高磷血症是慢性肾脏病(chronic kidney disease,CKD)，尤其是终末期肾病患者常见的并发症，其加速CKD进展，导致继发性甲状旁腺功能亢进和骨代谢异常，也是患者心血管事件和死亡风险增加的独立危险因素。我国CKD患者高磷血症的患病率高，但血磷控制达标率低，是目前临床管理的难点。近年来，国内外有关CKD患者高磷血症的研究取得了较大的进展，一些新的降磷药物相继问世，为临床优化高磷血症的管理提供了新的手段。基于此，中国医院协会血液净化中心分会组织我国肾脏病学及血液净化领域专家，结合循证医学证据和临床实践经验，制定了本共识，对血磷管理时机、管理目标值等提出了相关推荐意见，对饮食管理、降磷药物使用、控制继发性甲状旁腺功能亢进、充分透析及加强患者教育等提出了实践指导意见。本共识旨在进一步规范CKD患者的血磷管理，降低高磷血症的发生率，提高血磷控制率，改善患者预后。

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.