Publications

Abstract

This is the protocol for a review and there is no abstract. The objectives are as follows: 1.The efficacy of the available aluminium salts, calcium salts, sevelamer hydrochloride, lanthanum carbonate, iron salts and magnesium-based phosphate binders in treatment of hyperphosphataemia. 2.To assess their impact on the development of SHPT or low bone turnover based on surrogate markers (PTH, bone specific alkaline phosphatase, osteocalcin or other bone turnover markers) and the serum calcium, phosphate, the calcium by phosphate product, PTH levels. In addition, the influence of these drugs would be assessed in relation to lipid profile, tissue calcification and common symptoms such as pruritis and bone or muscle pain. 3.To study the impact of these agents on BMD assessed by dual-energy X-ray absorptiometry (DXA) or quantitative computerised tomography (QCT) and on bone turnover and mineralization based on histomorphometry and fracture rates. 4.To assess other patient-based 'hard' endpoints such as incidence of cardiovascular events, number of hospital admissions and all-cause mortality rates. 5.To assess the impact of various phosphate binders on metastatic calcification rates. 6.To assess cost effectiveness and quality of life. 7.Patient compliance with therapy and the incidence and nature of side effects.