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Secondary hyperparathyroidism

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https://www.readbyqxmd.com/read/29786181/-new-scenarios-in-secondary-hyperparathyroidism-etelcalcetide-position-paper-of-nephrologists-form-lombardy
#1
Antonio Bellasi, Mario Cozzolino, Fabio Malberti, Giovanni Cancarini, Ciro Esposito, Augusto Genderini, Carlo Maria Guastoni, Patrizia Ondei, Giuseppe Pontoriero, Ugo Teatini, Giuseppe Vezzoli, Piergiorgio Messa, Francesco Locatelli
Bone mineral abnormalities (defined as Chronic Kidney Disease Mineral Bone Disorder; CKD-MBD) are prevalent and associated with a substantial risk burden and poor prognosis in CKD population. Several lines of evidence support the notion that a large proportion of patients receiving maintenance dialysis experience a suboptimal biochemical control of CKD-MBD. Although no study has ever demonstrated conclusively that CKD-MBD control is associated with improved survival, an expanding therapeutic armamentarium is available to correct bone mineral abnormalities...
May 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29786179/-update-2017-of-the-kdigo-guidelines-on-chronic-kidney-disease-mineral-and-bone-disorder-ckd-mbd-what-are-the-real-changes
#2
Marzia Pasquali, Antonio Bellasi, Giuseppe Cianciolo, Carlo Massimetti, Maria Cristina Mereu, Luigi Morrone, Vincenzo Panuccio
Guidelines for the assessment, diagnosis and therapy of the alterations that characterize the CKD-MBD are an important support in the clinical practice of the nephrologist. Compared to the KDIGO guidelines published in 2009, the 2017 update made changes on some topics on which there was previously no strong evidence both in terms of diagnosis and therapy. The recommendations include the diagnosis of bone anomalies in CKD-MBD and the treatment of mineral metabolism abnormalities with particular regard to hyperphosphataemia, calcium levels, secondary hyperparathyroidism and anti-resorptive therapies...
May 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29782253/-mineral-and-bone-disorders-in-chronic-heart-failure
#3
E V Reznik, I G Nikitin
In many patients, chronic heart failure (CHF) is associated with chronic kidney disease (CKD). Virtually all patients with terminal CKD and many patients with early CKD display various disorders of mineral and bone metabolism (MBM) related with all-cause mortality and high risk of cardiovascular complications. This review addressed disorders of mineral and bone metabolism in patients with CHF, including hypocalcemia, hyperphosphatemia, vitamin D insufficiency/deficiency, secondary hyperparathyroidism, changed levels of FGF23 and Klotho, osteoporosis, osteopenia, their clinical and prognostic significance, and possibilities of their correction...
2018: Kardiologiia
https://www.readbyqxmd.com/read/29779028/dietary-changes-involving-bifidobacterium-longum-and-other-nutrients-delays-chronic-kidney-disease-progression
#4
Yuko Iwashita, Masaki Ohya, Mitsuru Yashiro, Tomohiro Sonou, Kazuki Kawakami, Yuri Nakashima, Takuro Yano, Yu Iwashita, Toru Mima, Shigeo Negi, Kaoru Kubo, Koichi Tomoda, Toshitaka Odamaki, Takashi Shigematsu
BACKGROUND: Recent studies suggest that prebiotic and/or probiotic treatments ameliorate kidney function in humans and animals by improving the gut environment. However, the gut microbiota and kidney disease interactions remain to be determined. This study investigated whether synbiotics modulate the gut microbiota and ameliorate kidney function using a rat model of chronic kidney disease (CKD). As uremic toxins are associated with CKD-related mineral and bone disorder, the secondary aim was to evaluate the relationship between synbiotics and secondary hyperparathyroidism (SHPT)...
May 18, 2018: American Journal of Nephrology
https://www.readbyqxmd.com/read/29775967/bilateral-breast-calciphylaxis-in-a-patient-who-survived-earlier-extensive-tissue-necrosis-5-years-previously-a-case-report
#5
E M J Verstappen, A J G Maaskant-Braat, M R Scheltinga
INTRODUCTION: Calciphylaxis is a rare condition including patchy dermal necrosis that mostly affects chronic hemodialysis patients. The syndrome usually heralds impending death although patients may survive following a set of measures including an adapted dialysis regimen. The present case is a unique patient who recovered from an earlier episode of upper leg calciphylaxis 5 years previously but developed fatal bilateral breast necrosis. PRESENTATION OF CASE: A 69 year old Caucasian woman with a history of atrial fibrillation, hypertension, CVA, hyperparathyroidectomy for secondary hyperparathyroidism and end stage renal disease with hemodialysis recovered in 2012 from extensive symptomatic left upper leg necrosis due to calciphylaxis...
May 7, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29773914/risk-factors-for-severe-hypocalcemia-after-parathyroidectomy-in-dialysis-patients-with-secondary-hyperparathyroidism
#6
Xiaoliang Sun, Xiaoqing Zhang, Yao Lu, Ling Zhang, Meng Yang
Severe hypocalcemia (SH) is a common and serious complication in dialysis patients with secondary hyperparathyroidism (SHPT) after parathyroidectomy (PTX). The aim is to explore the risk predictors of SH in post-PTX dialysis ESRD patients with SHPT. 129 consecutive dialysis patients with SHPT underwent PTX were retrospectively reviewed. A total of 22 clinical parameters were included in the study. SH was defined as the minimum values of serum calcium lower than 1.875 mmol/L (7.5 mg/dL) after surgery. Univariate analysis showed that pruritus, lumbar X-ray changes of renal osteodystrophy, pre- and post-operative intact parathyroid hormone (iPTH), Calcium, alkaline phosphatase, and gland mass were significantly different between SH and non-SH groups...
May 17, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29771721/the-impact-of-surgical-strategy-on-the-consequences-of-secondary-hyperparathyroidism
#7
Mehmet Uludag, Kinyas Kartal
No abstract text is available yet for this article.
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29768384/therapeutic-experience-of-severe-and-recurrent-secondary-hyperparathyroidism-in-a-patient-on-hemodialysis-for-18-years-a-case-report
#8
Mingwen Zhu, Zongming Zhang, Fangcai Lin, Jieping Miao, Pei Wang, Chong Zhang, Hongwei Yu, Hai Deng, Zhuo Liu, Limin Liu, Baijiang Wan, Haiyan Yang, Mengmeng Song, Yue Zhao, Nan Jiang, Zichao Zhang, Zhenya Zhang, Lijie Pan
INTRODUCTION: For patients with refractory secondary hyperparathyroidism (SHPT), parathyroidectomy (PTX) has received increasing attention. However, evidence-based medicine shows that there is still controversy regarding surgical methods, efficacy, and safety. We retrospectively analyzed the process of diagnosis and treatment in one patient with severe SHPT and long-term chronic renal failure (CRF), so as to further improve the therapeutic effect. CASE PRESENTATION: A 61-year-old female with SHPT and CRF manifested as no urine for 18 years, underwent PTX 4 times since September 2010, with satisfactory final recovery...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29767854/emerging-association-between-parathyroid-hormone-and-anemia-in-hemodialysis-patients
#9
REVIEW
Motoko Tanaka, Hirotaka Komaba, Masafumi Fukagawa
Anemia is a common complication of chronic kidney disease (CKD). There are various causes of renal anemia such as decreased production of erythropoietin, resistance to erythropoietin, shortened survival of red blood cells, and bone marrow fibrosis. Secondary hyperparathyroidism (SHPT) is a less recognized, but potentially significant cause of renal anemia in CKD patients. Parathyroid hormone (PTH) has been regarded as a uremic toxin that has multiple adverse effects, and its elevated levels have been associated with renal anemia in hemodialysis patients...
May 16, 2018: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/29765869/nutritional-secondary-hyperparathyroidism-in-two-ponies
#10
Luca Lacitignola, Pasquale De Luca, Rossella Santovito, Maria Severa Di Comite, Antonio Crovace
Nutritional secondary hyperparathyroidism (NSH) is uncommon in horses. Aim of this report is evaluate an alternative therapeutic approach and provide more information on the diagnostic procedures, through detailed microscopic findings of the bone lesions pony with NSH. Administration of tiludronate along with a balanced diet can be used in a treatment protocol for ponies with NSH. This case report suggests that tiludronate can be used to ameliorate the clinical signs of NSH.
2018: Open Veterinary Journal
https://www.readbyqxmd.com/read/29764395/longitudinal-changes-in-bone-and-mineral-metabolism-after-cessation-of-cinacalcet-in-dialysis-patients-with-secondary-hyperparathyroidism
#11
Irene Ruderman, Edward R Smith, Nigel D Toussaint, Tim D Hewitson, Stephen G Holt
BACKGROUND: The calcimimetic agent cinacalcet is effective for the management of secondary hyperparathyroidism (SHPT) in dialysis patients. Changes to reimbursement of cinacalcet in Australia provided an opportunity to assess effects of medication cessation on biochemical and clinical outcomes in dialysis patients, including changes to novel biomarkers such as calciprotein particles (CPP). CPP are nanoparticles of mineral and protein in the circulation associated with increased vascular calcification in patients with chronic kidney disease...
May 15, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29763933/the-calcium-sensing-receptor-gene-polymorphism-rs1801725-and-calcium-related-phenotypes-in-hemodialysis-patients
#12
Alicja E Grzegorzewska, Dariusz Bednarski, Monika Świderska, Adrianna Mostowska, Paweł P Jagodziński
BACKGROUND/AIMS: The calcium-sensing receptor gene (CASR) rs1801725 variant is responsible for a non-conservative amino-acid change (A986S) in the calcium-sensing receptor cytoplasmic tail. We hypothesized that rs1801725 polymorphism might be helpful in understanding Ca-related abnormalities in HD patients. METHODS: In 1215 subjects (245 on cinacalcet), we determined the associations of rs1801725 with secondary hyperparathyroidism (sHPT)-related laboratory parameters, PTH-decreasing effect of cinacalcet hydrochloride, coronary artery disease (CAD), myocardial infarction (MI), nephrolithiasis-related ESRD, and mortality...
May 10, 2018: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29762046/effects-of-calcimimetics-on-long-term-outcomes-in-dialysis-patients-literature-review-and-bayesian-meta-analysis
#13
Greta Lozano-Ortega, Nathalie Waser, Mark E Bensink, Sarah Goring, Heather Bennett, Geoffrey A Block, Glenn M Chertow, Marie-Louise Trotman, Kerry Cooper, Adrian R Levy, Vasily Belozeroff
AIM: Randomized controlled trials (RCTs) with clinical outcomes are considered the gold standard for regulatory approval. However, by design they are only able to answer a small number of clinical questions. Other high-quality studies are required for clinical decision-making. The EVOLVE was the largest RCT, evaluating the effects of cinacalcet on clinical outcomes among adult patients receiving maintenance dialysis suffering from secondary hyperparathyroidism. While the EVOLVE trial did not reach its primary end point, imbalance in subjects' age at randomization and discontinuation rates are two of the reasons that the lack of mortality benefit is in question...
May 15, 2018: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/29757564/-re-operation-treatment-in-uremic-patients-complicated-with-persistent-secondary-hyperparathyroidism-after-parathyroidectomy-with-autotransplantation
#14
Shao Jun Bo, Xian Fa Xu, Chuan Ya Qiu, Tian Tian Wang, Yu Dong Ning, Hong Yue Li
Objective: To analyze the clinical profile and therapeutic effect of re-operation treatment in uremic patients complicated with persistent secondary hyperparathyroidism(SHPT)after parathyroidectomy with autotransplantation. Method: Twelve persistent SHPT patients who were treated with reoperation of paramyroidectomy(PTX)were enrolled in this study during the period from Jan 2014 to Jul 2017 in our hospital.We evaluated the location of the remaining parathyroid glands by ultrasonography,dual-phase 99 Tcm-sestamibi scintigraphy,CT and MR imaging of the neck before the operation...
January 20, 2018: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
https://www.readbyqxmd.com/read/29753400/updates-on-the-mechanisms-and-the-care-of-cardiovascular-calcification-in-chronic-kidney-disease
#15
REVIEW
Lucie Hénaut, Jean-Marc Chillon, Saïd Kamel, Ziad A Massy
In chronic kidney disease (CKD), the progressive decrease in renal function leads to disturbances of mineral metabolism that generally cause secondary hyperparathyroidism. The increase in serum parathyroid hormone is associated with reduced serum calcium and calcitriol levels and/or increased serum fibroblast growth factor-23 and phosphate levels. The resulting CKD-associated disorder of mineral and bone metabolism is associated with various other metabolic dysregulations such as acidosis, malnutrition, inflammation, and accumulation of uremic toxins...
May 2018: Seminars in Nephrology
https://www.readbyqxmd.com/read/29745791/prevention-and-management-of-osteoporosis-and-osteoporotic-fractures-in-persons-with-a-spinal-cord-injury-or-disorder-a-systematic-scoping-review
#16
Nour Zleik, Frances Weaver, Robert L Harmon, Brian Le, Reshmitha Radhakrishnan, Wanda D Jirau-Rosaly, B Catharine Craven, Mattie Raiford, Jennifer N Hill, Bella Etingen, Marylou Guihan, Michael H Heggeness, Cara Ray, Laura Carbone
OBJECTIVES: The primary objective was to review the literature regarding methodologies to assess fracture risk, to prevent and treat osteoporosis and to manage osteoporotic fractures in SCI/D. STUDY DESIGN: Scoping review. Settings/Participants: Human adult subjects with a SCI/D. OUTCOME MEASURES: Strategies to identify persons with SCI/D at risk for osteoporotic fractures, nonpharmacological and pharmacological therapies for osteoporosis and management of appendicular fractures...
May 10, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29741651/serum-phosphate-optimal-timing-and-range-associated-with-patients-survival-in-haemodialysis-the-cosmos-study
#17
José L Fernández-Martín, Adriana Dusso, Pablo Martínez-Camblor, Maria P Dionisi, Jürgen Floege, Markus Ketteler, Gérard London, Francesco Locatelli, José L Górriz, Boleslaw Rutkowski, Willem-Jan Bos, Christian Tielemans, Pierre-Yves Martin, Rudolf P Wüthrich, Drasko Pavlovic, Miha Benedik, Diego Rodríguez-Puyol, Juan J Carrero, Carmine Zoccali, Jorge B Cannata-Andía
Background: Serum phosphate is a key parameter in the management of chronic kidney disease-mineral and bone disorder (CKD-MBD). The timing of phosphate measurement is not standardized in the current guidelines. Since the optimal range of these biomarkers may vary depending on the duration of the interdialytic interval, in this analysis of the Current management of secondary hyperparathyroidism: a multicentre observational study (COSMOS), we assessed the influence of a 2- (midweek) or 3-day (post-weekend) dialysis interval for blood withdrawal on serum levels of CKD-MBD biomarkers and their association with mortality risk...
May 7, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29734949/a-case-of-hyperparathyroidism-associated-parkinsonism-successfully-treated-with-cinacalcet-hydrochloride-a-calcimimetic
#18
Yuichiro Ohya, Masato Osaki, Shota Sakai, Shunsuke Kimura, Chiharu Yasuda, Tetsuro Ago, Takanari Kitazono, Shuji Arakawa
BACKGROUND: Some metabolic disorders, including abnormal calcium metabolism, can develop and worsen parkinsonism. However, whether hyperparathyroidism can cause parkinsonism remains controversial. CASE PRESENTATION: An 83-year-old woman with a history of right thalamic hemorrhage and drug-induced parkinsonism, was admitted due to worsening of parkinsonian symptoms including mask-like face, bradykinesia, freezing of gait, and rigidity. She had been diagnosed with autoimmune hepatitis and was being treated with prednisolone...
May 7, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29725779/expansive-renal-osteitis-fibrosa-a-case-report
#19
Gabriel Silva Andrade, Abrahão Cavalcante Gomes de Souza Carvalho, Tibério Gomes Magalhães, Edson Luiz Cetira Filho, Roberta Barroso Cavalcante, Renato Luiz Maia Nogueira
Hyperparathyroidism (HPT) is an endocrine metabolic disorder characterized by increased secretion of parathyroid hormone. Untreated secondary HPT leads to renal osteodystrophy (ROD). Facial skeletal abnormalities in patients with ROD are rare. The purpose of this paper is to report a conservative surgical approach of exuberant osteitis fibrosa lesions in patient with chronic kidney disease. A 24-year-old female was referred to maxillofacial surgery department with giants ROD affecting palate, maxilla, and mandible, resulting in esthetic and functional impairment...
May 4, 2018: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29724589/discovery-of-evocalcet-a-next-generation-calcium-sensing-receptor-agonist-for-the-treatment-of-hyperparathyroidism
#20
Hiroshi Miyazaki, Yousuke Ikeda, Osamu Sakurai, Tsutomu Miyake, Rie Tsubota, Jyunko Okabe, Masataka Kuroda, Yutaka Hisada, Tetsuya Yanagida, Hikaru Yoneda, Yukihito Tsukumo, Shin Tokunaga, Takehisa Kawata, Rikiya Ohashi, Hajime Fukuda, Koki Kojima, Ayako Kannami, Takayuki Kifuji, Naoya Sato, Akiko Idei, Taku Iguchi, Tetsuya Sakairi, Yasunori Moritani
The calcium-sensing receptor (CaSR) plays an important role in sensing extracellular calcium ions and regulating parathyroid hormone secretion by parathyroid gland cells, and the receptor is a suitable target for the treatment of hyperparathyroidism. Cinacalcet hydrochloride is a representative CaSR agonist which widely used for the hyperparathyroidism. However, it has several issues to clinical use, such as nausea/vomiting and strong inhibition of CYP2D6. We tried to improve these issues of cinacalcet for a new pharmaceutical agent as a preferable CaSR agonist...
April 24, 2018: Bioorganic & Medicinal Chemistry Letters
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