information.

The Critical Need to Treat Hyperphosphatemia

Hyperphosphatemia is a dire consequence of end-stage renal disease (ESRD) and is associated with an increase in morbidity and mortality.1,2

In large, cross-sectional studies of patients undergoing dialysis for a year or longer, the mean serum phosphorus level was 6.2 mg/dL—with 60% of patients having levels elevated above the current K/DOQI guideline of 5.5 mg/dL.2,3 The morbidities associated with hyperphosphatemia include secondary hyperparathyroidism, renal osteodystrophy, progression of chronic renal failure, and a predisposition to vascular and soft-tissue calcification.2

As shown in Figure 1, elevated serum phosphorus levels are associated with an increase in relative mortality risk. Compared to patients with serum phosphorus levels of 5.5 mg/dL or less, patients with serum phosphorus levels of 7.9 mg/dL or more had a 40% increase in relative mortality risk.2


Likewise, as shown in Figure 2, patients with Ca x P product levels between 73 and 132 mg2/dL2 had a significantly greater relative mortality risk than patients with Ca x P product levels between 43 and 52 mg2/dL2.2


However, this association of increased relative mortality risk did not hold true for increased serum calcium levels as shown in Figure 3.2


In sum, the mortality risk associated with elevated serum phosphorus levels and elevated Ca x P product levels is significant. As a result, it is essential to gain control of serum phosphorus levels and the Ca x P product.

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