PHOSPHATE BINDER THERAPY AND SERUM PHOSPHATE CONTROL FOLLOWING INITIATION OF HAEMODIALYSIS

Hyperphosphataemia is associated with increased all-cause mortality in patients with chronic kidney disease (CKD), but serum phosphate (P) levels can be managed by dialysis, diet and the use of P binders. Serum P data were obtained retrospectively from a US dialysis provider for the 9 months following initiation of haemodialysis (HD) in CKD patients, who were then grouped according to the variations in their serum P. Group baseline characteristics and changes in P binder use over time were described. Variations in average monthly serum P values from months 4 to 9 were classified as either consistently in the target range (CT, 3.5–5.5 mg/dL), consistently low (CL, < 3.5 mg/dL), consistently high (CH, > 5.5 mg/dL), or varying between the low and target (LT), target and high (TH) or the low and high ranges (LH). For each group, baseline characteristics and changes in P binder use during the study were compared with CT (the reference group) to identify differences. In total, 47742 eligible patients were allocated to the six groups: CT, 7301; CL, 131; CH, 5001; LT, 6469; TH, 24469; LH, 4371. CH, TH, and LH were significantly younger than CT, with fewer comorbidities, higher incidence of elevated parathyroid hormone (PTH) and higher mean serum P; CH and TH also had higher levels of P binder use. CL and LT were older, with more comorbidities, lower PTH levels and lower levels of P binder use than CT. Overall, comparing months 8–9 with baseline (months 1–3), more patients received P binder therapy (51.7 vs 35.0%), on a larger percentage of days (50.0 vs 30.9%), but with little change in mean serum P (5.3 vs 5.2 mg/dL). By group, mean serum P increased numerically in CH (7.5 vs 6.6 mg/dL) and TH (5.6 vs 5.4 mg/dL) but decreased in other groups. Serum P can be difficult to control following initiation of HD. Patients with elevated serum P were younger, and most had higher P binder use than the reference group. Overall, binder use was lower than in other studies of HD patients. Dietary education and higher doses of the most effective P binders may be needed to improve P management

Keep Your Fans to Yourself: The Disjuncture between Sport Studies' and Pop Culture Studies' Perspectives on Fandom

This essay explores different understandings of fans and fandom between sport studies and pop culture studies through presentation of survey data originally collected for a study on global fandom/global fan studies. Email surveys from 65 fan scholars around the world reveal important distinctions between sport scholars and pop culture scholars in terms of their basic understandings of fans and fandom, the role of self-reflexivity in fan research, and the location of sport and other pop culture scholarship in the academy. Analysis points to a disjuncture between sport and pop culture fan studies that ultimately limits the ability to fully understand the range of fan experiences and fandoms