Study found that hyperphosphatemia can interfere with the efficacy of kidney medicines

It is reported that hyperphosphatemia can place patients with chronic kidney disease (CKD) on the fast track to renal failure according to a study published in the upcoming "Journal of the American Society NePHrology" (JASN). . To make matters worse, phosphate may interfere with the effectiveness of important kidney medicines.

The kidneys of patients with CKD cannot effectively remove waste, such as excessive phosphate in the blood. As a result, the kidneys become overloaded with phosphate. Dr. Carmine Zoccali (CNR-IBIM, Clinical Epidemiology and Pathophysiology of Nephrology and Hypertension, University of Reggio Calabria, Italy) and his colleagues wanted to know how phosphate overload affects the kidneys of patients with chronic kidney disease. They also want to know if phosphate overload can change the effect of ramipril, a drug that can slow the progression of kidney disease. (The use of ramipril and other generic drugs represents the current standard of care for CKD patients.)

The researchers studied the health information of 331 CKD patients and divided them into four groups based on their phosphate levels.

The main result is:

• Patients in the two highest phosphate levels had faster progression to severe renal insufficiency or renal failure than those with lower phosphate levels, even if their blood phosphate levels were still normal or nearly normal.

• Higher phosphate levels reduce the benefits of Ramipril.

These results indicate that phosphate levels can predict which CKD patients are progressing to serious problems of renal failure. They also suggest that high phosphate levels can interfere with the effects of important kidney medicines.

Further studies should test whether reducing phosphate levels can improve kidney health and optimize patient medication. Dr. Zoccali said: "Our research has opened exciting possibilities for reducing phosphates through diet or drug treatment, which may enhance the response of certain CKD patients to certain drugs. If our results are in a new clinical The trials can be replicated and interventions aimed at reducing phosphate levels will be a relevant step in the fight against these dangerous kidney diseases."

Co-authors of the study include Piero Ruggenenti MD, Annalisa Perna, Giuseppe Remuzzi MD, FRCP (Mario Negri Pharmacology Institute, Italy); CNR-IBIM (Department of Epidemiology and Pathophysiology of Renal Diseases and Hypertension, University of Reggio Calabria, Italy) Dr Daniela Leonardis MD, Rocco Tripepi, Giovanni Tripepi, and Dr Francesca Mallamaci.