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phosphorus and progression of renal disease

Yu Ho Lee, Jin Sug Kim, Se-Yun Kim, Yang Gyun Kim, Ju-Young Moon, Kyung-Hwan Jeong, Tae Won Lee, Chun-Gyoo Ihm, Sang-Ho Lee
BACKGROUND: Endocan, previously called endothelial cell-specific molecule-1, is a soluble proteoglycan that is secreted from vascular endothelial cells. Elevated plasma endocan levels were shown to be associated with poor cardiovascular outcomes in patients with chronic kidney disease (CKD). We investigated the clinical relevance of plasma and urine endocan levels in patients with immunoglobulin A nephropathy (IgAN). METHODS: Sixty-four patients with IgAN and 20 healthy controls were enrolled in this study...
September 2016: Kidney Research and Clinical Practice
Taketo Uchiyama, Norifumi Tatsumi, Sahoko Kamejima, Tsuyoshi Waku, Ichiro Ohkido, Keitaro Yokoyama, Takashi Yokoo, Masataka Okabe
Chronic kidney disease (CKD) disrupts mineral homeostasis and its representative pathosis is defined as secondary hyperparathyroidism (SHPT). SHPT occurs during the early course of progressive renal insufficiency, and is associated with mortality and cardiovascular events. SHPT results in reduction of calcium-sensing receptor (CaSR) and vitamin D receptor (VDR) in the parathyroid glands during CKD. However, the precise mechanism of CaSR and VDR reduction is largely unknown. CKD was induced through two-step 5/6 nephrectomy, and then CKD rats and sham-operated rats were maintained for 8 weeks on diets containing 0...
October 2016: Human Cell
Maria Abajo, Àngels Betriu, David Arroyo, Marta Gracia, M Dolores Del Pino, Isabel Martínez, Jose M Valdivielso, Elvira Fernández
BACK GROUND: The leading cause of premature death in chronic kidney disease (CKD) is cardiovascular disease (CVD), but risk assessment in renal patients is challenging. The aim of the study was to analyse the factors that predict accelerated progression of common carotid intima-media thickness (CCIMT) in a CKD cohort after 2 years of follow-up (2010-12). METHODS: The study included 1152 patients from the NEFRONA cohort with CKD stages 3-5D and without a clinical history of CVD...
August 27, 2016: Nephrology, Dialysis, Transplantation
Margarita S Biragova, Svetlana A Gracheva, Alexandra M Glazunova, Sergey A Martynov, Irina N Ulaynova, Alexandr V Ilyin, Yury I Philippov, Guliya M Musaeva, Minara S Shamkhalova, Marina V Shestakova
AIMS: The objective of our study was to evaluate the role of mineral and bone metabolism disorders associated with chronic kidney disease (MBD-CKD) in the development and progression of cardiac and renal pathology in patients with type 1 diabetes mellitus (T1DM) of long duration. METHODS: We investigated 96 patients with T1DM of long duration, with CKD at different stages (0-5), including patients on hemodialysis (HD) and with kidney transplantation (KT). Along with overall clinical examination, we assessed markers of MBD (calcium, phosphorus, parathormone, vitamin D, fibroblast growth factor (FGF) 23) and levels of cardiac injury marker (atrial natriuretic peptide, NT-proBNP)...
August 2016: Diabetes Research and Clinical Practice
Shahanas Chathoth, Samir Al-Mueilo, Cyril Cyrus, Chittibabu Vatte, Awatif Al-Nafaie, Rudaynah Al-Ali, Brendan J Keating, Fahad Al-Muhanna, Amein Al Ali
BACKGROUND: The osteocyte-derived hormone, fibroblast growth factor 23 (FGF23), regulates the phosphorus metabolism and suppresses 1,25-dihydroxyvitamin D production, thereby mitigating hyperphosphatemia in patients with renal disorders. An elevated FGF23 level is suggested to be an early biomarker of altered phosphorus metabolism in the initial stages of chronic kidney disease (CKD) and acts as a strong predictor of mortality in dialysis patients. In the Saudi population, there is no report on the FGF23 level in CKD patients to date...
December 2015: Cardiorenal Medicine
Mohamed G Atta, Michelle M Estrella, Derek M Fine, Katie Zook, Jose Manuel Monroy Trujillo, James H Stein, Gregory M Lucas
Fibroblast growth factor23 (FGF23), an early marker of kidney dysfunction, is associated with cardiovascular death. Its role in HIV-positive individuals is unknown. We measured FGF23 in 100 HIV-negative and 191 HIV-positive nondiabetic adults with normal baseline estimated glomerular filtration rate (GFR). We measured GFR by iohexol annually, albumin-creatinine ratio (ACR) every 6 months, as well as pulse wave velocity, carotid plaque, and carotid intima media thickness (IMT) at baseline and 2 years. Progressive albuminuria was defined as follow-up ACR ≥2-fold than baseline and ≥30 mg/g...
2016: PloS One
Wen Xiu Chang, Ning Xu, Takanori Kumagai, Takeshi Shiraishi, Takahiro Kikuyama, Hiroki Omizo, Kazuhiro Sakai, Shigeyuki Arai, Yoshifuru Tamura, Tatsuru Ota, Shigeru Shibata, Yoshihide Fujigaki, Zhong Yang Shen, Shunya Uchida
BACKGROUND: Although hyperphosphatemia is deemed a risk factor of the progression of chronic kidney disease (CKD), it remains unclear whether the normal range of serum phosphorus likewise deteriorates CKD. A propensity score analysis was applied to examine the causal effect of the normal range of serum phosphorus on the incidence of end-stage renal disease (ESRD). METHODS: A retrospective CKD cohort of 803 participants in a single institution was analyzed. Propensity score was estimated using 22 baseline covariates by multivariate binary logistic regression for the different thresholds of time-averaged phosphorus (TA-P) in the normal range of serum phosphorus incremented by 0...
2016: PloS One
Jamshid Norouzi, Ali Yadollahpour, Seyed Ahmad Mirbagheri, Mitra Mahdavi Mazdeh, Seyed Ahmad Hosseini
BACKGROUND: Chronic kidney disease (CKD) is a covert disease. Accurate prediction of CKD progression over time is necessary for reducing its costs and mortality rates. The present study proposes an adaptive neurofuzzy inference system (ANFIS) for predicting the renal failure timeframe of CKD based on real clinical data. METHODS: This study used 10-year clinical records of newly diagnosed CKD patients. The threshold value of 15 cc/kg/min/1.73 m(2) of glomerular filtration rate (GFR) was used as the marker of renal failure...
2016: Computational and Mathematical Methods in Medicine
Julius U Okoye, Ejikeme B Arodiwe, Ifeoma I Ulasi, Chinwuba K Ijoma, Obinna D Onodugo
BACKGROUND: As kidney function declines, there is a progressive deterioration in mineral homeostasis with disruption of normal serum and tissue concentration of phosphorus and calcium, and changes in circulating levels of hormones-parathyroid hormone (PTH), calcitriol (1,25(OH)2 D), and Fibroblast growth factor-23 (FGF-23). OBJECTIVE: This study was aimed at determining the prevalence of markers of CKD-MBD in pre-dialysis patients. METHODS: We evaluated consecutively 168 subjects made up of 85 CKD patients and 83 healthy controls, who were attending the renal clinics and medical outpatient of University of Nigeria Teaching Hospital, Enugu...
September 2015: African Health Sciences
Hyo Jin Kang, Do Kyong Kim, Su Mi Lee, Kyung Han Kim, Seung Hee Han, Ki Hyun Kim, Seong Eun Kim, Young Ki Son, Won Suk An
BACKGROUND: Niacin supplementation improves dyslipidemia and lowers serum phosphorus levels in patients with chronic kidney disease (CKD). We evaluated whether low-dose niacin supplementation can improve dyslipidemia, lower serum phosphorus levels, and be administered with a low frequency of adverse effects in patients with CKD. METHODS: We retrospectively analyzed the clinical records of patients with CKD who had taken niacin from January 2009 to June 2011. We excluded patients with CKD stage 1 and 5...
March 2013: Kidney Research and Clinical Practice
C A Brown, J Elliott, C W Schmiedt, S A Brown
Chronic kidney disease (CKD) is the most common metabolic disease of domesticated cats, with most affected cats being geriatric (>12 years of age). The prevalence of CKD in cats exceeds that observed in dogs, and the frequency of the diagnosis of CKD in cats has increased in recent decades. Typical histologic features include interstitial inflammation, tubular atrophy, and fibrosis with secondary glomerulosclerosis. In contrast to people and dogs, primary glomerulopathies with marked proteinuria are remarkably rare findings in cats...
March 2016: Veterinary Pathology
Dorota Drożdż, Przemko Kwinta, Krystyna Sztefko, Katarzyna Zachwieja, Monika Miklaszewska, Tomasz Drożdż, Monika Łatka, Jacek A Pietrzyk
UNLABELLED: In children with chronic kidney disease (CKD) anemia and calcium-phosphate disturbances are already present at early stages of the disease and require a comprehensive treatment. The aim of this study was to evaluate the efficacy of the treatment of biochemical disturbances, depending on the severity of CKD in children. MATERIAL AND METHODS: The study included 71 children (44 boys, 27 girls) with CKD stage 1-5. Mean age was 11 ± 5 years, mean height: 135...
2015: Przegla̧d Lekarski
M Tarazi, P Ellanti, M J McKenna, M Kilbane, P A McCormick, C Hurson
INTRODUCTION: Byler disease (progressive familial intrahepatic cholestasis) is associated metabolic bone disease as a consequence of chronic malabsorption. CASE PRESENTATION: A 33-year-old man with decompensated liver disease secondary to Byler disease was referred to the orthopaedic department with progressive pain over this right proximal tibia. On examination, he had an antalgic gait. Tenderness was localised to the proximal tibia just distal to the tibial tubercle and bilateral foot swelling...
2016: International Journal of Surgery Case Reports
Eduardo Slatopolsky
Mechanistic understanding of secondary hyperparathyroidism, vascular calcification, and regulation of phosphate metabolism in chronic kidney disease (CKD) has advanced significantly in the past five decades. In 1960, Bricker developed the 'intact nephron hypothesis', opening the door for hundreds of investigations. He emphasized that 'as the number of functioning nephrons decreases, each remaining nephron must perform a greater fraction of total renal excretion'. Phosphate per se, independent of Ca(2+) and calcitriol, directly affects the development of parathyroid gland hyperplasia and secondary hyperparathyroidism...
April 2011: Kidney International
Jing Wang, Xiao-yan Zhang, You-Fei Guan
Phosphorus plays important roles in a variety of biological processes such as energy metabolism, cell signaling, nuclenic acid synthesis and membrane function. A major role of the kidney is to maintain phosphorus homeostasis. It is not surprising that when renal function begins to decline in CKD patients, the homeostasis is disrupted and serum concentration of phosphorus begins to increase. Hyperphosphatemia leads to a series of complications including secondary hyperparathyroidism, renal osteodystrophy, cardiovascular diseases and progression of CKD, which contributing to the excess mortality of CKD...
August 2015: Sheng Li Ke Xue Jin Zhan [Progress in Physiology]
S Lai, A Molfino, B Coppola, S De Leo, V Tommasi, A Galani, S Migliaccio, E A Greco, T Gnerre Musto, M Muscaritoli
OBJECTIVE: Patients with chronic kidney disease (CKD) present a markedly increased cardiovascular (CV) morbidity and mortality since the early stages of the disease and a high prevalence of malnutrition, inflammation, and accelerated atherosclerosis. Personalized nutritional intervention, with of a low-protein diet (LPD), since the early stages of CKD should be able to achieve significant metabolic improvements. In our study we have verified the effects of a personalized dietary intervention in patients in the CKD stages 3/4 KDOQI on nutritional, metabolic and vascular indices...
September 2015: European Review for Medical and Pharmacological Sciences
Arnold J Felsenfeld, Barton S Levine, Mariano Rodriguez
Calcium, phosphorus, and magnesium homeostasis is altered in chronic kidney disease (CKD). Hypocalcemia, hyperphosphatemia, and hypermagnesemia are not seen until advanced CKD because adaptations develop. Increased parathyroid hormone (PTH) secretion maintains serum calcium normal by increasing calcium efflux from bone, renal calcium reabsorption, and phosphate excretion. Similarly, renal phosphate excretion in CKD is maintained by increased secretion of fibroblast growth factor 23 (FGF23) and PTH. However, the phosphaturic effect of FGF23 is reduced by downregulation of its cofactor Klotho necessary for binding FGF23 to FGF receptors...
November 2015: Seminars in Dialysis
F U Dzgoeva, M Iu Sopoev, T M Gatagonova, T L Bestaeva, O V Khamitsaeva
AIM: To establish possible pathogenetic relationships between the marker of bone mineral metabolism fibroblast growth factor 23 (FGF-23) and the markers of cardiovascular diseases characterizing the state of cardiomyocytes and that of the vascular wall of the aorta and large vessels in chronic kidney disease (CKD). SUBJECTS AND METHODS: A total of 110 patients (57 men and 53 women) aged 25 to 65 years (mean age 56 ± 2.2 years) with different stages of CKD were examined...
2015: Terapevticheskiĭ Arkhiv
L Iu Milovanova, Iu S Milovanov, D V Kudriavtseva, M M Markina, S Iu Milovanova, L V Kozlovskaia, M V Lebedeva, V D Beketov, S V Moiseev, N A Mukhin, V V Fomin, A A Svistunov
UNLABELLED: AIM. To analyze changes in the serum concentrations of the morphogenetic proteins fibroblast growth factor 23 (FGF-23) and Klotho, as well as sclerostin, an osteocyte-secreted glycoprotein, in relation to the degree of hypertension, left ventricular (LV) hypertrophy, and arterial stiffness in patients with chronic kidney disease (CKD) at its different stages. SUBJECTS AND METHODS: Sixty-five patients (33 men and 32 women) aged 20-65 years, including 25 with chronic glomerulonephritis, 15 with tubulointerstitial nephritis, and 25 with hypertensive nephrosclerosis, were examined...
2015: Terapevticheskiĭ Arkhiv
Tomoki Kawasaki, Yoshitaka Maeda, Hisazumi Matsuki, Yuko Matsumoto, Masanobu Akazawa, Tamaki Kuyama
BACKGROUND: Whether phosphate itself has nephrotoxicity in patients with chronic kidney disease (CKD) is controversial, although phosphate excretion into urine may cause tubular damage in rat models. To evaluate actual phosphate load on each nephron, we examined the association between 24-h urinary phosphorus excretion per creatinine clearance (24-h U-P/CCr), a newly proposed index that is a surrogate for nephron load, and CKD progression in patients with CKD. METHODS: We conducted a single-center, retrospective cohort study...
2015: BMC Nephrology
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