Why some dialysis patients no need take the Binder?

Why some dialysis patients no need take the Binder ?

Phosphate binders are prescribed when patients have high phosphorus to protect their bones. If patients are able to limit the amount of phosphorus in foods they eat or they do enough hours of dialysis, the phosphorus level in their blood may stay in the target range. However, most patients have to take binders when they eat to keep their phosphorus in range.

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Thanks Beth!
I didn’t know the impact of Phosphorus on bones. May be my wife’s current test results of Alkaline Phosphatase has something to do with bone although her phosphorus became normal after 2 weeks of staying high (we did give her good binder (Renvela 800 mg component is sevelaner carbonate in tablet form ) twice a day after a meal.

And,yes as the question asked about why some patients don’t need any binder at all. My wife also didn’t need to have it almost fot 6-7 months(excluding first 2 months of dialysis and last 2 weeks of dialysis,out of total 10 months ) when her phosphorus was always in normal range .

Hi Faconnerd,
I’d be sure to ask your wife’s dietitian how Renvela should be taken. It’s my understanding (and the full prescribing information says this) is to take it WITH means. In my old clinic where I worked as a social worker, the dietitian told patients to take their phosphate binder during means rather than before or after meals. Here’s what the FDA approved prescribing information says:

Inform patients to take Renvela with meals and adhere to their prescribed diets.
For patients using an oral medication where a reduction in the bioavailability of that medication would have a clinically significant effect on its safety or efficacy, advise the patient to take the oral medication at least one hour before or three hours after Renvela.
For Renvela powder, brief the patient on preparation of the powder in water.
Advise patients to report new onset or worsening of existing constipation or bloody stools promptly to their physician [see Warnings and Precautions (5.1)].

Your wife’s dietitian is the expert so far as advising patients how to take phosphate binders and the foods to limit due to their high phosphorus content.

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Yes, you got it right. It’s actually WITH the meal which I have given to my wife.
Doctors - one of the Nephrologist said with the meal and current one said after the meal so I had to look for the drug proposed direction of use myself for it.

Sorry for quoting it ‘after the meal’ earlier.

And,yes - we did limit her phosphorus food intake between 2 dialysis sessions.

It’s important to know the phosphorus content in foods and unfortunately that’s no listed on food labels. Here’s a nutrition counter that lists sodium, potassium, phosphorus and more in many foods. If she can stick with what’s in her diet prescription, she should be able to keep her bones and blood vessels healthy. https://aakp.org/wp-content/uploads/2021/03/NutritionCounter_English_030321_Digital-2.pdf