This article brings you the highlights of 2016 from the COMPACT RENAL
team, relating specifically to the issue of mineral bone disease in chronic kidney disease.
Expert perspectives: the challenge of phosphate control
Professors Angel De Francisco and Laurent Juillard recorded a discussion of the potential solutions to the issue of hyperphosphatemia, including improving education and communication with physicians and patients regarding its significance, and the possibility of reducing pill burden.
In a two–part question and answer feature, Professor Fouque provided a more in depth look at the problems surrounding hyperphosphatemia. Part One covers the importance of phosphate binders, why patients fail to reach phosphate targets despite treatment, and the reasons behind poor adherence. In Part Two Professor Fouque discusses ways to help improve adherence and the potential impact of sucroferric oxyhydroxide.
News & views
Highlights from the selection of articles published by the COMPACT team include a summary of recent DOPPS data regarding pill burden. Dr Fissell and colleagues showed an association between greater pill burden and non-achievement of phosphate targets, but also the impact of non-compliance even at a low rate of 1-3 times a month.
The issue of adherence was addressed in another article summarising four studies. The range of factors behind non-adherence was examined by Ghimire et al, whilst Joson et al looked at the impact of intentional vs unintentional (simply forgetting) non-adherence on phosphorus levels. In order to identify patients at risk of poor compliance, Umeukeje et al assessed the use of a simple self-motivation questionnaire: greater motivation correlated with adherence and phosphate control. A study by Reese et al looked at creating motivation, and found a trend towards improved serum phosphate with provision of a financial incentive.
ERA-EDTA 2016 congress: advances in the management of hyperphosphatemia
At a satellite symposium at the 2016 ERA-EDTA Congress, Professor Philip Kalra presented data on the dangers of hyperphosphatemia, results from randomized controlled trials of phosphate binders, and new information on the iron-based binder, sucroferric oxyhydroxide.
In order to really understand the importance of managing hyperphosphatemia, the COMPACT team provided a downloadable presentation outlining the relationship between phosphate dysregulation and vascular calcification.