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What is IBS-C?
Irritable bowel syndrome with constipation (IBS-C) is a gastrointestinal disorder characterized by abdominal pain and constipation, that significantly impacts the health and quality of life of affected patients. IBS-C is a common condition with a multi-factorial pathophysiology. There are currently no specific tests or biomarkers for diagnosis of IBS-C. Therefore, IBS-C is diagnosed by symptoms and by eliminating other disorders.
It is estimated that there are ~11 million people in the U.S. with IBS-C.
What is Hyperkalemia?
Hyperkalemia is a potentially life-threatening condition in which blood levels of potassium are elevated above normal. Potassium is a nutrient that is critical to the normal function of nerve and muscle cells, including those in the heart. Normal potassium blood levels are tightly balanced and maintained primarily by the kidneys. For people with chronic kidney disease (CKD), heart failure and diabetes, and particularly those also taking renin-angiotensin-aldosterone system (RAAS) inhibitors, there is a greater risk of developing hyperkalemia due to the kidneys' reduced ability to keep potassium in balance.
Several published guidelines have suggested that physicians should reduce, and possibly discontinue, RAAS inhibition when hyperkalemia develops in order to manage the risk of elevated potassium in CKD and heart failure patients. The alternative medications used to control hypertension, including diuretics and calcium channel blockers, are less effective than RAAS inhibitors, particularly in patients with failing kidneys and severe hypertension.
What is Hyperphosphatemia?
Hyperphosphatemia, a nearly universal condition in the more than 550,000 patients in the U.S. with CKD on dialysis, is an electrolyte disorder in which there is an elevated level of phosphate in the blood.
While dialysis is the basis for homeostatic electrolyte management, dialysis regimens are unable to successfully remove excess phosphate in order to achieve a neutral phosphate balance. As a result, approximately 80% of patients with CKD on dialysis require phosphate-lowering therapy on top of restrictive, low phosphorus diets.
Management of hyperphosphatemia has been a long-time challenge. While the 2017 Kidney Disease Improving Global Outcomes (KDIGO) clinical practice guidelines recommend lowering elevated phosphate levels toward the normal range (2.5-4.5 mg/dL or 0.81-1.45mmol/L), due to the difficulties in managing phosphorus, most clinicians target phosphorus levels between 3.5-5.5 mg/dL (1.13-1.78 mmol/L), based on the 2003 Kidney Disease Outcomes Quality Initiative (KDOQI) clinical practice guidelines.