NEJM issue:It has a nice drug review on Oral Phosphate Binders in patients with kidney diseases.
It highlights the history of binders, cost differences and basic characteristics of types of binders
1. Ca based
2. Sevelamer family
3. Mg Based
5. Aluminium based
What was more fascinating is whats under development.
**Fermagate ( a new mg based binder)
**Colestilan ( non metallic anion exchange resin)
**Niacin and Nicotinamide
What is also interesting is the point that patients with advanced kidney diseases have elevated salivary phosphate concentration. And no matter what they eat, that gets absorbed. A study showed that chewing gum containing a novel chitosan compound was effective in lowering serum phosphate levels and salivary phosphate levels.
A good review for fellows!
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