Let's simply learn about phosphate binders taken by kidney patients.

Has your doctor told you to take a medication called 'Phosphate Binders'? Or have you noticed that your blood phosphate levels are high? This name may sound a bit strange to you. But don't worry. This is a medication that is often prescribed to people with kidney disease. Today, we will talk about it in a very simple way that you can understand.

Simply put, what are these phosphate binders?

Very simple. Phosphate binders are a type of medication that is given to lower the level of phosphate in your body. Phosphate is a mineral that our body needs. But like anything, too much of it can cause problems. That's when a doctor will prescribe this medication.

Although some of these medications can be purchased over the counter, you should never use them without talking to your doctor. This is very important.

Why does our body need phosphate?

Phosphate is an electrolyte in our body. Simply put, it is a mineral that is essential for our body to function. Think about it, phosphate helps to make our bones and teeth strong. Not only that, but phosphate is also essential for the energy production of our body's cells, the formation of cell membranes, and the formation of DNA (Deoxyribonucleic acid), which contains our genetic information.

We get this phosphate from the food we eat and drink. A healthy person's body takes in only the amount it needs, and the rest is excreted in urine and feces. But for some reason, especially when the kidneys are not functioning properly, the body is unable to excrete the extra phosphate in this way. That's when phosphate builds up in the blood and causes problems.

Who needs this phosphate binder?

Most often, a doctor will prescribe this medication if the phosphate level in your blood is much higher than normal. This condition is medically known as hyperphosphatemia .

This condition is most likely to occur in people with chronic kidney disease (CKD) and those who have complete kidney failure and are undergoing dialysis.

Why is this medicine given to dialysis patients?

It is normal for phosphate to accumulate in the blood as the kidneys fail. When phosphate levels increase, it begins to pull calcium from the bones. Over time, this weakens the bones and increases the risk of fractures. Phosphate binders are given to dialysis patients to prevent bone-related diseases.

What is the ideal phosphate level in the blood?

The normal blood phosphate level for a healthy adult is between 2.8 and 4.5 milligrams per deciliter (mg/dL) . For young children, this value is slightly higher, between 4.0 and 7.0 mg/dL .

What foods and drinks are highest in phosphate?

If you have kidney disease, you need to be especially careful about what you eat and drink, because just like taking medication, diet control is also very important.

How does this medicine called phosphate binder work?

The way this works is amazing. When we eat food, the phosphate in that food is absorbed into our bodies through the middle part of the small intestine, which we call the jejunum .

When you take this phosphate binder with a meal, the medicine goes into your stomach and "binds" with the extra phosphate in your food. It's like a magnet. When it sticks, it can't be absorbed into your bloodstream. Then, the extra phosphate is passed out of your body in your stool. Pretty simple, right?

Types of phosphate binders and how to get them?

There are several types of phosphate binders. Depending on your condition, your doctor will choose the type that is most suitable for you.

• Calcium carbonate - (e.g. Tums®, Alka-Seltzer®)
• Sevelamer - (e.g. Renvela®, Renagel®)
• Lanthanum carbonate - (e.g. Fosrenol®)
• Calcium acetate - (e.g. PhosLo®, Phoslyra®)
• Sucroferric oxyhydroxide - (e.g. Velphoro®)

Which is the best type?

Calcium-containing supplements (such as calcium carbonate) are often prescribed. However, some studies have found that when these calcium-containing supplements are taken long-term, the extra calcium can build up in the blood vessels. This is called vascular calcification . This can increase the risk of blood clots or stroke. For this reason, your doctor may sometimes recommend a calcium-free supplement (such as Sevelamer).

How should I take this medicine?

This is the most important thing. For this medicine to work properly, the time you take it is very important. Follow your doctor's instructions exactly.

• Tell your doctor about any other medications you are taking (including vitamins and herbal remedies), as some medications may interact with this one.
• Depending on the type of medication, the way it should be taken may vary:
• Some of them need to be chewed and swallowed 10-15 minutes before eating .
• Some of them need to be chewed and swallowed as soon as you start eating .
• Some of them need to be swallowed whole , with the first two or three mouthfuls of the meal .
• Some come in powder form. They should be dissolved in water and taken with the first two or three mouthfuls of a meal .
• Some of them should be chewed and swallowed immediately after eating .

Are there any side effects to this medicine?

Like any medication, this type of medication can cause minor side effects, but not everyone gets them.

If these symptoms are bothersome to you, talk to your doctor. They may be able to change your medication.

When should you see a doctor?

If you experience severe side effects, be sure to tell your doctor. Also, sometimes the increase in phosphate in the blood can cause a decrease in calcium levels in the body. This is called hypocalcemia . If you experience the following symptoms, seek medical advice immediately.

• Muscle twitching
• Memory problems
• Anger without reason
• Numbness of the lips, tongue, fingers, or feet
• Seizures
• Heartbeat abnormalities (Arrhythmia)

Questions to ask your doctor

When you go to your next doctor's appointment, keep these questions in mind. Asking them can help you gain a better understanding of your condition.

• "What type of phosphate binder do you recommend for me?"
• "What are the possible side effects?"
• "How should I take this medicine? Before or after food?"
• "How many times a day should I take it?"
• "How many pills should I take for a main meal? How many pills should I take for a snack?"
• "Are there any other medications I should stop taking while taking this medicine?"
• "How long will I have to take this medicine?"
• "What kind of tests are being done to see if this medicine works?"
• "Do I need to see a dietitian?"