Phosphate binders for preventing and treating chronic kidney disease-mineral and bone disorder (CKD-MBD)
Abstract
Background: Phosphate binders lower serum phosphate levels for people with chronic kidney disease (CKD). This is an updated review, previously published in 2011 and 2018. New studies have been published and an update of the current evidence is needed.
Objectives: To assess the benefits and harms of phosphate binders for people with CKD and whether phosphate binders have different effects compared with each other.
Search methods: We searched the Cochrane Kidney and Transplant Register of Studies to 16 December 2024 by contacting the Information Specialist, using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, the International Clinical Trials Registry Platform Search Portal, and ClinicalTrials.gov.
Selection criteria: We included randomised controlled trials (RCTs) or quasi-RCTs of adults with CKD (any glomerular filtration rate; GFR) comparing a phosphate binder to placebo, usual care, or a different phosphate binder with follow-up of at least eight weeks. The key outcomes were death (all causes), cardiovascular death, hypercalcaemia, nausea, constipation, serum phosphate, and vascular calcification.
Data collection and analysis: Two authors independently selected studies for inclusion and extracted study data. We adjudicated the risk of bias using the Cochrane RoB 1 tool, and we used GRADE to assess the evidence certainty. We estimated treatment effects using random-effects meta-analysis. We…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 20,913 participants or records.
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