RECRUITING Not applicable ClinicalTrials.gov

Pragmatic Randomised Trial of High Or Standard PHosphAte Targets in End-stage Kidney Disease (PHOSPHATE)

Sponsor: The University of Queensland • ClinicalTrials.gov ID: NCT03573089

Registry updated: 2026-08-26

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Description

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.

Interventions

Liberal phosphate target (Drug)
All phosphate-lowering medications in use at baseline will be discontinued. Phosphate-lowering medications will be prescribed only if serum phosphate concentration exceeds 2.50 mmol/L. The choice and dosages of phosphate-lowering medications will be at the discretion of treating physicians and/or participants.
Intensive phosphate target (Drug)
This will be achieved by prescribing phosphate-lowering medications aimed to intensively lower serum phosphate concentration towards normal level (≤1.50 mmol/L). The choice and dosages of phosphate-lowering medications will be at the discretion of treating physicians and/or participants.

Eligibility criteria

Inclusion Criteria: 1. Age ≥45 years, or Age ≥18 years with diabetes, 2. ESKD on haemodialysis or peritoneal dialysis, for at least 3 months, 3. Currently prescribed at least one phosphate-lowering medication at any dose 4. Able to provide informed consent Exclusion Criteria: 1. Elective kidney transplantation scheduled, 2. Concomitant major illness / comorbidity that may result in death in the next 6 months in the view of the treating physician, 3. Participation in an interventional study that is likely to affect serum phosphate concentration.

Conditions

Kidney Failure, Chronic Hyperphosphatemia

Locations

Royal Prince Alfred Hosptial — Camperdown, New South Wales, Australia
Nepean Hospital — Kingswood, New South Wales, Australia
St George Hospital — Kogarah, New South Wales, Australia
Royal North Shore Hospital — Saint Leonards, New South Wales, Australia
Western Sydney Renal Service — Westmead, New South Wales, Australia
Wollongong Hospital — Wollongong, New South Wales, Australia
Sunshine Coast University Hospital — Birtinya, Queensland, Australia
Royal Brisbane and Women's Hospital — Brisbane, Queensland, Australia
Princess Alexandra Hospital — Brisbane, Queensland, Australia
Bundaberg Hospital — Bundaberg, Queensland, Australia
Cairns Hospital — Cairns, Queensland, Australia
Fraser Coast Renal Service — Hervey Bay, Queensland, Australia
Mackay Hospital — Mackay, Queensland, Australia
Logan Hospital — Meadowbrook, Queensland, Australia
Gold Coast University Hospital — Southport, Queensland, Australia
Townsville University Hospital — Townsville, Queensland, Australia
Central and Northern Adelaide Renal and Transplant Service — Adelaide, South Australia, Australia
Flinders Medical Centre — Bedford Park, South Australia, Australia
Austin Health — Heidelberg, Victoria, Australia
Royal Melbourne Hospital — Melbourne, Victoria, Australia
St Vincent's Hospital Melbourne — Melbourne, Victoria, Australia
Latrobe Regional Hospital — Traralgon, Victoria, Australia
Armadale Hospital — Armadale, Washington, Australia
Serviço Ubaense de Nefrologia Ltda — Ubá, Minas Gerais, Brazil
BRA Santa Casa de Misericórdia de Ponta Grossa — Ponta Grossa, Paraná, Brazil
Sociedade Hospitalar Angelina Caron — Campina Grande, Paraíba, Brazil
Hospital de Clinicas Porto Alegre — Porto Alegre, Rio Grande do Sul, Brazil
Fundacao Felice Rosso - Hospital Felicio Rocho — Barro Preto, Brazil
Hospital Alemao Oswaldo Cruz — São Paulo, Brazil
Foothills Hospital/ U of Calgary — Calgary, Alberta, Canada
Alberta Health Services — Edmonton, Alberta, Canada
St. Paul's Hospital — Vancouver, British Columbia, Canada
Vancouver General Hospital — Vancouver, British Columbia, Canada
St. Boniface General Hospital — Winnipeg, Manitoba, Canada
Dalhousie University — Halifax, Nova Scotia, Canada
Queen's University — Kingston, Ontario, Canada
London Health Sciences Centre — London, Ontario, Canada
Sunnybrook Health Sciences Centre — North York, Ontario, Canada
Oakville Trafalgar Memorial Hospital — Oakville, Ontario, Canada
Orillia Soldier's Memorial Hospital — Orillia, Ontario, Canada
Lakeridge Health — Oshawa, Ontario, Canada
The Ottawa Hospital — Ottawa, Ontario, Canada
Mackenzie Health — Richmond Hill, Ontario, Canada
Scarborough Hospital Network — Scarborough Village, Ontario, Canada
St Michael's Hospital — Toronto, Ontario, Canada
University Health Network - University of Toronto — Toronto, Ontario, Canada
St. Joseph's Healthcare Hamilton — Toronto, Ontario, Canada
St. Joseph's Healthcare Toronto — Toronto, Ontario, Canada
The Charles Lemoyne Hospital — Longueuil, Quebec, Canada
McGill University Health Centre — Montreal, Quebec, Canada
Hopital Maisonneuve Rosemont — Montreal, Quebec, Canada
CHUM — Montreal, Quebec, Canada
Jewish General Hospital — Montreal, Quebec, Canada
Sacre Coeur Hospital — Montreal, Quebec, Canada
CHU de Quebec Universite Laval — Québec, Quebec, Canada
Centre hospitalier universitaire de Sherbrooke (CHUS) — Sherbrooke, Quebec, Canada
Centre Hospitalier Universitaire de Sherbrooke — Sherbrooke, Quebec, Canada
Prairie Vascular Research Inc — Regina, Saskatchewan, Canada
Red Deer Hospital; — Red Deer, Canada
Humber River Hospital — Toronto, Canada
Michael Garron Hospital — Toronto, Canada
Trillium Health Partners — Toronto, Canada
AURA Paris Plaisance — Paris, France
Hadassah University — Jerusalem, Israel
Shaare Zedek Medical Centre — Jerusalem, Israel
Meir Hospital — Kfar Saba, Israel
Sheba Hospital — Ramat Gan, Israel
Tel Aviv Sourasky Medical Center — Tel Aviv, Israel
Auckland City Hospital — Auckland, New Zealand
Christchurch Hospital — Christchurch, New Zealand
Dunedin Hospital — Dunedin, New Zealand
Waikato DHB — Hamilton, New Zealand
Hawkes Bay Hospital — Hastings, New Zealand
Middlemore Hospital — Otahuhu, New Zealand
Waitematā Hospital — Takapuna, New Zealand
Northland DHB — Whangarei, New Zealand
Khoo Teck Puat Hospital — Singapore, Singapore
Tan Tock Seng Hospital Pte. Ltd. — Singapore, Singapore
Woodlands Health — Singapore, Singapore
Ramathibodi Hospital — Bangkok, Khet Ratchathewi, Thailand
Cambridge University Hospitals NHS Foundation Trust — Cambridge, Cambridgeshire, United Kingdom
University Hospitals Plymouth NHS Trust — Plymouth, Devon, United Kingdom
Dorset County Hospital NHS Foundation Trust — Dorchester, Dorset, United Kingdom
South Tyneside And Sunderland NHS Foundation Trust — Sunderland, Durham, United Kingdom
East and North Hertfordshire NHS Trust — Stevenage, Hertfordshire, United Kingdom
East Kent Hospitals University NHS Foundation Trust — Canterbury, Kent, United Kingdom
NHS Greater Glasgow and Clyde — Glasgow, Kent, United Kingdom
James Paget University Hospitals NHS Foundation Trust — Great Yarmouth, Norfolk, United Kingdom
NHS Lanarkshire — Airdrie, North Lanarkshire, United Kingdom
South Tees Hospitals NHS Foundation Trust — Middlesbrough, North Yorkshire, United Kingdom
York and Scarborough Teaching Hospitals NHS Foundation Trust — York, North Yorkshire, United Kingdom
Nottingham University Hospitals NHS Trust — Nottingham, Nottinghamshire, United Kingdom
NHS Highland — Inverness, Scotland, United Kingdom
NHS Ayrshire and Arran — Kilmarnock, Scotland, United Kingdom
Shrewsbury and Telford Hospital NHS Trust — Shrewsbury, Shropshire, United Kingdom
Sheffield Teaching Hospitals NHS Foundation Trust — Sheffield, South Yorkshire, United Kingdom
University Hospital of North Midlands NHS Trust — Stoke-on-Trent, Staffordshire, United Kingdom
West Suffolk Hospital — Bury St Edmunds, Suffolk, United Kingdom
University Hospitals Sussex NHS Foundation Trust — Brighton, Sussex, United Kingdom
Bradford Teaching Hospital NHS Foundation Trust — Bradford, West Yorkshire, United Kingdom
Wirral University Teaching Hospital NHS Foundation Trust — Birkenhead, Wirral, United Kingdom
University Hospital Birmingham NHS foundation Trust — Birmingham, United Kingdom
Cardiff and Wales University Local Health Board — Cardiff, United Kingdom
North Cumbria Integrated Care NHS Foundation Trust — Carlisle, United Kingdom
Epsom and St Helier University Hospitals NHS Trust — Carshalton, United Kingdom
Gloucestershire Hospital NHS Foundation Trust — Cheltenham, United Kingdom
Portsmouth Hospitals University NHS Trust — Cosham, United Kingdom
University Hospitals Coventry & Warwickshire — Coventry, United Kingdom
University Hospitals of Derby and Burton — Derby, United Kingdom
Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust — Doncaster, United Kingdom
The Dudley Group NHS Foundation Trust — Dudley, United Kingdom
Royal Devon and Exeter NHS Foundation Trust — Exeter, United Kingdom
Hull University Teaching Hospital NHS Trust — Hull, United Kingdom
Ipswich Hospital (East Suffolk & North Essex Foundation Trust) — Ipswich, United Kingdom
University Hospitals Of Leicester NHS Trust — Leicester, United Kingdom
Royal Liverpool University Hospitals — Liverpool, United Kingdom
University Hospital Aintree — Liverpool, United Kingdom
Guy's and St Thomas' NHS Foundation Trust — London, United Kingdom
King's College Hospital NHS Foundation Trust — London, United Kingdom
St George's University Hospitals NHS Foundation Trust — London, United Kingdom
Manchester University NHS Foundation Trust — Manchester, United Kingdom
The Newcastle Upon Tyne Hospitals NHS Foundation Trust — Newcastle upon Tyne, United Kingdom
Royal Berkshire NHS Foundation Trust — Reading, United Kingdom
Salford Royal NHS Foundation Trust — Salford, United Kingdom
Mid and South Essex NHS Foundation Trust — Southend-on-Sea, United Kingdom
The Royal Wolverhampton NHS Trust — Wolverhampton, United Kingdom

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Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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