
Hyperphosphatemia in dialysis patients increases cardiovascular risk and mortality, making phosphorus management crucial. Current treatments include dietary restrictions and phosphate binders, but adherence is often poor due to pill burden and tolerability issues. Phosphate absorption occurs via transcellular and paracellular pathways, with the latter predominant in humans. Tenapanor, a first-in-class phosphate absorption inhibitor, targets the sodium-hydrogen exchanger 3, effectively reducing serum phosphate levels. Clinical studies demonstrate that tenapanor significantly lowers phosphate levels in patients on maintenance dialysis, offering a novel, complementary approach to existing phosphate binders.
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