The Curious Clinicians 85 - NephMadness 2024
Mar 5, 2024
Dr. Jeff Kott, a nephrology specialist, discusses phosphate binders in acute kidney injury and the usefulness of urine anion gap in non-gap metabolic acidosis. The podcast explores NephMadness 2024 and the impact of TWDFNR practices on patient care. It delves into the debate on nephrology selections, patient-centered AKI treatment options, and emphasizes informed decision-making in nephrology.
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Hyperphosphatemia in CKD Explained
- Hyperphosphatemia mainly arises from high phosphate intake plus impaired kidney phosphate clearance.
- Fibroblast growth factor 23 (FGF23) rises first in CKD before parathyroid hormone and hyperphosphatemia.
Harms of Hyperphosphatemia
- Hyperphosphatemia triggers adverse effects like abnormal bone remodeling and cardiovascular risks.
- It worsens acidosis and inflammation, impacting overall patient outcomes negatively.
Phosphate Control in CKD
- CKD treatment aims to lower phosphate toward normal to prevent vascular calcification.
- Phosphate binders help reduce phosphate but their effect on outcomes remains unclear.