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Ckd mineral bone disease

Michelle R Hoffmann, Peter A Senior, Stephanie T Jackson, Guylaine Ferland, Nancy Presse, Kailash Jindal, Ping Li, Abeer S Alzaben, Diana R Mager
PURPOSE: Patients with diabetes (DM) and chronic kidney disease (CKD) are at increased risk for suboptimal bone health. The study objective was to investigate the relationships between vitamin D (vitD), vitamin K1 (vitK1), and calcium intake with bone mineral density (BMD) and vitamin D status in an ambulatory population with DM and CKD. METHODS: Adults (age 18-80 years; n = 62) with DM and CKD (stages 1-4) were recruited from the Northern Alberta Renal Program...
October 25, 2016: Canadian Journal of Dietetic Practice and Research
Mauro Boronat, Ángelo Santana, Elvira Bosch, Dionisio Lorenzo, Marta Riaño, César García-Cantón
BACKGROUND/AIMS: Different biochemical abnormalities of metabolic bone disease have been associated with anemia of chronic kidney disease (CKD), mainly in hemodialysis patients. However, all of these abnormalities are closely inter-related and their individual effect on the development of anemia is uncertain. This study was aimed to assess the relationship between anemia and a set of metabolic bone disease biomarkers in a cohort of adult patients with advanced non-dialysis-dependent CKD...
October 20, 2016: Nephron
Jongha Park
Cardiovascular (CV) risk assessment is not easy in chronic kidney disease (CKD) patients. Age, male sex, race, family history of CV disease, smoking status and diabetes should be considered as CV risk factors as the general population. It is also accepted that hypertension (HTN) is associated with the greater risk of CV complications in this population. However, there are some concerns in this issue.First, supporting evidence for specific blood pressure (BP) targets in CKD is scarce. Many observational studies reported a J-shaped association between BP level and CV mortality unlike a linear association in the general population...
September 2016: Journal of Hypertension
Catharine M Sturgeon, Stuart Sprague, Alison Almond, Etienne Cavalier, William D Fraser, Alicia Schimnich-Algeciras, Ravinder Singh, Jean-Claude Souberbielle, Hubert W Vesper
Parathyroid hormone (PTH) measurement in serum or plasma is a necessary tool for the exploration of calcium/phosphorus disorders, and is widely used as a surrogate marker to assess skeletal and mineral disorders associated with chronic kidney disease (CKD), referred to as CKD-bone mineral disorders (CKD-BMD). CKD currently affects >10% of the adult population in the United States and represents a major health issue worldwide. Disturbances in mineral metabolism and fractures in CKD patients are associated with increased morbidity and mortality...
October 13, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
Sandesh Parajuli, Dana F Clark, Arjang Djamali
Patients with CKD are at increased risk for cardiovascular events, hospitalizations, and mortality. Kidney transplantation (KTx) is the preferred treatment for end-stage kidney disease. Although comorbidities including anemia and bone and mineral disease improve or are even halted after KTx, kidney transplant recipients carry higher cardiovascular mortality risk than the general population, as well as an increased risk of infections, malignancies, fractures, and obesity. When comparing CKD with CKD after transplantation (CKD-T), the rate of decline of estimated glomerular filtration rate (eGFR) is significantly lower in CKD-T...
September 2016: Advances in Chronic Kidney Disease
Inés Olaizola, Hena Caorsi, Laura Fajardo, Alejandro Ferreiro, Nieves Campistrus, Deyanira Dolinsky, Alicia Petraglia, Pablo Ambrosoni
Introduction: The mineral bone disorder, particularly secondary hyperparathyroidism, in chronic kidney disease (CKD) has a systemic impact affecting not only bone metabolism. Therefore its correction is important to prevent cardiovascular, inflammatory and immune diseases. Objective: To assess the effectiveness and safety of intravenous paricalcitol administered over a 6 month period for the treatment of secondary hyperparathyroidism (SHPT) in patients undergoing conventional hemodialysis, with close follow-up of treatment response...
July 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Kyla L Naylor, Amit X Garg, S Joseph Kim, Gregory A Knoll
Fractures are associated with morbidity and mortality. Individuals with chronic kidney disease (CKD) experience bone mineral metabolism changes, which increases fracture risk. Researchers have quantified the epidemiology of fractures in adults with CKD using administrative health databases from Ontario, Canada, held at the Institute for Clinical Evaluative Sciences. Results demonstrated that many individuals with non-transplant CKD sustain fractures, with the risk increasing as kidney function declines. However, fracture risk in kidney transplant recipients was lower than previously described, which suggests recipients may not be a high-risk fracture group...
2016: Healthcare Quarterly
Niloofar Hajizadeh, Mehryar Mehrkash, Daryoosh Fahimi, Mostafa Qorbani, Nina Shafa
INTRODUCTION: Although some descriptive and cross-sectional studies have been reported about bone mass in chronic kidney disease (CKD) children, only a few studies investigated markers of bone turnover and the bone mass measurements. OBJECTIVES: The aim of this study was to evaluate the association between bone mineral density (BMD) and biochemical markers of bone turnover in hemodialysis (HD) children. PATIENTS AND METHODS: The children who had received dialysis for at least the preceding 6-month were included...
2016: Journal of Renal Injury Prevention
Giuseppe Cianciolo, Mario Cozzolino
During the last decade, a new view into the molecular mechanisms of chronic kidney disease-mineral bone disorder (CKD-MBD) has been proposed, with fibroblast growth factor 23 (FGF23) as a novel player in the field. Enhanced serum FGF23 levels cause a reduction in serum phosphate, together with calcitriol suppression and consequent hyperparathyroidism (HPT). In contrast, reduced serum FGF23 levels are associated with hyperphosphatemia, higher calcitriol levels and parathyroid hormone (PTH) suppression. In addition, serum FGF23 levels are greatly increased and positively correlated with serum phosphate levels in CKD patients...
October 2016: Clinical Kidney Journal
Simona Mihai, Elena Codrici, Ionela Daniela Popescu, Ana-Maria Enciu, Elena Rusu, Diana Zilisteanu, Radu Albulescu, Gabriela Anton, Cristiana Tanase
Chronic kidney disease, despite being a "silent epidemic" disease, represents one of the main causes of mortality in general population, along with cardiovascular disease, which is the leading cause of poor prognosis for these patients. The specific objective of our study was to characterize the relationship between the inflammatory status, the bone disorders markers, and kidney failure in chronic kidney disease patient stages 2-4, in order to design a novel biomarker panel that improves early disease diagnosis and therapeutic response, thus being further integrated into clinical applications...
2016: Disease Markers
Toshifumi Sugatani, Olga A Agapova, Yifu Fang, Alycia G Berman, Joseph M Wallace, Hartmut H Malluche, Marie-Claude Faugere, William Smith, Victoria Sung, Keith A Hruska
Dysregulation of skeletal remodeling is a component of renal osteodystrophy. Previously, we showed that activin receptor signaling is differentially affected in various tissues in chronic kidney disease (CKD). We tested whether a ligand trap for the activin receptor type 2A (RAP-011) is an effective treatment of the osteodystrophy of the CKD-mineral bone disorder. With a 70% reduction in the glomerular filtration rate, CKD was induced at 14 weeks of age in the ldlr-/- high fat-fed mouse model of atherosclerotic vascular calcification and diabetes...
September 22, 2016: Kidney International
María Luisa Ceballos Osorio, Francisco Cano Schuffeneger
: Growth failure is one of the most relevant complications in children with chronic kidney disease (CKD). Among others, growth hormone (GH) resistance and bone mineral disorders have been identified as the most important causes of growth retardation. OBJECTIVES: 1. To characterize bone mineral metabolism and growth hormone bio-markers in CKD children treated with chronic peritoneal dialysis (PD). 2. To evaluate height change with rhGH treatment. PATIENTS AND METHOD: A longitudinal 12-month follow-up in prepuberal PD children...
September 19, 2016: Revista Chilena de Pediatría
Jan Rossaint, Mark Unruh, Alexander Zarbock
During chronic kidney disease (CKD), bone mineral metabolism is disturbed owing in part to the endogenous hormone fibroblast growth factor 23 (FGF23). Elevated FGF23 levels are seen in CKD patients. Current research has demonstrated that FGF23 directly modulates the immune response and host defense to bacterial infections. FGF23 also impairs the activation and recruitment of neutrophils, which are the main immune effector cells required for host defense against bacterial infections. In addition, while FGF23 levels reduce leukocyte recruitment and functions, inflammatory conditions may also-in a reverse fashion-contribute to elevated FGF23 levels in the circulation...
September 22, 2016: Nephrology, Dialysis, Transplantation
Magdalena Jankowska, Abdul Rashid Qureshi, Peter Barany, Olof Heimburger, Peter Stenvinkel, Bengt Lindholm
AIM: Autosomal dominant polycystic kidney disease (ADPKD), a systemic disorder caused by mutation in genes encoding polycystins, has been reported to lead to metabolic derangements including new-onset diabetes mellitus after kidney transplantation. We analyzed markers of insulin resistance (IR), inflammation, nutritional status and insulin-like growth factor-1 (IGF-1) in end-stage renal disease (ESRD) patients with ADPKD and ESRD patients with other primary kidney diseases. METHODS: In a post hoc cross-sectional analysis in 254 non-diabetic CKD 5 patients starting on dialysis, glucose metabolism (insulin, IGF-1, homeostasis model assessment of IR, HOMA-IR), inflammation (high sensitivity C-reactive protein, interleukin-6, and tumor necrosis factor), nutritional status, and bone mineral density (BMD), were assessed...
September 22, 2016: Nephrology
Chu Zhou, Fang Wang, Jin-Wei Wang, Lu-Xia Zhang, Ming-Hui Zhao
BACKGROUND: Mineral and bone disorder (MBD), especially hyperphosphatemia, is an independently risk factor for adverse prognosis in patients with chronic kidney disease (CKD). However, CKD-MBD among Chinese population was poorly studied. This study aimed to investigate the status of MBD and its association with cardiovascular parameters in Chinese patients with predialysis CKD. METHODS: Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE) is a prospective multicenter cohort study involving predialysis CKD patients in China...
2016: Chinese Medical Journal
Yao Jiang, Zhixiang Shen, Jingjing Zhang, Changying Xing, Xiaoming Zha, Chong Shen, Ming Zeng, Guang Yang, Huijuan Mao, Bo Zhang, Xiangbao Yu, Bin Sun, Chun Ouyang, Yifei Ge, Lina Zhang, Chen Cheng, Jing Zhang, Caixia Yin, Huimin Chen, Ningning Wang
BACKGROUND: In chronic kidney disease (CKD) patients, decreased heart rate variability (HRV) reflects impaired cardiac automatic nervous function and high risk of cardiovascular disease (CVD). Lower HRV in patients with severe secondary hyperparathyroidism (SHPT), a clinical manifestation of CKD-mineral and bone disorder (CKD-MBD), could be reversed by parathyroidectomy (PTX). It has been proved that leptin interacts with the autonomic nervous function. However, the associations between leptin and HRV in CKD patients and their longitudinal changes in SHPT patients after PTX are still unknown...
2016: American Journal of Nephrology
Valentin David, Connor Francis, Jodie L Babitt
The bone-secreted hormone fibroblast growth factor 23 (FGF23) has an essential role in phosphate homeostasis by regulating expression of the kidney proximal tubule sodium-phosphate co-transporters as well as parathyroid hormone levels. Induction of FGF23 early in chronic kidney disease (CKD) helps to maintain normal phosphorous levels. However, high FGF23 levels become pathologic as kidney disease progresses and are associated with an increased risk of CKD progression, cardiovascular events, and death. The factors responsible for increasing FGF23 levels early in CKD are unknown, but recent work has proposed a role for inflammation and disordered iron homeostasis...
August 31, 2016: American Journal of Physiology. Renal Physiology
Ben-Chung Cheng, Ying-Chou Chen
This study investigated whether bone mineral density (BMD) affects readmission risk in patients with chronic kidney diseases (CKD) who received denosumab therapy. The study design was a retrospective case review of patients with CKD. Baseline age, sex, and body mass index were recorded for all patients included in the study. All comorbidities were recorded. All subjects underwent dual energy X-ray absorptiometry assay of the lumbar spine and right hip for BMD. The primary outcome was readmission. Predictive variables were categorized and compared between readmitted and non-readmitted patients...
August 31, 2016: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
Joerg C Schefold, Gerasimos Filippatos, Gerd Hasenfuss, Stefan D Anker, Stephan von Haehling
Heart failure (HF) is a major health-care problem and the prognosis of affected patients is poor. HF often coexists with a number of comorbidities of which declining renal function is of particular importance. A loss of glomerular filtration rate, as in acute kidney injury (AKI) or chronic kidney disease (CKD), independently predicts mortality and accelerates the overall progression of cardiovascular disease and HF. Importantly, cardiac and renal diseases interact in a complex bidirectional and interdependent manner in both acute and chronic settings...
October 2016: Nature Reviews. Nephrology
Nobuki Hayakawa, Atsushi Suzuki
Metabolic bone disorders that are represented by secondary hyperparathyroidism occur with the progression of chronic kidney disease(CKD). The administration of activated vitamin D is expected to improve high-turnover bone disorders and is widely used for the management of bone mineral diseases in patients with CKD and end-stage renal disease. CKD is an underlying disease of secondary osteoporosis and coexists with primary osteoporosis at a high rate. With regard to osteoporosis patients with renal insufficiency, the administration of activated vitamin D is also thought to reduce the fracture incidence by both increasing bone mass and reducing falls...
September 2016: Clinical Calcium
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