VIDEO: Recent advancements in treatment of hyperphosphatemia

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Advances are really several. The knowledge is good. To understand that phosphorus, or hyperphosphatemia, is bad and it's associated with bad outcomes for the patients. It's associated with cardiovascular disease. And I think the awareness brings focus on the area to try to achieve better control. So there's a large variety of phosphate binders that are used and have been used over the years. There's no ideal one. Many patients take combinations of them trying to achieve this. But as I mentioned, it requires a large number of pills and they need to be taken at the time of the meal so that they can bind any phosphorus that's associated with the meal. And so it's a bit troublesome, and really this whole approach is causing difficulty in achieving control. But a big advance might be the recent understanding of the mechanisms of phosphate absorption. That's the way that phosphorus is absorbed from the intestine. And I think this has been a problem because it was studied in some detail, obviously in animals, but that turns out not to be perhaps quite the same way as it works in humans. So there's transporters, proteins that move phosphorus from the intestine into the bloodstream. And they've been the focus really of how phosphorus is absorbed. But there may be another pathway where phosphorus moves between the cells, and this provides another potential mechanism to target. So I think with increased understanding of the mechanisms involved in how phosphorus is absorbed may ultimately lead to new targets and new mechanisms that can be targeted with new drugs to try to limit the amount of phosphorus that actually enters the body. So hopefully this will turn out to be helpful.