Consequences of hyperphosphatemia and elevated levels of the calcium-phosphorus product in dialysis patients

Control of serum phosphorus levels is a central goal in the management of p atients with chronic renal failure. Inadequate control of serum phosphorus leads to elevated levels of the calcium-phosphorus product. This plays a pi votal role in vascular calcification, cardiovascular disease, calciphylaxis , and death. Elevated phosphorus and elevated levels of the calcium-phospho rus product are both significant predictors of cardiovascular mortality, at phosphorus and calcium-phosphorus product levels that were considered safe until recently. A lowering of levels such that phosphorus is maintained be tween 2.2 and 5.5 mg/dl calcium-phosphorus product is below 55 mg(2)/dl(2), and serum calcium is at 9.2-9.6 mi respectively, might well be the goal of therapeutic management strategies. Curr Opin Nephrol Hypertens 10:563-568. (C) 2001 Lippincott Williams & Wilkins.