Read by QxMD icon Read

Phosphate binders

James Tattersall
Current guidelines focus on conventional dialysis defined as 3-5 hours, three times per week, and suggest that longer or more frequent dialysis be considered. This paper presents the case for considering that shorter or less frequent dialysis should also be considered. More frequent and/or longer dialysis facilitates control of fluid overload, blood pressure, and phosphate levels. These benefits will require time to translate into probable hard outcome improvement. Patients are unlikely to participate in productive or pleasurable activities while undergoing dialysis in center or traveling to treatment...
October 20, 2016: Seminars in Dialysis
Motoko Tanaka, Kazuki Yoshida, Shingo Fukuma, Kazuko Ito, Kazutaka Matsushita, Masafumi Fukagawa, Shunichi Fukuhara, Tadao Akizawa
OBJECTIVES: Anemia is an important prognostic factor in hemodialysis patients. It has been reported that parathyroidectomy ameliorates anemia and reduces the requirement of postoperative erythropoiesis-stimulating agents. The objective of this study was to assess the effect of cinacalcet, which is considered as a pharmacological parathyroidectomy, on anemia in hemodialysis patients. METHODS: We used data from a prospective cohort of Japanese hemodialysis patients with secondary hyperparathyroidism; the criteria were: intact parathyroid hormone concentrations ≥ 180 pg/mL or use of an intravenous or oral vitamin D receptor activator...
2016: PloS One
Sarah Ma Caney
OBJECTIVES: The objective of this study was to learn about owner experiences of chronic kidney disease (CKD), focusing on use of therapeutic renal diets (TRDs) and intestinal phosphate binders (IPBs). METHODS: An online survey was promoted to UK-based cat owners. RESULTS: In total, 859 owners participated. Most cats (n = 620; 72.18%) had two or more clinical signs at the time of their CKD diagnosis. Most common were polydipsia (n = 462; 53...
October 17, 2016: Journal of Feline Medicine and Surgery
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
Han Shao, N Padmanathan, David McNulty, Colm O Dwyer, Kafil M Razeeb
A binder-free cobalt phosphate hydrate (Co3(PO4)2·8H2O) multilayer nano/microflake structure is synthesized on nickel foam (NF) via a facile hydrothermal process. Four different concentrations (2.5, 5, 10, and 20 mM) of Co(2+) and PO4(-3) were used to obtain different mass loading of cobalt phosphate on the nickel foam. The Co3(PO4)2·8H2O modified NF electrode (2.5 mM) shows a maximum specific capacity of 868.3 C g(-1) (capacitance of 1578.7 F g(-1)) at a current density of 5 mA cm(-2) and remains as high as 566...
October 12, 2016: ACS Applied Materials & Interfaces
Susanne Johansson, Maria Leonsson-Zachrisson, Mikael Knutsson, Andrew G Spencer, Eric D Labonté, Desiree Deshpande, Jill Kohler, Kenji Kozuka, Dominique Charmot, David P Rosenbaum
Tenapanor (RDX5791, AZD1722), a first-in-class small molecule with minimal systemic availability, is an inhibitor of the sodium/hydrogen exchanger isoform 3. Tenapanor acts locally in the gut where it reduces absorption of sodium and phosphate. It is being studied in patients with chronic kidney disease requiring dialysis, who are often administered phosphate binders such as sevelamer to help control hyperphosphatemia. We investigated whether co-administration of tenapanor with phosphate binders (sevelamer or calcium-based binders) impacts on the pharmacodynamic effects of tenapanor...
September 22, 2016: Clinical Pharmacology in Drug Development
Steven Habbous, Sebastian Przech, Rey Acedillo, Sisira Sarma, Amit X Garg, Janet Martin
BACKGROUND: It remains unclear which phosphate binders should be preferred for hyperphosphatemia management in chronic kidney disease (CKD). METHODS: We performed a systematic review and meta-analysis of randomized trials comparing sevelamer or lanthanum with other phosphate binders in CKD. RESULTS: Fifty-one trials (8829 patients) were reviewed. Compared with calcium-based binders, all-cause mortality was nonsignificantly lower with sevelamer {risk ratio [RR] 0...
September 20, 2016: Nephrology, Dialysis, Transplantation
Markus Ketteler, Orfeas Liangos, Patrick H Biggar
INTRODUCTION: Hyperphosphatemia is a hallmark of advanced chronic kidney disease (CKD) and associated with adverse outcomes. Preclinical and epidemiological studies strongly support a causal relationship between hyperphosphatemia and mortality as well as cardiovascular complications, especially including vascular, valvular and soft-tissue calcifications. Thus, appropriate phosphate lowering is considered to play a major role in health and longevity of CKD patients. In this respect, phosphate binders are the most powerful therapeutic option, while dietary phosphate restriction and intensified dialysis are valuable supportive approaches...
October 2016: Expert Opinion on Pharmacotherapy
Diana Jalal, Molly McFadden, Jamie P Dwyer, Kausik Umanath, Erwin Aguilar, Yoram Yagil, Barbara Greco, Mohammed Sika, Julia B Lewis, Tom Greene, Simin Goral
Introduction Oral phosphate binders are the main stay of treatment of hyperphosphatemia. Adherence rates to ferric citrate, a recently approved phosphate binder, are unknown. Methods We conducted a post-hoc analysis to evaluate whether adherence rates were different for ferric citrate vs. active control in 412 subjects with end stage kidney disease (ESKD) who were randomized to ferric citrate vs. active control (sevelamer carbonate and/or calcium acetate). Adherence was defined as percent of actual number of pills taken to total number of pills prescribed...
September 12, 2016: Hemodialysis International
Jordi Bover, Pablo Ureña-Torres, José Luis Górriz, María Jesús Lloret, Iara da Silva, César Ruiz-García, Pamela Chang, Mariano Rodríguez, José Ballarín
Cardiovascular (CV) calcification is a highly prevalent condition at all stages of chronic kidney disease (CKD) and is directly associated with increased CV and global morbidity and mortality. In the first part of this review, we have shown that CV calcifications represent an important part of the CKD-MBD complex and are a superior predictor of clinical outcomes in our patients. However, it is also necessary to demonstrate that CV calcification is a modifiable risk factor including the possibility of decreasing (or at least not aggravating) its progression with iatrogenic manoeuvres...
August 29, 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Yung-Feng Lung, Ying-Sui Sun, Chun-Kai Lin, Jun-Yen Uan, Her-Hsiung Huang
The patients with end-stage of renal disease (ESRD) need to take oral phosphate binder. Traditional phosphate binders may leave the disadvantage of aluminum intoxication or cardiac calcification. Herein, Mg-Fe-Cl hydrotalcite-like nanoplatelet (HTln) is for the first time characterized as potential oral phosphate binder, with respect to its phosphorus uptake capacity in cow milk and cellular cytotoxicity. A novel method was developed for synthesizing the Mg-Fe-Cl HTln powder in different Mg(2+): Fe(3+) ratios where the optimization was 2...
2016: Scientific Reports
Wanli You, Yu-Ming M Huang, Smitha Kizhake, Amarnath Natarajan, Chia-En A Chang
Inhibition of the protein-protein interaction (PPI) mediated by breast-cancer-gene 1 C-terminal (BRCT) is an attractive strategy to sensitize breast and ovarian cancers to chemotherapeutic agents that induce DNA damage. Such inhibitors could also be used for studies to understand the role of this PPI in DNA damage response. However, design of BRCT inhibitors is challenging because of the inherent flexibility associated with this domain. Several studies identified short phosphopeptides as tight BRCT binders...
August 2016: PLoS Computational Biology
Mario Cozzolino, Michela Mangano, Lorenza Magagnoli, Luca Di Lullo, Andrea Galassi, Diego Brancaccio, Antonio Bellasi
Several factors influence the choice of phosphate binder for patients, including older age, male gender, post-menopause, diabetes, low bone turnover, vascular/valvular calcification and inflammation. Unlike calcium-based phosphate binders, non-calcium-based phosphate binders, such as sevelamer and lanthanum carbonate, have been able to reduce the progression of bone disease to adynamic bone among patients with CKD. New iron-based phosphate binders are now available. With multiple options available for the reduction of phosphate, the focus has been on agents that do not contain calcium...
July 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Chiara Ralli, Patrizio Imperiali, Ennio Duranti
The home extracorporeal hemodialysis, which aroused a great interest in the past, has not kept its promises due to the complexity and expectations for family involvement in treatment management. In the United States NxStage One portable system was proposed and designed for home use. In this work we describe, starting from the history of home hemodialysis, the method with NxStage system by comparing it with the conventional HD in 5 patients. The dialysis efficiency was similar between the two treatments, even if home hemodialysis showed a reduction in serum urea, creatinine and phosphorus...
July 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Andrea Galassi, Maria Enrica Giovenzana, Eleonora Galbiati, Sara Auricchio, Sara Colzani, Renzo Scanziani
Phosphate binders represent a common intervention in renal patients affected by chronic kidney disease and mineral bone disorder (CKD-MBD). Although counteracting P overload through binders adoption is argued by a physiology-driven approach, the efficacy of this intervention on hard endpoints remains poorly evident. The inconsistencies between rationale and methodological weakness, concerning the clinical relevance of P binding in chronic kidney disease, will be herein discussed with special focus on the need of a multi-factorial treatment against CKD-MBD, which is currently more achievable due to the variety of P binders and the rapid evolution of nutritional therapy, dialysis techniques and nursing science...
July 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
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
Kei Yabuki, Eisuke Shiba, Hiroshi Harada, Kazuyoshi Uchihashi, Atsuji Matsuyama, Joji Haratake, Masanori Hisaoka
Lanthanum carbonate (LC) is one of the most potent phosphate binders currently used to reduce serum phosphate levels in dialysis patients with end-stage renal disease (ESRD). LC forms insoluble complexes with dietary phosphate that pass through the gastrointestinal (GI) tract with little absorption. GI lesions due to lanthanum deposition in biopsy specimens or those in endoscopic submucosal dissection (ESD) in dialysis patients have been recently identified. Here, we describe more detailed histopathological findings in the gastroduodenal mucosa and regional lymph nodes in three patients with gastric cancer...
August 2, 2016: Pathology, Research and Practice
Pieter Joubert, Markus Ketteler, Carolina Salcedo, Joan Perello
Cardiovascular calcification (CVC) associated with conditions such as ageing, diabetes or renal impairment, results from the deposition of hydroxyapatite in the endothelium or media of blood vessels. Key medical management options are directed towards controlling plasma calcium and phosphate concentrations (e.g. parathormone inhibition, phosphate binders, dialysis), enhancing the effect of calcification inhibitors (e.g. fetuin-A, pyrophosphate, vitamin K, osteopontin, matrix Gla protein) and decreasing the effect of promoters of calcification (e...
September 2016: Medical Hypotheses
V Premuzc, V Ivkovic, N Leko, Z Stipancic, T Teskera, M Vinkovic, M Barisic, S Karanovic, A Vrdoljak, I Vukovic, Z Dika, M Laganovic, B Jelakovic
OBJECTIVE: Early vascular aging (EVA) is a feature of chronic kidney disease(CKD) and pulse wave velocity(PWV) is independent predictor of premature cardiovascular(CV) mortality. High blood pressure(BP) and vascular calcifications contribute mostly to EVA in this group. Endemic nephropathy(EN), an environmental form of aristolochic acid nephropathy, is a chronic tubulointerstitial salt wasting nephropathy characterized with later onset and milder forms of hypertension (HT), and in line with this we hypothesized that arterial stiffness progresses slowlier in EN pts resulting in lower CV mortality...
September 2016: Journal of Hypertension
Thomas Welte, Frederic Arnold, Kristin Technau-Hafsi, Elke Neumann-Haefelin, Rika Wobser, Stefan Zschiedrich, Gerd Walz, Albrecht Kramer-Zucker
UNLABELLED: Calciphylaxis is a rare and often fatal condition mostly associated with end-stage renal disease. The pathophysiology remains elusive and treatment options are scarce. We present a rare case of severe calciphylaxis after kidney transplantation in a patient with persistent hyperparathyroidism. CASE DESCRIPTION: A 78-year-old man with a history of end-stage renal disease developed edema and ulcerations on both lower limbs 14 months after kidney transplantation while receiving an mammalian target of rapamycin inhibitor to manage polyoma virus-associated nephropathy...
April 2016: Transplantation Direct
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"