How do you approach the management of persistent hyperphosphatemia in ESKD patients who are non-adherent to phosphate binders?

How do you approach the management of persistent hyperphosphatemia an ESKD patient who is non-adherent to phosphate binders?

• Spend time talking to the patient to understand if side effects, cost, or social reasons are contributing to non-adherence
• Switch to binders with a lower pill burden
• Involve the renal dietitian for focused dietary counseling
• Celebrate small improvements in serum phosphorus to provide encouragement
• Other