[Kidney and bone update : the 5-year history and future of CKD-MBD. Progress of phosphate binders].

Hyperphosphatemia is a serious complication which has been linked with an increased risk of cardiovascular mortality in patients with chronic kidney disease. Especially in end stage renal disease (ESRD) patients, the nutritional disturbance due to strict phosphate restriction with protein restriction is certainly associated with patients' survival. Firstly, the aggressive phosphorus removal by blood purification modality is also important for the good control in serum phosphate level. Secondary, the active phosphate binder therapy is actual effective treatment for ESRD patients with hyperphosphatemia. Until recently, none of the available agents fulfilled the criteria of an ideal phosphate binders. However, several phosphate binder such as calcium carbonate, sevelamer hydrochloride, lanthanum carbonate and so on, are available in Japan. This review work is describing about the history and clinical manifestation of these phosphate binders.