Phosphorus balance in ESRD management—the challenges of diet and dialysis
Adequate protein nutrition can come at the expense of controlling phosphorus1
Phosphorus balance can be an ongoing challenge in ESRD, because phosphate content in food is closely
related to protein content2
- Providing adequate dietary protein may increase phosphate intake2
Even with KDOQI-recommended dietary phosphorus intake, there is a compelling need for phosphate reduction in dialysis patients
Phosphate binders are a treatment option in the management of positive phosphorus balance6,7
See results from clinical studies with FOSRENOL
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Important Safety Information
- FOSRENOL is contraindicated in patients with bowel obstruction, ileus, and fecal impaction.
- Serious cases of gastrointestinal obstruction, ileus, subileus, gastrointestinal perforation, and fecal impaction have been reported in patients taking lanthanum, some requiring surgery or hospitalization. Risk factors for gastrointestinal obstruction and perforation include altered gastrointestinal anatomy, hypomotility disorders, and concomitant medications.
- Instruct patients to chew or crush the tablet completely to reduce the risk of serious adverse gastrointestinal events. Patients with poor dentition, or those who have difficulty chewing tablets may be prescribed the oral powder or advised to crush the tablet completely. Advise patients to take FOSRENOL with or immediately after meals.
- Patients with acute peptic ulcer, ulcerative colitis, Crohn’s disease, or bowel obstruction were not included in FOSRENOL clinical studies.
- FOSRENOL has radio-opaque properties and may give the appearance typical of an imaging agent during abdominal X-ray procedures.
- The most common adverse reactions seen with FOSRENOL in clinical trials included nausea, vomiting, diarrhea, and abdominal pain.
There is potential for FOSRENOL to interact with:
These concomitant medications should be dosed separately from FOSRENOL to avoid drug interactions. See the Full Prescribing Information for dosing recommendations.
||compounds that bind to cationic antacids (i.e., aluminum-, magnesium-, or calcium-based)
||oral quinolone antibiotics
||thyroid hormone replacement therapy
- FOSRENOL is Pregnancy Category C. FOSRENOL is not recommended for use during pregnancy. It is not known whether FOSRENOL is excreted in human milk. Use caution when prescribing FOSRENOL to a nursing woman.
- The safety and efficacy of FOSRENOL in pediatric patients have not been established. The use of FOSRENOL in this population is not recommended.
FOSRENOL is indicated to reduce serum phosphate in patients with end stage renal disease (ESRD).
Please click here for Full Prescribing Information.
References: 1. Shinaberger CS, Greenland S, Kopple JD, et al. Is controlling phosphorus by decreasing dietary protein intake beneficial or harmful in individuals with chronic kidney disease? Am J Clin Nutr. 2008;88:1511-1518. 2. Boaz M, Smetana S. Regression equation predicts dietary phosphorus intake from estimate of dietary protein intake. J Am Diet Assoc.1996;96:1268-1270. 3. K/DOQI Clinical Practice Guidelines for Nutrition in Chronic Renal Failure. Am J Kidney Dis. 2000;35(suppl 2):S17-S104. 4. Eknoyan G, Levin A, Levin NW; for the National Kidney Foundation. K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis. 2003;42(suppl 3):S1-S201. 5. Ramirez JA, Emmett M, White MG, et al. The absorption of dietary phosphorus and calcium in hemodialysis patients. Kidney Int. 1986;30:753-759. 6. Salusky IB, Goodman WG. Managing phosphate retention: is a change necessary? Nephrol Dial Transplant. 2000;15:1738-1742. 7. Finn WF. Phosphorus management in end-stage renal disease. Semin Dial. 2005:18:8-12.
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