Phosphate homeostasis

There is now good data that elevated serum phosphate levels are associated with increased cardiovascular risk.

CAPD is not as efficient at clearing phosphate as haemodialysis.

The stimuli to PTH secretion are low serum calcium concentration, low vitamin D levels and elevated phosphate levels.

Vitamin D increases calcium absorption from the gut: it does not lower blood phosphate concentration.

Phosphate binders should be taken just before meals so that they are present in the gut and available to bind phosphate when required.