Magnesium based phosphate binder caution

Dr Yun Hui Sheryl Wong1, Ms Ann Berwick1, Ms Anne Nguyen1, Ms Kate Morley2, Dr Mark Thomas1

1Royal Perth Hospital, Perth, Australia, 2Amity Health, Albany, Australia

Introduction: As chronic kidney disease progresses through the 5 stages, hyperphosphataemia occurs, resulting in bone demineralisation, vascular and soft tissue calcification, cardiovascular disease and secondary hyperparathyroidism. Dietary restriction of phosphate alone becomes insufficient over time to counteract this process and various phosphate binders are commonly prescribed to reduce the absorption of phosphate from the gastrointestinal tract.

Magnesium based phosphate binders have been shown to be non-inferior to sevelamer for the management of hyper-phosphataemia. However, there is a vast array of commercial magnesium-based supplements available to the Australian consumer.

Methods: We discuss these supplements and present them in a table.

Results: Considerable heterogeneity exists not only in their magnesium content, but the concentration of other additional ions like calcium, potassium and phosphate.

Conclusion: The clinician should note that caution should be exercised when prescribing these supplements, particularly to the chronic kidney disease population.


Sheryl completed her basic physician training in Melbourne at the Alfred Hospital, did a short general medicine stint at Royal Hobart Hospital in Tasmania and is now a Nephrology Advanced Trainee in Royal Perth Hospital in WA. Her interests include home dialysis, interventional nephrology and indigenous health.


The ASM is hosted by Australian and New Zealand Society of Nephrology.

The aims of the Society are to promote and support the study of the kidney and urinary tract in health and disease, and to ensure the highest professional standards for the practice of nephrology in Australia and New Zealand.

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