Phosphate Frustration: Treatment Options to Complement Current Therapies

Figure 3

Only a small proportion of dietary phosphate is addressed by binders and dialysis [23, 25, 27, 44–46, 52–55]. Phosphate binders and dialysis can address ∼730 mg of phosphate per day (for example, an average of 300 mg/day of phosphorus binding was used for binders and not the potential maximum of 400 mg/day). However, this is far less than the mean daily dietary phosphate consumption in the US (∼1400 mg), particularly for diets high in phosphate additives, which can add ∼1,100 mg phosphate. Therefore, over 1,000 mg phosphate per day may not be addressed by binders and dialysis, increasing the risk of hyperphosphatemia and associated negative clinical outcomes. A net neutral phosphate balance can be achieved if patients strictly follow the guideline-recommended restricted phosphate intake and avoid most phosphate additives.