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hypocalcemia in ckd

Hiroshi Oiwa, Sho Mokuda
No abstract text is available yet for this article.
September 2016: Eur J Rheumatol
Pablo Molina, José L Górriz, Sandra Beltrán, Belén Vizcaino, Luis M Pallardó
Although some experimental targets involved in calcium deposition are emerging, no intervention has been described to reliably reverse vascular calcification (VC). We report a case of severe VC regression in a parathyroidectomized patient on hemodialysis over 12-year follow-up, highlighting the use of calcium-free phosphate binders and a 2.5 mEq/L calcium dialysate for reducing calcium loading, despite persistent asymptomatic hypocalcemia occurrences. This case suggests that phosphate-binder choice and calcium dialysate concentration could be influenced by other components of CKD-MBD besides biochemical parameters, such as the presence of VC, so concluding that asymptomatic hypocalcemia may not be as harmful as once supposed, and conferring greater prognostic weight to the presence of VC than to calcium levels...
October 10, 2016: Clinical Nephrology
Kalvin C Yu, Paul A D'Avanzo, Leigh Nesheiwat, Richard E Greene, Antonio Urbina, Perry N Halkitis, Farzana Kapadia
Data from a cross-sectional study of a clinic-based sample of older people living with HIV (PLWH; n = 100) were used to examine associations between biomarkers of physical health and neurocognitive impairment (NCI). In this sample, anemia, chronic kidney disease (CKD) stages 4-5, and hypocalcemia were associated with impairment in executive functioning or processing speed. Furthermore, participants with anemia were more likely to have CD4+ T cell counts <200 cells/mm(3) (χ(2) [1] = 19.57, p < ...
August 27, 2016: Journal of the Association of Nurses in AIDS Care: JANAC
Ariadna Pérez-Ricart, Maria Galicia-Basart, Maria Alcalde-Rodrigo, Alfons Segarra-Medrano, Josep-Maria Suñé-Negre, José-Bruno Montoro-Ronsano
BACKGROUND: Secondary hyperparathyroidism (SHPT) is a common complication in chronic kidney disease (CKD) patients. Cinacalcet could be a therapeutic option although its use is controversial in patients not receiving dialysis. Thus, the aim of this study is to assess the effectiveness and safety of cinacalcet in patients with CKD and SHPT without renal replacement treatment (RRT) and without renal transplantation (RT). METHODS: A retrospective observational study was conducted...
2016: PloS One
Takayuki Hamano, Chikako Nakano
The authors of Freedom study enrolling primary osteoporosis patients argued that the anti-fracture effect of denosmab is not dependent on baseline estimated glomerular filtration rate(eGFR)by showing the non-significant interaction term between treatment and CKD stage. However, given disproportionate numbers of patients in each subgroup(4069, 2817, and only 73 patients, in CKD stage 2, 3, and, 4, respectively), this study seems to lack the statistical power to reach a definite conclusion on the effect modification by CKD stage...
September 2016: Clinical Calcium
Jacek Zawierucha, Jolanta Małyszko, Jacek Małyszko, Teresa Dryl-Rydzyńska, Tomasz Prystacki, Wojciech Marcinkowski
Secondary hyperparathyroidism (sHPT) is a common complication being a consequence of metabolic disorders associated with chronic kidney disease (CKD). Treatment of the sHPT should lead to calcium-phosphate management stabilization and parathyroid hormone levels reduction. The phosphate binders, synthetic vitamin D analogs and calcimimetics are used in sHPT treatment. In this paper we analyzed the results of three month paricalcitol treatment of 36 hemodialysis patients with sHPT (serum iPTH> 500 pg/ml). 11 patients have additionally received cinacalcet...
2016: Przegla̧d Lekarski
Patricia Dreyer, Monique Nakayama Ohe, Livia Marcela Dos Santos, Ilda Sizue Kunii, Rodrigo Oliveira Santos, Aluizio Barbosa de Carvalho, Jose Gilberto Henriques Vieira
INTRODUCTION: Hyperparathyroidism is a frequent complication of chronic kidney disease (CKD). Total parathyroidectomy (PTX) with parathyroid tissue autotransplantation (AT) is a treatment option in those individuals that do not respond to clinical management. OBJECTIVE: To evaluate grafted parathyroid tissue response during induced hypocalcemia among CKD patients who underwent total PTX with AT. METHODS: Eighteen patients with renal hyperparathyroidism were submitted to total PTX with parathyroid AT selected by stereomicroscopy between April and October 2008...
June 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Francescaromana Festuccia, Maryam Tayefeh Jafari, Alessandra Moioli, Claudia Fofi, Simona Barberi, Stefano Amendola, Salvatore Sciacchitano, Giorgio Punzo, Paolo Menè
BACKGROUND AND AIMS: In elderly subjects, renal insufficiency and osteoporosis often coexist with high risk of fracture and elevated socio-economic burden. Today a large number of effective anti-osteoporotic drugs are available but generally they are contraindicated in patients with chronic kidney disease (CKD) because of their progressive accumulation. Denosumab, instead, does not require dose adjustments for different degrees of renal impairment so it can be a valid treatment in osteoporotic patients with CKD...
July 9, 2016: Journal of Nephrology
Luca Di Lullo, Antonio Bellasi, Vincenzo Barbera, Mario Cozzolino, Domenico Russo, Antonio De Pascalis, Francesca Santoboni, Annalisa Villani, Silvia De Rosa, Marco Colafelice, Luigi Russo, Claudio Ronco
Cardiovascular disease and major cardiovascular events represent main cause of death in both acute and chronic kidney disease patients. Kidney and heart failure are common and frequently co-exist This organ-organ interaction, also called organ cross-talk, leads to well-known definition of cardiorenal syndrome (CRS). Here we will describe cardiovascular involvement in patients with acute kidney injury (AKI). Also known as Type-3 CRS or acute reno-cardiac CRS, it occurs when AKI contributes and/or precipitates development of acute cardiac injury...
May 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Sanjay Vikrant, Anupam Parashar
BACKGROUND: Disordered mineral metabolism is common complications of chronic kidney disease (CKD). However, there are limited data on the pattern of these disturbances in Indian CKD population. MATERIALS AND METHODS: This was a prospective observational study of CKD-mineral and bone disorder (CKD-MBD) over a period of 3 years. The biochemical markers of CKD-MBD, namely, calcium, phosphorus, alkaline phosphatase, intact parathyroid hormone (iPTH), and 25-hydoxyvitamin Vitamin D3 (25OHD), were measured in newly diagnosed CKD Stage 3-5 and prevalent CKD Stage 5D adult patients...
July 2016: Indian Journal of Endocrinology and Metabolism
Michal L Melamed, Rupinder Singh Buttar, Maria Coco
Patients with CKD stages 4 and 5 experience biochemical derangements associated with CKD-mineral bone disorder. Some of the key abnormalities are hyperparathyroidism, hyperphosphatemia, hypocalcemia, and metabolic acidosis. We review the available treatments for these conditions and the evidence behind the treatments. We conclude that there is greater evidence for treating hyperphosphatemia than hyperparathyroidism. Treatment of metabolic acidosis in small clinical trials appears to be safe. We caution the reader about side effects associated with some of these treatments that differ in patients with CKD Stages 4 and 5 compared with patients on dialysis...
July 2016: Advances in Chronic Kidney Disease
Moisés Carminatti, Natália Maria Silva Fernandes, Fernando Antônio Basile Colugnati, Helady Sanders-Pinheiro
OBJECTIVES: Kidney transplant recipients present with treatable complications related to chronic kidney disease, similarly to predialysis patients. The role of multidisciplinary clinics in the management of these complications in kidney transplant recipients is not fully understood. The objective of the present study was to compare the availability of specific treatments for chronic kidney disease-related complications between predialysis patients and kidney transplant recipients, both followed by a multidisciplinary team...
June 15, 2016: Experimental and Clinical Transplantation
Christopher Thiam Seong Lim
Oral sodium phosphate (OSP), an effective bowel purgative, is available over the counter (OTC) and requires a substantially lower volume than polyethylene glycol-based preparative agents. Rarely, OSP consumption has been associated with acute hypocalcemia and hyperphosphatemia. We describe a case of chronic kidney disease patient developing symptomatic hypocalcemia following OTC OSP.
May 2016: Indian Journal of Pharmacology
Takaaki Kimura, Kazuhiro Shiizaki, Makoto Kuro-O
Klotho was originally identified as an anti-aging gene that accelerated aging when disrupted and extended life span when overexpressed in mice. The Klotho gene encodes a single-pass transmembrane protein and is expressed in the kidney and parathyroid gland. Klotho protein functions as an obligate subunit of the receptor for fibroblast growth factor 23 (FGF23). FGF23 is a hormone secreted from osteocytes and osteoblasts and acts on renal tubular cells to promote phosphate excretion into the urine and suppress synthesis of active form of vitamin D (1,25-dihydroxyvitamin D3;1,25(OH)(2)D(3))...
June 2016: Clinical Calcium
Masanori Tokumoto
Secondary hyperparathyroidism (SHPT) is characterized by the acceleration of bone turnover due to the over-secretion of parathyroid hormone, which is accompanied with parathyroid hyperplasia. The pathogenesis includes the reduced production of calcitriol due to the elevated serum fibroblast growth factor 23 (FGF23) level to maintain phosphate (P) homeostasis, and its resultant hypocalcemia. Although the mechanism parathyroid glands sense P remains unknown, the expressions of calcium (Ca) sensing receptor and vitamin D receptor, which sense serum level of Ca and calcitriol respectively, down-regulate in chronic kidney disease...
June 2016: Clinical Calcium
Vitali Shilo, Justin Silver, Tally Naveh-Many
PURPOSE OF REVIEW: Micro-RNAs (miRNAs) are important to the function of many cells including endocrine systems. We present the reported changes in miRNA profiles in parathyroid adenomas and carcinomas. We review the essential roles of parathyroid miRNAs to the response of the parathyroid to hypocalcemia and uremia. RECENT FINDINGS: miRNA profiling in parathyroid adenomas and carcinomas revealed alterations in their miRNA expression. To study the function of miRNAs in the parathyroid, mice with parathyroid-specific deletion of dicer, the enzyme essential for miRNA maturation, were studied...
July 2016: Current Opinion in Nephrology and Hypertension
Nigar Sekercioglu, Jason W Busse, M Fatih Sekercioglu, Arnav Agarwal, Shaun Shaikh, Luciane Cruz Lopes, Reem A Mustafa, Gordon H Guyatt, Lehana Thabane
BACKGROUND: Chronic kidney disease-mineral and bone disorders (CKD-MBD) have been associated with poor health outcomes, including diminished quality and length of life. Standard management for CKD-MBD includes phosphate restricted diet, vitamin D and phosphate binders. Persistently elevated parathyroid hormone levels may require the addition of cinacalcet hydrochloride (cinacalcet), which sensitizes calcium receptors in the parathyroid gland. PURPOSE: The objective of this systematic review is to compare, in patients with CKD-MBD the effect of cinacalcet versus standard treatment on patient-important outcomes, including parathyroidectomy, fractures, hospitalizations due to cardiovascular events, cardiovascular mortality, all-cause mortality, and intermediate outcomes, in particular Kidney Disease Outcome Quality Initiative targets...
July 2016: Renal Failure
Yukihiro Wada, Masayuki Iyoda, Ken Iseri, Noriko Arai-Nunota, Tomohiro Saito, Toma Hamada, Shohei Tachibana, Misa Ikeda, Takanori Shibata
Denosumab (DMAb), a complete human type monoclonal antibody directed against the receptor activator of nuclear factor-κB ligand, has gained attention as a novel treatment for osteoporosis. However, its efficacy in patients with chronic kidney disease (CKD) remains unclear. We describe a 64-year-old man with severe bone loss and persistent secondary hyperparathyroidism (SHPT) after renal transplantation, whose condition failed to respond to conventional pharmacologic or surgical interventions. He underwent parathyroidectomy with left forearm autograft of crushed tiny parathyroid gland (PTG) particles...
2016: Tohoku Journal of Experimental Medicine
Mark R Fielden, Charles Dean, Kurt Black, Satin G Sawant, Raju Subramanian, James E Tomlinson, Sarah Walter, Cameron Zimmermann, Mark W Griggs, Marie E McKeon, Elise M Lewis, Carol Beevers, Ian Pyrah
Etelcalcetide is a novel d-amino acid peptide that functions as an allosteric activator of the calcium-sensing receptor and is being developed as an intravenous calcimimetic for the treatment of secondary hyperparathyroidism in patients with chronic kidney disease on hemodialysis. To support clinical development and marketing authorization, a comprehensive nonclinical safety package was generated. Primary adverse effects included hypocalcemia, tremoring, and convulsions. Other adverse effects were considered sequelae of stress associated with hypocalcemia...
May 2016: International Journal of Toxicology
Changlin Mei, Nan Chen, Xiaoqiang Ding, Xueqing Yu, Li Wang, Jiaqi Qian, Mei Wang, Gengru Jiang, Xuemei Li, Fanfan Hou, Li Zuo, Niansong Wang, Hong Liu
Introduction Secondary hyperparathyroidism (SHPT) develops in patients with chronic renal failure. Cinacalcet hydrochloride has been used successfully in U.S., Europe, and Japan in the treatment of SHPT, while maintaining serum levels of calcium and phosphorus. The efficacy and safety profile of Cinacalcet treatment vs. conventional treatments has been of great interest in clinical practice. In this recent phase III study conducted in China, efficacy and safety of a calcimimetic agent, Cinacalcet (Kyowa Hakko Kirin Co...
March 4, 2016: Hemodialysis International
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