PHOSPHATE

To determine if, compared to a strategy of liberalized serum phosphate control, intensive phosphate lowering aimed at reduction of serum phosphate concentration towards the normal level (less or equal to 1.5 mmol/l) reduces the risk of fatal or non-fatal major adverse cardiovascular events in patients with End-stage kidney disease receiving dialysis. During end-stage kidney disease, clinical guidelines suggest reducing elevated phosphate levels in the blood. However, the effect of lowering blood phosphate levels on important patient-centred outcomes has never been tested. This trial will evaluate whether compared to high levels, lowering blood phosphate levels would reduce death or major events due to heart disease, improve physical health, and be cost-effective. investigator-initiated, international, multi-centre, prospective, randomized, open-label,parallel group, superiority and pragmatic large simple trial