Do you use a phosphate binder to manage inpatient hyperphosphatemia in patients with AKI who have no history of CKD?  

I agree there is uncertainty about optimal serum phosphate concentrations in patients, and essentially no data in AKI. However, increases in Phos do result in an increased risk of metastatic calcification, and increases FGF23 and PTH, even in AKI and these changes clearly have increased risks, thus,...

There remains uncertainty about optimal serum phosphate targets even in patients with CKD and moreover, there is no data that I am aware of in the setting AKI. I would probably only start a phosphate-lowering agent if the serum phosphate exceeded 7.5 mg/dL and would be conscientious about discontinu...

I agree, there is no clear data in AKI. I would start a binder if phos is >7 and they are on solids until kidney function recovers. 

I do in certain instances. If the patient is eating solid meals then it would make sense to use a binder. If the patient is not eating or getting feeding continuous then that is a different issue. With continuous feedings which are already low phosphorus, it is possible to try low dose more frequent...

AKI with hyperphosphatemia who is on tube feeding, would make sense to be on phosphorus absorption inhibitor (Tenapanor) rather than on binder. Although no data yet, just makes more sense mechanistically, may be we will see this coming in the future. And I hope we identify the target level that impa...