Figure 1.

Timeline of phosphate binder development. Phosphate binders were first introduced in the 1970s. Severe safety concerns (e.g., cognitive disorders) were associated with aluminum-based binders, the earliest iteration of phosphate binders. The safety of phosphate binders has improved since their introduction, but adverse effects, particularly those affecting the GI system, are still common for current options. GI, gastrointestinal.