Table 1. Comparison between the current and the proposed new paradigm of phosphate restriction.

	Current paradigm	New paradigm
Rationale	High blood phosphate promotes vascular calcification and cardiovascular events	High urine phosphate injures renal tubules and induces renal fibrosis
Goal	To lower blood phosphate	To lower blood FGF23
Indication	ESRD with hyperphosphatemia (∼0.3% of the total CKD patients)	CKD stages 2–5 with high blood FGF23 levels (∼35% of all CKD stages 2–5 patients)

Abbreviations: CKD, chronic kidney disease; ESRD, end-stage renal disease; FGF23, fibroblast growth factor-23.