This guideline covers managing hyperphosphataemia in children, young people and adults with stage 4 or 5 chronic kidney disease. It makes recommendations on dietary management and phosphate binders, to reduce variation in care and the risk of hyperparathyroidism for people with chronic kidney disease.
This guideline includes recommendations on:
Who is it for?
- Healthcare professionals
- Commissioners and providers
- People with stage 4 or 5 chronic kidney disease and their families and carers
Is this guideline up to date?
We checked this guideline in April 2017 and are updating the recommendations on cost effectiveness of phosphate binders for children, young people and adults with chronic kidney disease stages 4–5, both on dialysis and not on dialysis.
See the guideline in development page for progress on the update.
Guideline development process
This guideline was previously called hyperphosphataemia in chronic kidney disease: management of hyperphosphataemia in patients with stage 4 or 5 chronic kidney disease.
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.