Hyperphosphatemia is a significant problem in patients with chronic kidney disease, with high serum phosphate levels associated with increased mortality.

Many patients cannot adequately maintain serum phosphate concentrations at recommended levels despite current treatments such as dietary phosphate restriction, dialysis, phosphate binders, and controlling secondary hyperparathyroidism.

Tenapanor and nicotinamide are two promising new treatments for hyperphosphatemia; by inhibiting active gastrointestinal phosphate absorption, these treatments may prove to be useful alternative or additional therapies for hyperphosphatemia in chronic kidney disease.