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Hyperphosphatemia

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https://www.readbyqxmd.com/read/28550080/two-phosphate-targets-in-end-stage-renal-disease-trial-target-a-randomized-controlled-trial
#1
Ron Wald, Christian G Rabbat, Louis Girard, Amit X Garg, Karthik Tennankore, Jessica Tyrwhitt, Andrew Smyth, Andrea Rathe-Skafel, Peggy Gao, Andrea Mazzetti, Jackie Bosch, Andrew T Yan, Patrick Parfrey, Braden J Manns, Michael Walsh
BACKGROUND AND OBJECTIVES: Hyperphosphatemia is common among recipients of maintenance dialysis and is associated with a higher risk of mortality and cardiovascular events. A large randomized trial is needed to determine whether lowering phosphate concentrations with binders improves patient-important outcomes. To inform such an effort we conducted a pilot randomized controlled trial. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a randomized controlled trial of prevalent hemodialysis recipients already receiving calcium carbonate as a phosphate binder at five Canadian centers between March 31, 2014 and October 2, 2014...
May 26, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28533541/development-of-a-novel-chronic-kidney-disease-mouse-model-to-evaluate-the-progression-of-hyperphosphatemia-and-associated-mineral-bone-disease
#2
Takashi Tani, Hideo Orimo, Akira Shimizu, Shuichi Tsuruoka
Medial arterial calcification (MAC) and renal osteodystrophy are complications of mineral bone disease (MBD) associated with chronic kidney disease (CKD). Our aim was to develop a novel mouse model to investigate the clinical course of CKD-MBD. Eight-week-old C57BL/6 J male mice were assigned to the following groups: the control group, fed a standard chow for 6 or 12 weeks; the CKD-normal phosphorus (NP) group, fed a chow containing 0.2% adenine, with normal (0.8%) phosphorus, for 6 or 12 weeks; and the CKD-high phosphorus (HP) group, fed 6 weeks with the 0...
May 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28531397/most-consumed-processed-foods-by-patients-on-hemodialysis-alert-for-phosphate-containing-additives-and-the-phosphate-to-protein-ratio
#3
Marcela T Watanabe, Raphael M Araujo, Barbara P Vogt, Pasqual Barretti, Jacqueline C T Caramori
BACKGROUND AND AIMS: Hyperphosphatemia is common in patients with chronic kidney disease (CKD) stages IV and V because of decreased phosphorus excretion. Phosphatemia is closely related to dietary intake. Thus, a better understanding of sources of dietary phosphate consumption, absorption and restriction, particularly inorganic phosphate found in food additives, is key to prevent consequences of this complication. Our aims were to investigate the most commonly consumed processed foods by patients with CKD on hemodialysis, to analyze phosphate and protein content of these foods using chemical analysis and to compare these processed foods with fresh foods...
August 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28525508/analysis-of-hypo-and-hyperphosphatemia-in-an-intensive-care-unit-cohort
#4
Marcus Broman, Amanda M J Wilsson, Fredrik Hansson, Bengt Klarin
BACKGROUND: Blood phosphate levels are vulnerable to fluctuations and changes in phosphate levels are often neglected. The aim of this study was to evaluate whether deviations in phosphate levels correlate to higher 180-day overall mortality or morbidity. METHODS: Four thousand six hundred fifty-six patients with 19,467 phosphate values treated at the adult intensive care unit at Skåne University Hospital, Lund, Sweden during 2006-2014 were retrospectively divided into a control group and 3 study groups: hypophosphatemia, hyperphosphatemia, and a mixed group showing both hypo/hyperphosphatemia...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28522697/circulating-microrna-125b-predicts-the-presence-and-progression-of-uremic-vascular-calcification
#5
Chia-Ter Chao, You-Pi Liu, Sheng-Fang Su, Hsiang-Yuan Yeh, Hsuan-Yu Chen, Pei-Jung Lee, Wan-Jiun Chen, Yee-Ming Lee, Jenq-Wen Huang, Chih-Kang Chiang, Kuan-Yu Hung, Huei-Wen Chen
OBJECTIVE: Vascular calcification (VC) is a major cause of mortality in patients with end-stage renal diseases. Biomarkers to predict the progression of VC early are in urgent demand. APPROACH AND RESULTS: We identified circulating, cell-free microRNAs as potential biomarkers using in vitro VC models in which both rat and human aortic vascular smooth muscle cells were treated with high levels of phosphate to mimic uremic hyperphosphatemia. Using an Affymetrix microRNA array, we found that miR-125b and miR-382 expression levels declined significantly as biomineralization progressed, but this decline was only observed for miR-125b in the culture medium...
May 18, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28515448/involvement-of-vascular-aldosterone-synthase-in-phosphate-induced-osteogenic-transformation-of-vascular-smooth-muscle-cells
#6
Ioana Alesutan, Jakob Voelkl, Martina Feger, Denise V Kratschmar, Tatsiana Castor, Sobuj Mia, Michael Sacherer, Robert Viereck, Oliver Borst, Christina Leibrock, Meinrad Gawaz, Makoto Kuro-O, Stefan Pilz, Andreas Tomaschitz, Alex Odermatt, Burkert Pieske, Carsten A Wagner, Florian Lang
Vascular calcification resulting from hyperphosphatemia is a major determinant of mortality in chronic kidney disease (CKD). Vascular calcification is driven by aldosterone-sensitive osteogenic transformation of vascular smooth muscle cells (VSMCs). We show that even in absence of exogenous aldosterone, silencing and pharmacological inhibition (spironolactone, eplerenone) of the mineralocorticoid receptor (MR) ameliorated phosphate-induced osteo-/chondrogenic transformation of primary human aortic smooth muscle cells (HAoSMCs)...
May 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28515153/differential-regulation-of-renal-klotho-and-fgfr1-in-normal-and-uremic-rats
#7
Juan R Muñoz-Castañeda, Carmen Herencia, Maria Victoria Pendón-Ruiz de Mier, Maria Encarnación Rodriguez-Ortiz, Juan M Diaz-Tocados, Noemi Vergara, Julio M Martínez-Moreno, Maria Dolores Salmerón, William G Richards, Arnold Felsenfeld, Makoto Kuro-O, Yolanda Almadén, Mariano Rodríguez
In renal failure, hyperphosphatemia occurs despite a marked elevation in serum fibroblast growth factor (FGF)-23. Abnormal regulation of the FGFR1-Klotho receptor complex may cause a resistance to the phosphaturic action of FGF23. The purpose of the present study was to investigate the regulation of renal Klotho and FGF receptor (FEFR)-1 in healthy and uremic rats induced by 5/6 nephrectomy. In normal rats, the infusion of rat recombinant FGF23 enhanced phosphaturia and increased renal FGFR1 expression; however, Klotho expression was reduced...
May 17, 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/28513870/activation-of-the-nrf2-are-signaling-pathway-prevents-hyperphosphatemia-induced-vascular-calcification-by-inducing-autophagy-in-renal-vascular-smooth-muscle-cells
#8
Li Yao, Jian Wang, Bin-Yao Tian, Tian-Hua Xu, Zi-Tong Sheng
This study investigates the effect of nuclear factor erythroid 2-related factor 2-antioxidant response element (Nrf2-ARE) signaling pathway in vascular calcification (VC) via inducing Autophagy in renal vascular smooth muscle cells (VSMCs). VSMCs were assigned into six experimental groups: the normal control, high phosphorus, si-negative control (si-NC), Nrf2-siRNA, over-expressed Nrf2 and negative control (NC) groups. RT-PCR was applied to detect the mRNA expressions of the desired Nrf2-ARE signaling pathway-related genes (Nrf2, NQO-1, HO-1, γ-GCS)...
May 17, 2017: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/28508978/acute-tumoral-calcinosis-due-to-severe-hyperphosphatemia-in-a-maintenance-hemodialysis-patient
#9
Keizo Nishime, Hiroki Takahashi
We report the case of a maintenance hemodialysis patient with severe hyperphosphatemia (26.6 mg/dL) who developed acute tumoral calcinosis. The patient started receiving maintenance hemodialysis after being diagnosed with type 2 diabetes mellitus. The patient's phosphate levels suddenly increased. He had not taken the prescribed phosphate binders for the past 5 years. He noticed swelling of the palmar aspects of his right thumb, which was diagnosed as tumoral calcinosis. His serum phosphate level reached 26...
November 2016: CEN Case Reports
https://www.readbyqxmd.com/read/28469534/effect-of-vitamin-d-supplementation-on-delayed-hyperphosphatemia-in-pediatric-acute-lymphoblastic-leukemia-patients-during-induction-chemotherapy
#10
Anthony W Lee, Gale L Romanowski, James A Proudfoot, Dennis J Kuo
OBJECTIVES: Vitamin D plays a role in maintaining bone health and calcium metabolism, but recent studies cast doubt on vitamin D supplementation's benefits in survivors of acute lymphoblastic leukemia (ALL). Vitamin D supplementation could increase serum phosphate through increased intestinal absorption of phosphate and suppression of parathyroid hormone, which would lead to decreased renal phosphate excretion. Because of the potential for renal injury during induction chemotherapy for ALL, Vitamin D supplementation's potential for increasing hyperphosphatemia could outweigh its suggested but unproven benefits...
March 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28464802/phosphate-binders-affect-vitamin-k-concentration-by-undesired-binding-an-in-vitro-study
#11
A Neradova, S P Schumacher, I Hubeek, P Lux, L J Schurgers, M G Vervloet
BACKGROUND: Vascular calcification is a major contributing factor to mortality in end stage renal disease (ESRD). Despite the efficacy of phosphate binders to improve hyperphosphatemia, data on vascular calcification are less clear. There seems to be a difference in attenuation or delay in progression between different binders. In this in vitro experiment we tested whether phosphate binders could limit bioavailability of vitamin K2 by undesired binding. Vitamin K-deficiency limits activation of the vascular tissue mineralization inhibitor matrix γ-carboxyglutamate (Gla) protein (MGP) thereby exacerbating vascular calcification...
May 2, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28455644/treatment-of-pediatric-chronic-kidney-disease-mineral-and-bone-disorder
#12
REVIEW
Mark R Hanudel, Isidro B Salusky
PURPOSE OF REVIEW: In this paper, we review the pathogenesis and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD), especially as it relates to pediatric CKD patients. RECENT FINDINGS: Disordered regulation of bone and mineral metabolism in CKD may result in fractures, skeletal deformities, and poor growth, which is especially relevant for pediatric CKD patients. Moreover, CKD-MBD may result in extra-skeletal calcification and cardiovascular morbidity...
April 28, 2017: Current Osteoporosis Reports
https://www.readbyqxmd.com/read/28450695/hyperphosphatemia-a-cause-of-high-anion-gap-metabolic-acidosis-report-of-a-case-and-review-of-the-literature
#13
Seyed Ali Sadjadi, Alexander Pi
BACKGROUND Hyperphosphatemia is a common problem in patients with kidney failure. It is usually mild and rarely severe enough to cause metabolic acidosis on its own. Besides kidney failure, use of phosphate containing enemas, rhabdomyolysis, and tumor lysis syndrome are common causes of severe hyperphosphatemia. CASE REPORT A 74-year-old man with a history of diabetes mellitus type II, arterial hypertension, and end stage renal disease, who was on hemodialysis and who had undergone hemicolectomy for ischemic bowel disease, and had not eaten for several days, developed severe metabolic acidosis, with an anion gap (AG) of 31 meq/L, -uncorrected for serum albumin...
April 28, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28445887/use-of-phosphorus-binders-among-non-dialysis-chronic-kidney-disease-patients-and-mortality-outcomes
#14
Simran K Bhandari, In-Lu A Liu, Dean A Kujubu, Trung Huynh, Hind Behayaa, Csaba P Kovesdy, Kamyar Kalantar-Zadeh, Steven J Jacobsen, John J Sim
BACKGROUND: Whether the benefits of phosphorus binders extend to those without end stage renal disease is uncertain. Among a large diverse non-dialysis chronic kidney disease (CKD) population with hyperphosphatemia, we sought to evaluate phosphorus binder use and compare mortality risk between patients prescribed and not prescribed binders. METHODS: A retrospective cohort study within an integrated health system (January 1, 1998 - December 31, 2012) among CKD patients (age ≥18) was performed...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28432604/phosphate-imbalance-in-patients-with-heart-failure
#15
REVIEW
E C Christopoulou, T D Filippatos, E Megapanou, M S Elisaf, G Liamis
Patients with heart failure often exhibit electrolyte abnormalities, such as hyponatremia or hypokalemia/hyperkalemia. Although not as common as the other electrolyte disturbances observed in patients with heart failure, phosphate imbalance is also of high importance in this population. The aim of this review is to present the mechanisms of low or high phosphate serum levels in patients with heart failure and its role in the pathogenesis and progression of heart dysfunction. Hypophosphatemia in patients with heart failure may be the result of co-existing electrolyte and acid-base abnormalities, pharmacological treatments, decreased intestinal absorption or secondary to sympathetic nervous system activation and co-morbidities, such as diabetes mellitus or heavy alcohol consumption...
May 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28422826/idiopathic-hypoparathyroidism-with-extensive-intracranial-calcification-in-children-first-report-from-saudi-arabia
#16
Naglaa M Kamal, Hamed A Alghamdi, Abdulrahman A Halabi, Ayman A Bakkar, Ali Algarni, Abdullah Alharbi, Abdulla A Alharthi, Rawan A Alharbi, Laila M Sherief
RATIONALE: Pediatric idiopathic hypoparathyroidism with extensive intracranial calcifications outside the basal ganglia (BG) is extremely rare with less than 10 cases worldwide. PATIENT CONCERNS: An 11-year-old Saudi male child presented with tetany with otherwise normal neurological and other body system examination diagnoses severe hypocalcemia for differential diagnosis. INTERVENTIONS: Further investigations revealed hyperphosphatemia and undetectable serum intact parathyroid hormone...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28419560/fibroblast-growth-factor-23-concentration-in-dogs-with-chronic-kidney-disease
#17
L M Harjes, V J Parker, K Dembek, G S Young, L H Giovaninni, M M Kogika, D J Chew, R E Toribio
BACKGROUND: Chronic kidney disease (CKD) is associated with hyperphosphatemia, decreased vitamin D metabolite concentrations, and hyperparathyroidism. This syndrome is known as CKD-mineral bone disorder (CKD-MBD). Recently, it has been shown that an increase in fibroblast growth factor-23 (FGF-23) concentration is an early biomarker of CKD in people. It is an independent risk factor for both progression of renal disease and survival time in humans and cats with CKD. Information about FGF-23 in healthy dogs and those with CKD is lacking...
May 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28398983/effectiveness-of-educational-or-behavioral-interventions-on-adherence-to-phosphate-control-in-adults-receiving-hemodialysis-a-systematic-review
#18
Molly Milazi, Ann Bonner, Clint Douglas
BACKGROUND: People with end-stage kidney disease (ESKD) develop impaired excretion of phosphate. Hyperphosphatemia develops in ESKD as a result of the kidney's reduced ability to excrete ingested phosphate load and is characterized by high bone turnover and increased musculoskeletal morbidity including bone pain and muscle weakness. Increased serum phosphate levels are also associated with cardiovascular disease and associated mortality. These effects are significant considering that cardiovascular disease is the leading cause of death in ESKD, making phosphate control a crucial treatment goal...
April 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28394304/the-diet-and-haemodialysis-dyad-three-eras-four-open-questions-and-four-paradoxes-a-narrative-review-towards-a-personalized-patient-centered-approach
#19
REVIEW
Giorgina Barbara Piccoli, Maria Rita Moio, Antioco Fois, Andreea Sofronie, Lurlinys Gendrot, Gianfranca Cabiddu, Claudia D'Alessandro, Adamasco Cupisti
The history of dialysis and diet can be viewed as a series of battles waged against potential threats to patients' lives. In the early years of dialysis, potassium was identified as "the killer", and the lists patients were given of forbidden foods included most plant-derived nourishment. As soon as dialysis became more efficient and survival increased, hyperphosphatemia, was identified as the enemy, generating an even longer list of banned aliments. Conversely, the "third era" finds us combating protein-energy wasting...
April 10, 2017: Nutrients
https://www.readbyqxmd.com/read/28391286/basal-ganglia-calcification-with-tetanic-seizure-suggest-mitochondrial-disorder
#20
Josef Finsterer, Barbara Enzelsberger, Adam Bastowansky
BACKGROUND Basal ganglia calcification (BGC) is a rare sporadic or hereditary central nervous system (CNS) abnormality, characterized by symmetric or asymmetric calcification of the basal ganglia. CASE REPORT We report the case of a 65-year-old Gypsy female who was admitted for a tetanic seizure, and who had a history of polyneuropathy, restless-leg syndrome, retinopathy, diabetes, hyperlipidemia, osteoporosis with consecutive hyperkyphosis, cervicalgia, lumbalgia, struma nodosa requiring thyroidectomy and consecutive hypothyroidism, adipositas, resection of a vocal chord polyp, arterial hypertension, coronary heart disease, atheromatosis of the aorta, peripheral artery disease, chronic obstructive pulmonary disease, steatosis hepatis, mild renal insufficiency, long-term hypocalcemia, hyperphosphatemia, impingement syndrome, spondylarthrosis of the lumbar spine, and hysterectomy...
April 9, 2017: American Journal of Case Reports
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