Authors' reply

BMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.6997.124c (Published 08 July 1995) Cite this as: BMJ 1995;311:124
  1. John A Kanis,
  2. Naveen A T Hamdy,
  3. Ian T Fairey
  1. Professor Clinical research fellow WHO Collaborative Centre for Metabolic Bone Diseases, Department of Human Metabolism and Clinical Biochemistry, University of Sheffield Medical School, Sheffield S10 2RX
  2. Clinical data manager Leo Laboratories, Princes Risborough HP27 9RR

    EDITOR,--Mark S McGregor and colleagues suggest that the threshold for serum phosphate concentration above which phosphate binding agents might be given should be lower than 2.2 mmol/l. We accept this point for patients before they receive dialysis, but in patients receiving dialysis the serum phosphate concentration that best balances the risk of extraskeletal calcification and osteomalacia is probably the value that we quoted.1 If McGregor and colleagues' suggestion of 1.7 mmol/l for serum phosphate concentration is used as the threshold then a higher proportion of patients treated with placebo (18%) than with alfacalcidol (15%) developed hyperphosphataemia. Thus the …

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