VIDEO: Unmet needs of patients with hyperphosphatemia

Editor’s note: This is an automatically generated transcript. Please notify iwaters@healio.com if there are concerns regarding accuracy of the transcription.

I think the biggest is we don't have good outcomes trial data to support many of the actions that we take. There is the ongoing hypothesis that high phosphorus is a major contributor to the rapid progression of cardiovascular disease that claims the lives of more than half of our dialysis patients. That's a great hypothesis, and it's difficult to have trials to answer that, but there are attempts.

I'm an old nephrologist and I've been around when we didn't control phosphorus, and we didn't treat [parathyroid hormone] PTH, and people had horrible bone disease and severe hyperparathyroidism. And my concern about these trials that are randomizing patients to relatively poor phosphorus control, say about 6.5 [mg/dL], to better phosphorus control, say less than 5 [mg/dL], is if they don’t show an improvement in cardiovascular benefit, people may misinterpret that, that it’s not effective for controlling PTH and helping with bone disease.

The animal studies are indisputable in this, and there's no reason to think humans are any different. We need more data in this area to educate patients and give them reliable information so they can make a choice whether they want to take all of these medications and what the benefit is [that] they're going to get. But I don't want to see us lose sight of the fact that phosphate control does play a major role in bone health.