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Hyperphosphatemia

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https://www.readbyqxmd.com/read/28087877/erratum
#1
Heather Nyman, Karly Pippitt, Alisyn Hansen, Karen Gunning
The article incorrectly stated: "Elevations of both fibroblast growth factor 23 (FGF23) and parathyroid hormone (PTH) lead to hyperphosphatemia and hypocalcemia because of decreased urinary excretion of phosphorus." In fact, FGF23 normally acts to lower blood phosphate levels. Furthermore, an elevated phosphorus level causes an increase in serum calcium levels and not hypocalcemia. This information has been corrected in the online version of the article.
November 2016: Journal of Family Practice
https://www.readbyqxmd.com/read/28078600/net-budgetary-impact-of-ferric-citrate-as-a-first-line-phosphate-binder-for-the-treatment-of-hyperphosphatemia-a-markov-microsimulation-model
#2
Steven M Brunelli, Scott P Sibbel, David Van Wyck, Amit Sharma, Andrew Hsieh, Glenn M Chertow
Ferric citrate (FC) has demonstrated efficacy as a phosphate binder and reduces the requirements for erythropoiesis-stimulating agents (ESAs) and intravenous (IV) iron in dialysis patients. We developed a net budgetary impact model to evaluate FC vs. other phosphate binders from the vantage of a large dialysis provider. We used a Markov microsimulation model to simulate mutually referential longitudinal effects between serum phosphate and phosphate binder dose; categories of these defined health states. Health states probabilistically determined treatment attendance and utilization of ESA and IV iron...
January 11, 2017: Drugs in R&D
https://www.readbyqxmd.com/read/28064444/phosphate-binders-and-targets-over-decades-do-we-have-it-right-now
#3
Morgan Marcuccilli, Michel Chonchol, Anna Jovanovich
In advanced renal disease, the kidney is unable to maintain phosphate balance due to decreased urinary excretion as well as the imbalance of the bone metabolic axis. It is well established that hyperphosphatemia is associated with increased cardiovascular events and mortality in patients with chronic kidney disease (CKD). However, there are no randomized controlled trials that demonstrate a clear benefit on hard outcomes in lowering serum phosphate levels to recommended targets in the CKD or dialysis population...
January 8, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28045952/predictive-factors-of-one-year-mortality-in-a-cohort-of-patients-undergoing-urgent-start-hemodialysis
#4
Luciene P Magalhães, Luciene M Dos Reis, Fabiana G Graciolli, Benedito J Pereira, Rodrigo B de Oliveira, Altay A L de Souza, Rosa M Moyses, Rosilene M Elias, Vanda Jorgetti
BACKGROUND: Chronic kidney disease (CKD) affects 10-15% of adult population worldwide. Incident patients on hemodialysis, mainly those on urgent-start dialysis at the emergency room, have a high mortality risk, which may reflect the absence of nephrology care. A lack of data exists regarding the influence of baseline factors on the mortality of these patients. The aim of this study was to evaluate the clinical and laboratory characteristics of this population and identify risk factors that contribute to their mortality...
2017: PloS One
https://www.readbyqxmd.com/read/28009416/sleep-quality-and-risk-factors-of-atherosclerosis-in-predialysis-chronic-kidney-disease
#5
Ibrahim Guney, Yavuz Sultan Selim Akgul, Vedat Gencer, Harun Aydemir, Uysaler Aslan, Samil Ecirli
INTRODUCTION: Chronic kidney disease (CKD) patients have more frequent sleep disorders and cardiovascular disease than normals. Since arterial stiffness as a risk factor of atherosclerosis can be evaluated with pulse wave velocity (PWV), we aimed to investigate the prevalance of sleep quality (SQ) and the relationship between SQ and risk factors of atherosclerosis and whether there is a relationship between SQ and PWV (the indicator of arterial stiffness) in predialysis CKD patients. METHODS: This cross-sectional study was carried out in CKD patients followed at the Nephrology Department in Konya, Turkey, between November 2014 and March 2015...
December 19, 2016: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28005411/a-mutation-in-the-dmp1-gene-alters-phosphate-responsiveness-in-mice
#6
Shoji Ichikawa, Rita Gerard-O'Riley, Dena Acton, Amie K McQueen, Isabel E Strobel, Phillip C Witcher, Jian Q Feng, Michael J Econs
Mutations in the dentin matrix protein 1 (DMP1) gene cause autosomal recessive hypophosphatemic rickets (ARHR). Hypophosphatemia in ARHR results from increased circulating levels of a phosphaturic hormone, fibroblast growth factor 23 (FGF23). Similarly, elevated FGF23, caused by mutations in the PHEX gene, is responsible for the hypophosphatemia in X-linked hypophosphatemic rickets (XLH). Previously, we demonstrated that a Phex mutation in mice creates a lower set point for extracellular phosphate, where an increment in phosphorus further stimulates Fgf23 production to maintain low serum phosphorus levels...
December 22, 2016: Endocrinology
https://www.readbyqxmd.com/read/27995443/pseudohypoparathyroidism-one-gene-several-syndromes
#7
REVIEW
O Tafaj, H Jüppner
Pseudohypoparathyroidism (PHP) and pseudopseudohypoparathyroidism (PPHP) are caused by mutations and/or epigenetic changes at the complex GNAS locus on chromosome 20q13.3 that undergoes parent-specific methylation changes at several sites. GNAS encodes the alpha-subunit of the stimulatory G protein (Gsα) and several splice variants thereof. Heterozygous inactivating mutations involving the maternal GNAS exons 1-13 cause PHP type Ia (PHP1A). Because of much reduced paternal Gsα expression in certain tissues, such as the proximal renal tubules, thyroid, and pituitary, there is little or no Gsα protein in the presence of maternal GNAS mutations, thus leading to PTH-resistant hypocalcemia and hyperphosphatemia...
December 19, 2016: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/27988050/a-quick-reference-on-phosphorus
#8
REVIEW
Ashley E Allen-Durrance
Phosphorus, or phosphate, is the body's major intracellular anion involved in numerous biological processes. Most phosphate is intracellular, with the remaining amount contained within soft tissues and the extracellular space. Parathyroid hormone, calcitriol, calcitonin, and phosphatonins regulate normal phosphate homeostasis by adjusting renal and/or gastrointestinal absorption and/or excretion. Hypophosphatemia occurs secondary to decreased gastrointestinal absorption, transcellular shifts, increased renal excretion, or some combination of these general mechanisms...
December 14, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27971356/cost-effectiveness-analysis-of-sucroferric-oxyhydroxide-in-treatment-of-hyperphosphatemia-in-patients-with-chronic-kidney-disease
#9
D Ugrekhelidze, R Yagudina, A Kulikov
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27971351/budget-impact-analysis-of-sucroferric-oxyhydroxide-in-treatment-of-hyperphosphatemia-in-patients-with-chronic-kidney-disease
#10
D Ugrekhelidze, R Yagudina, A Kulikov
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27966564/habitual-dietary-phosphorus-intake-and-urinary-excretion-in-chronic-kidney-disease-patients-a-3-day-observational-study
#11
L Salomo, A-L Kamper, G M Poulsen, S K Poulsen, A Astrup, M Rix
Hyperphosphatemia in chronic kidney disease (CKD) is associated with vascular calcification, cardiovascular morbidity and mortality. The aim of this study was to estimate the daily dietary phosphorus intake compared with recommendations in CKD patients and to evaluate the reproducibility of the 24-h urinary phosphorus excretion. Twenty CKD patients stage 3-4 from the outpatient clinic, collected 24-h urine and kept dietary records for 3 consecutive days. The mean daily phosphorus intake was 1367±499, 1642±815 and 1426±706 mg/day, respectively (P=0...
December 14, 2016: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/27965186/impact-of-sevelamer-hydrochloride-on-serum-magnesium-concentrations-in-hemodialysis-patients
#12
Ryota Ikee, Takayuki Toyoyama, Toko Endo, Masataka Tsunoda, Nobuo Hashimoto
Serum Mg levels are elevated in patients with renal insufficiency: harmful effects of hypomagnesemia have been reported in patients receiving hemodialysis (HD). In this cross-sectional study, which included 86 HD patients (male : female = 56:30, age 68 ± 12 years), we examined the clinical factors associated with serum Mg levels, with a focus on sevelamer, a phosphate binder widely used to control the hyperphosphatemia of HD patients. The mean serum Mg concentration among our patients was 2.48 ± 0.37 mg/dL (1...
December 12, 2016: Magnesium Research: Official Organ of the International Society for the Development of Research on Magnesium
https://www.readbyqxmd.com/read/27957353/short-term-pth-1-34-therapy-in-children-to-correct-severe-hypocalcemia-and-hyperphosphatemia-due-to-hypoparathyroidism-two-case-studies
#13
Pooja E Mishra, Betsy L Schwartz, Kyriakie Sarafoglou, Kristen Hook, Youngki Kim, Anna Petryk
The standard treatment of hypoparathyroidism is to control hypocalcemia using calcitriol and calcium supplementation. However, in severe cases this approach is insufficient, and the risks of intravenous (i.v.) calcium administration and prolonged hospitalization must be considered. While the use of recombinant human parathyroid hormone 1-34 [rhPTH(1-34)] for long-term control of hypocalcemia has been established, the benefits of short-term rhPTH(1-34) treatment in children have not been explored. We report two patients with hypoparathyroidism treated with rhPTH(1-34)...
2016: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/27951564/preventive-strategies-for-vascular-calcification-in-patients-with-chronic-kidney-disease
#14
Takashi Shigematsu, Tomohiro Sonou, Masaki Ohya, Keitaro Yokoyama, Hiraku Yoshida, Takashi Yokoo, Kouji Okuda, Asuka R Masumoto, Yuko Iwashita, Keiko Iseki, Satoko Kunimoto, Yukiko Yamano
BACKGROUND: Vascular calcification is significant because of the close association between the degree of vascular calcification and cardiovascular mortality in chronic kidney disease (CKD) patients. SUMMARY: There are 2 types of vascular calcification in CKD patients. One is endothelial vascular calcification, a common type of vascular calcification. Another is medial vascular calcification, a specific type that is common in CKD patients. The former is mainly associated with atherosclerosis due to hyperlipidemia, especially hypercholesterolemia...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27936520/factors-effective-on-peritoneal-phosphorus-transport-and-clearance-in-peritoneal-dialysis-patients%C3%A2
#15
Egemen Cebeci, Meltem Gursu, Sami Uzun, Serhat Karadag, Rumeyza Kazancioglu, Savas Ozturk
AIMS: Transport characteristics of phosphorus are different from other small solutes that are evaluated in routine peritoneal equilibration test (PET) in peritoneal dialysis (PD) patients. We aimed to evaluate peritoneal phosphorus clearance and permeability, and their relationship with peritoneal membrane transport type and creatinine clearance as well as factors affecting peritoneal phosphorus clearance. METHODS: 70 adult patients on a PD program were included in our study...
February 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/27933339/efficacy-and-safety-of-osteoporosis-medications-in-a-rat-model-of-late-stage-chronic-kidney-disease-accompanied-by-secondary-hyperparathyroidism-and-hyperphosphatemia
#16
M Ota, M Takahata, T Shimizu, Y Kanehira, H Kimura-Suda, Y Kameda, H Hamano, S Hiratsuka, D Sato, N Iwasaki
: This study showed that bisphosphonate was safe and effective for the treatment of bone disorders in stage 4 chronic kidney disease (CKD) rats. Intermittent teriparatide therapy showed an anabolic action on bone even under secondary hyperparathyroidism conditions without having an adverse effect on mineral metabolism in late-stage CKD. INTRODUCTION: Patients with late-stage CKD are at high risk for fragility fractures. However, there are no consensus on the efficacy and safety of osteoporosis medications for patients with late-stage CKD...
December 8, 2016: Osteoporosis International
https://www.readbyqxmd.com/read/27929669/fgf23-is-not-required-to-regulate-fetal-phosphorus-metabolism-but-exerts-effects-within-12-hours-after-birth
#17
Yue Ma, Beth J Kirby, Nicholas A Fairbridge, Andrew C Karaplis, Beate Lanske, Christopher S Kovacs
Loss of fibroblast growth factor 23 (FGF23) causes hyperphosphatemia, extraskeletal calcifications, and early mortality; excess FGF23 causes hypophosphatemia with rickets or osteomalacia. However, FGF23 may not be important during fetal development. FGF23 deficiency (Fgf23 null) and FGF23 excess (Phex null) did not alter fetal phosphorus or skeletal parameters. In this study we further tested our hypothesis that FGF23 is not essential for fetal phosphorus regulation but becomes important after birth. Although co-receptor Klotho null adults have extremely high FGF23 concentrations, intact FGF23 was normal in Klotho null fetuses, as were fetal phosphorus and skeletal parameters, and placental and renal expression of FGF23 target genes...
December 8, 2016: Endocrinology
https://www.readbyqxmd.com/read/27928449/severe-asymptomatic-coronary-obstruction-in-chronic-hemodialysed-patient-a-case-report
#18
Voiculeț C, Zara O, Văcăroiu I, Bogeanu C, Tiron T, Turcu F, Aron G, Ciocâlteu A
Introduction. Arterial stiffness and vascular calcifications are independent predictors of cardiovascular morbidity and mortality in the chronic kidney disease (CKD) stage 5D population. According to the guidelines, patients on renal replacement therapy represent a very high cardiovascular risk class. Case report. We report the case of a 67-year-old hypertensive male patient, known with CKD stage 5D on hemodialysis (three times per week), secondary bone mineral disease, admitted for progressive right leg pain...
October 2016: Journal of Medicine and Life
https://www.readbyqxmd.com/read/27922249/severe-hyperphosphatemia-after-oral-laxative-administration-in-a-7-year-old-patient
#19
Çağlar Ödek, Tanıl Kendirli, Ayhan Yaman, Eda Didem Kurt-Şükür, Onur Telli, Berk Burgu, Z Birsin Özçakar
Sodium phosphate based laxatives are commonly used for constipation and pre-procedural bowel cleansing. Phosphate intoxication related with these preparations is well recognized. Herein, we present a case of severe hyperphosphatemia and seizure in a 7-year-old male patient after administration of an oral sodium phosphate based laxative. At the time of admission, serum phosphorus level was 25.6 mg/dl. Aggressive fluid therapy was started. Although serum phosphorus level decreased to 20.9 mg/dl eight hours after admission, hemodialysis was performed because of the preexisting renal disease and declined glomerular filtration rate...
2016: Turkish Journal of Pediatrics
https://www.readbyqxmd.com/read/27922245/a-novel-mutation-in-a-case-of-pseudohypoparathyroidism-type-ia
#20
Birgül Kırel, Meliha Demiral, Özkan Bozdağ, Kadri Karaer
Pseudohypoparathyroidism (PHP) type Ia is characterized by multiple hormone resistance; primarily parathyroid hormone (PTH) resistance and Albright's hereditary osteodystrophy (AHO) which involves skeletal and developmental defects. The AHO phenotype alone without hormone resistance is defined as pseudoPHP. A boy was first diagnosed as having both rickets and primary hypothyroidism at 2.5 months of age. His calcium level remained within normal levels after vitamin D treatment, but, elevated PTH and ALP levels and normal-high phosphate levels persisted during his follow-up by age of 2...
2016: Turkish Journal of Pediatrics
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