Abstract: Hyperphosphatemia is a common complication in patients with chronic kidney disease (CKD), particularly those with end-stage kidney disease. It accelerates the progression of CKD, contributes to secondary hyperparathyroidism and abnormal bone metabolism, and serves as an independent risk factor for increased cardiovascular events and mortality. Hyperphosphatemia is highly prevalent but poorly controlled in Chinese CKD patients, which is currently a challenge in clinical practice. In recent years, substantial progress has been made globally in hyperphosphatemia research, with several novel phosphate-lowering agents approved, providing new options for the management of hyperphosphatemia. Based on these advancements, the Chinese Hospital Association Blood Purification Center Branch organized a panel of experts in the field of nephrology and blood purification to develop this consensus document. Integrating evidence-based medicine and clinical expertise, the consensus provided recommendations on key aspects of hyperphosphatemia management, including timing of intervention and target serum phosphate levels. Some practical guidance on dietary phosphate restriction, phosphate-lowering agents use, secondary hyperparathyroidism control, adequate dialysis, and patient education was proposed. The consensus aims to standardize the management of serum phosphate in CKD patients, thereby reducing the incidence of hyperphosphatemia, improving serum phosphate control, and ultimately enhancing patient outcomes.

Key words: Chronic kidney disease, End-stage kidney disease, Hyperphosphatemia, Chronic kidney disease -mineral and bone disorder, Dialysis