Dr. Yap Yat Hin Desmond
Dr. Desmond Yat-Hin Yap joined the University Department of Medicine after his graduation from MBBS at the University of Hong Kong. He later pursued his Doctor of Medicine (MD) and Doctor of Philosophy (PhD) degree at the University of Hong Kong, both along the study of the immunopathogenesis and treatment of lupus nephritis.
His current major theme of research is immune-mediated glomerular diseases, with emphasis on lupus nephritis which is an important cause of renal failure especially in Asia. Dr. Yap was the co-First author for the Asian Guidelines for the management of lupus nephritis, co-published in the official journals of regional nephrology and rheumatology societies [Nephrology (Carlton) 2014; 19: 11-20 & Int J Rheum Dis 2013; 16: 25-36], and his research findings have also contributed to the latest KDIGO Clinical Practice Guideline for Glomerulonephritis 2021. He received the Hong Kong Society of Nephrology Young Investigator Award in 2009 for his research on serum immunoglobulin binding activity to human mesangial cells in lupus nephritis. Funded by the Li Shu Pui Clinical Fellowship (2014-2015), Dr. Yap worked as a research fellow at the Fiebiger-Nikolaus Centre, FriedrichAlexander University, Germany to study B cell homeostasis in immune-mediated diseases. Dr. Yap was awarded the LKS Faculty Teaching Medal in 2019, in recognition of his contributions in teaching and curriculum development. In 2021, he was awarded the prestigious Sir David
Todd Lectureship by the Hong Kong College of Physicians for his contributions in lupus nephritis research. Dr. Yap’s other research interest pertains to infective complications in renal failure
patients, focusing on viral hepatitis in kidney transplant recipients and recently COVID-19 infection in renal patients. He is a co-author for the chapter on infection control in a nephrology clinical practice guidelines to be jointly published by the Hospital Authority Central Renal Committee and the Hong Kong College of Physicians.
Dr. Yap is currently the EXCO member of the APSN and also serves as Council Member of various important professional societies including the Hong Kong Society of Nephrology, Hong Kong Society of Transplantation and the Hong Kong Society for Histocompatibility and Immunogenetics. Dr. Yap has published over 120 peer-reviewed articles in various internationally renowned journals, and is currently Subject Editor for Nephrology, the official journal of the Asian Pacific Society of Nephrology.
Abstract
Management of hyperphosphataemia – Non Calcium-based therapies
by Dr. Desmond Yap
As kidney disease progresses, phosphorus retention also increases. Phosphate lowering therapy for hyperphosphataemia is key to the treatment of patients with chronic kidney disease -mineral and bone disorder (CKD-MBD).
Phosphate-binding compounds have evolved from the original aluminum-based binders pioneered in the 1970s to calcium-based binders such as calcium acetate, and more recently, Calcium-free phosphate binders are increasingly favoured since calcium-based agents potentially cause harmful calcium overload and vascular calcification that confound the benefits of reducing serum phosphorus. Randomised controlled studies consistently show that these Calcium-free agents offer equivalent lowering of serum phosphorus and often effectively achieve phosphorus targets, exert mortality benefits and other pleiotropic effects versus calcium salts.
This sharing summarizes (1) the rationale to start non-calcium-based therapies (2) the evidence of efficacy and safety for recent calcium-free phosphate binders in CKD-MBD management. Dr. Yap will also share (2) the treatment targets of CKD-MBD based on international recommendation and clinical consideration.
