First, if the concentration for serum calcium remains at an optimum level (10mg/dL), the product of calcium and phosphorus increases due to the rise of serum phosphorus. If the product is over 70, the risk of metastatic calcification increases greatly. Hence, it is the priority to control the serum phosphorus level before patients replenish the calcium and use the vitamin D.
Second, high serum phosphorus decreases serum calcium, which stimulates the excessive secretion of parathyroid hormone.
Third, high serum phosphorus suppresses the activity of vitamin D3, which cause serious deficiency of active vitamin D.
The main causes to influence serum phosphorus concentration include: phosphorus content absorbed through diet; absorption ability of intestinal tract to phosphorus; the application of vitamin D and phosphorus combination agent; time, frequency and effect to take dialysis, and situation for residual renal function.
How to control the high status of phosphorus in renal failure patient?
For the treatment of high serum phosphorus, we need to consider below aspects:
First, patient with Chronic Kidney Disease should control the phosphorus absorption from the diet. But it influences other nutrition’s absorption if the control is too much. Generally, each person do not absorb over 1.2g phosphorus every day.
Second, patients with Chronic Kidney Disease can use phosphorus combination agent. In past, Al-P combination agent was used, which might cause Al poisoning and rarely use nowadays. The popular is Ca-P combination agent nowadays, like calcium carbonate, calcium acetate, calcium lactate, and calcium gluconate etc. Because calcium content in calcium carbonate is over 40 percent, which can decrease serum phosphorus, suppress parathyroid hormone secretion, not increase the product of Ca and P, contribute to the improvement of Al poisoning Osteopathy, and rectify the acid poisoning etc. Besides, it is cheap, so it is popular among doctors and patients. However, other Phosphorus combination agent has small amount of Calcium (8-13%), and only large dosages of it attains the treatment effect, which is not accepted by patients.
Moreover, phosphorus could pass the dialysis membrane freely, hence, add the dialysis frequency, expand the dialysis area, increase the dialysis time, augment the blood volume in dialysis, to take a sufficient dialysis is vital to decrease the serum phosphorus.
Therefore, it is requisite to control the level of serum phosphorus for dialysis patients. It is of great importance for the improvement of dialysis patient’s life quality and decreasing the occurrence of complications by taking assistant therapy constantly, for instance, adjust the diet, use adequate P-Ca combination agent and vitamin D. Certainly, if patients hope to get rid of these replacement approach, you can consult our online experts, and they can provide you professional analysis.
