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"Phosphate binders"

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https://www.readbyqxmd.com/read/29074818/randomized-clinical-trial-of-sevelamer-carbonate-on-serum-klotho-and-fibroblast-growth-factor-23-in-ckd
#1
Sophie Liabeuf, Jean-Philippe Ryckelynck, Najeh El Esper, Pablo Ureña, Christian Combe, Bertrand Dussol, Denis Fouque, Philippe Vanhille, Luc Frimat, Eric Thervet, Romuald Mentaverri, Dominique Prié, Gabriel Choukroun
BACKGROUND AND OBJECTIVES: Epidemiologic studies suggest that higher serum phosphaturic hormone fibroblast growth factor 23 levels are associated with increase morbidity and mortality. The aim of the FGF23 Reduction Efficacy of a New Phosphate Binder in CKD Trial was to evaluate the effect of sevelamer carbonate on serum C-terminal fibroblast growth factor 23 levels in normophosphatemic patients with CKD stage 3b/4. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Patients with CKD, eGFR between 45 and 15 ml/min per 1...
October 26, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29064180/a-service-review-to-assess-if-innovative-intensive-phosphate-dietary-education-can-help-reduce-phosphate-levels-to-the-recommended-range-in-a-hemodialysis-population
#2
Eileen A Duff, Fiona M Chawke
INTRODUCTION: Studies suggest that hemodialysis (HD) patients are less likely to adhere to phosphate dietary restriction than to potassium, sodium, or fluid restriction. It is particularly important that dietary education is provided appropriately, consistently, and reinforced regularly to encourage compliance with diet and phosphate-binder regimens. Patient awareness of the consequences of a chronically raised phosphate and its treatment is associated with lower serum phosphate levels...
October 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29064176/calciphylaxis-after-parathyroidectomy
#3
Sathish Karmegam, Anupkumar Shetty
A 60-year-old African American man with end stage renal disease on hemodialysis (HD) for the past 2.5 years developed severe hyperparathyroidism. Other past medical history included atrial fibrillation, type II diabetes mellitus, hypertension, gout, pericardial effusion needing pericardial window, deep vein thrombosis, mitral insufficiency, and cardiomyopathy with implantable cardioversion device placement. His parathyroid hormone (PTH) level peaked at 4,191 pg/mL despite being on cinacalcet, sevelamer, and paricalcitol...
October 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29064141/the-role-of-dietary-phosphate-restriction-in-chronic-kidney-disease
#4
Grahame J Elder, Avya Malik, Kelly Lambert
BACKGROUND AND OBJECTIVES: Patients with progressive chronic kidney disease (CKD) develop positive phosphate balance that is associated with increased cardiovascular risk and mortality. Modification of dietary phosphate is a commonly used strategy to improve outcomes but is complicated by the need for adequate dietary protein. Surprisingly, the evidence for patient-level benefits from phosphate restriction is tenuous, and the justification for using any phosphate binder for pre-dialysis patients is questionable...
October 24, 2017: Nephrology
https://www.readbyqxmd.com/read/29063671/magnesium-supplementation-a-consideration-in-dialysis-patients
#5
EDITORIAL
Mugurel Apetrii, Adrian Covic, Ziad A Massy
Even though disorders of magnesium (Mg) balance are common in dialyzed patients, this cation is often neglected. Many factors interfere with serum magnesium including diet, medications (eg, antacids or phosphate binders), and the dialysis prescription. Mg supplementation may help reduce serum phosphate concentration, PTH, and interfere with vascular calcification and bone mineralization. It could also decrease the all-cause and cardiovascular mortalities, although the results of current studies are conflicting...
October 23, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/29058057/effects-of-lanthanum-carbonate-on-coronary-artery-calcification-and-cardiac-abnormalities-after-initiating-hemodialysis
#6
Hideki Fujii, Keiji Kono, Kentaro Nakai, Shunsuke Goto, Tatsuya Nishii, Atsushi Kono, Shinichi Nishi
It is known that calcium-containing phosphate binders are more closely associated with the progression of vascular calcification than non-calcium-containing phosphate binders. In this study, we investigated the effect of the non-calcium-containing phosphate binder, lanthanum carbonate on the progression of coronary artery calcification and cardiovascular abnormalities compared to that of calcium-containing phosphate binder in chronic kidney disease patients during the early period after initiating hemodialysis...
October 20, 2017: Calcified Tissue International
https://www.readbyqxmd.com/read/29044930/effect-of-incident-nocturnal-home-hemodialysis-versus-incident-continuous-ambulatory-peritoneal-dialysis-on-employment-rate-clinical-and-laboratory-outcomes-a-1-year-retrospective-observation-study
#7
John Wing Li, Joseph Ho Sing Wong, Wai Leung Chak, Ka Foon Chau
INTRODUCTION: While studies demonstrated favorable outcomes of nocturnal home hemodialysis (NHHD), direct comparison on employment rate, clinical and laboratory outcomes between the NHHD and continuous ambulatory peritoneal dialysis (CAPD) had not been previously performed. METHODS: A 1-year retrospective observation study was performed in 20 incidents alternate night NHHD and 81 incident CAPD patients of Chinese ethnicity, who were sex, diabetic status, and Charlson comorbidity index matched, but not age due to our center's age limit for NHHD enrollment...
October 18, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28993865/two-year-cortical-and-trabecular-bone-loss-in-ckd-5d-biochemical-and-clinical-predictors
#8
H H Malluche, M-C Monier-Faugere, G Blomquist, D L Davenport
This prospective two-year study of patients on chronic dialysis measured changes in bone mineral density (BMD). Patients with higher baseline BMD and shorter dialysis vintage lost more bone. Treatment with anti-hypertensives acting on the central nervous system was protective against bone loss. Baseline serum levels of sclerostin and bone-specific alkaline phosphatase predicted bone loss. INTRODUCTION: This prospective 2-year study of chronic kidney disease on dialysis (CKD-5D) patients assessed trabecular and cortical bone loss at the hip and spine and examined potential demographic, clinical, and serum biochemical predictors of bone loss...
October 9, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28970367/a-pilot-study-of-okkidney-a-phosphate-counting-application-in-patients-on-peritoneal-dialysis
#9
Rameez Imtiaz, Katherine Atkinson, Julien Guerinet, Kumanan Wilson, Jullie Leidecker, Deborah Zimmerman
BACKGROUND: Hyperphosphatemia is associated with adverse outcomes in patients treated with peritoneal dialysis (PD). We have shown that a fixed meal phosphate binder dosing schedule is not appropriate. The purpose of this study was to evaluate the beta version of OkKidney, a phosphate counting app that matches meal phosphate content with binder dose. METHODS: A convenience sample of adult patients treated with PD completed a pre-survey that included the technology readiness index (TRI 2...
September 28, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28941764/kdoqi-us-commentary-on-the-2017-kdigo-clinical-practice-guideline-update-for-the-diagnosis-evaluation-prevention-and%C3%A2-treatment-of-chronic-kidney-disease-mineral-and-bone%C3%A2-disorder-ckd-mbd
#10
Tamara Isakova, Thomas L Nickolas, Michelle Denburg, Sri Yarlagadda, Daniel E Weiner, Orlando M Gutiérrez, Vinod Bansal, Sylvia E Rosas, Sagar Nigwekar, Jerry Yee, Holly Kramer
Chronic kidney disease-mineral and bone disorder (CKD-MBD) encompasses laboratory and bone abnormalities and vascular calcification and has deleterious effects on clinical outcomes. KDOQI (Kidney Disease Outcomes Quality Initiative), an initiative of the National Kidney Foundation, addressed this issue with the publication of a clinical practice guideline for bone metabolism and disease in CKD in 2003, and 2 years later, a new definition and classification scheme for CKD-MBD was developed following a KDIGO (Kidney Disease: Improving Global Outcomes) Controversies Conference...
September 20, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28939921/pathophysiology-and-treatment-of-cardiovascular-disease-in-pediatric-chronic-kidney-disease
#11
REVIEW
Nadine Khouzam, Katherine Wesseling-Perry
Life expectancy in patients with all stages of chronic kidney disease (CKD) falls far short of that in the general population. Cardiovascular disease is the leading cause of mortality in pediatric patients with CKD. In contrast to the intimal atherosclerotic lesions that characterize cardiovascular disease in the general population, vascular endothelial dysfunction, medial arterial calcification, and cardiac dysfunction contribute to cardiovascular pathological conditions in CKD. The pathogenesis of these lesions, the origins of which can be identified in the absence of traditional cardiovascular risk factors, is incompletely understood...
September 22, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28914962/impaired-phosphate-tolerance-revealed-with-an-acute-oral-challenge
#12
Mandy E Turner, Christine A White, Wilma M Hopman, Emilie C Ward, Paul S Jeronimo, Michael A Adams, Rachel M Holden
Elevated serum phosphate is consistently linked with cardiovascular disease (CVD) events and mortality in the setting of normal and impaired kidney function. However, serum phosphate does not often exceed the upper limit of normal until glomerular filtration rate (GFR) falls below 30 mL/min/m(2) . It was hypothesized that the response to an oral, bioavailable phosphate load will unmask impaired phosphate tolerance, a maladaptation not revealed by baseline serum phosphate concentrations. In this study rats with varying kidney function as well as normo-phosphatemic human subjects, with inulin-measured GFR (13...
September 15, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28900759/efficacy-and-safety-of-sevelamer-carbonate-in-hyperphosphatemic-pediatric-patients-with-chronic-kidney-disease
#13
Sahar Fathallah-Shaykh, Dorota Drozdz, Joseph Flynn, Randall Jenkins, Katherine Wesseling-Perry, Sarah J Swartz, Craig Wong, Beverly Accomando, Gerald F Cox, Bradley A Warady
BACKGROUND: Treatment for hyperphosphatemia in chronic kidney disease (CKD) involves dietary control of phosphorus intake, dialysis, and treatment with oral phosphate binders, none of which were approved by the Federal Food and Drug Administration in pediatric patients at the time of this study. METHODS: This was a phase 2, multicenter study (NCT01574326) with a 2-week, randomized, placebo-controlled, fixed-dose period (FDP) followed by a 6-month, single-arm, open-label, dose-titration period (DTP), with the aim to evaluate the safety and efficacy of sevelamer carbonate (SC) in hyperphosphatemic pediatric patients with CKD...
September 12, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28869940/severe-secondary-hyperparathyroidism-in-a-hemodialysis-patient-a-case-report-from-mongolia
#14
Saruultuvshin Adiya, Khurtsbayar Damdinsuren, Chuluuntsetseg Dorj
Secondary hyperparathyroidism (SHPT) occurs in patients with chronic renal failure complicated with renal bone disease and soft tissue/vascular calcification. In dialysis patients with severe SHPT, medical treatment may fail and parathyroidectomy (PTX) is indicated for definitive treatment. Severe hypocalcemia from hungry bone disease or postoperative hypoparathyroidism may occur during the postoperative period. We report here a case of severe SHPT in a hemodialysis patient treated with phosphate binders, calcitriol, and calcimimetics but who still required PTX...
2017: Blood Purification
https://www.readbyqxmd.com/read/28853704/comparison-of-hypoalbuminemia-corrected-serum-calcium-using-bcp-albumin-assay-to-ionized-calcium-and-impact-on-prescribing-in-hemodialysis-patients%C3%A2
#15
Wenxin Cindy Pan, Wynnie Lau, Andre Mattman, Mercedeh Kiaii, Beverly Jung
BACKGROUND: Albumin-corrected calcium (cCa) is recommended over ionized calcium (iCa) in hemodialysis (HD) patients per the Kidney Disease: Improving Global Outcomes position statements due to cost and feasibility. Two common albumin assays, bromocresol green (BCG) and bromocresol purple (BCP), produce differing results in uremic patients. All previous studies compared iCa to cCa from a BCG assay. This study, using the BCP assay, aimed to compare cCa and total calcium, respectively, to iCa...
August 30, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28852493/gastrointestinal-complications-induced-by-sevelamer-crystals
#16
Claudia Yuste, Evangelina Mérida, Eduardo Hernández, Ana García-Santiago, Yolanda Rodríguez, Teresa Muñoz, Gonzalo Jesús Gómez, Ángel Sevillano, Manuel Praga
BACKGROUND: Sevelamer is a phosphate binder widely used in chronic kidney disease (CKD) patients. Sevelamer, as well as other resin-based binders, can crystallize leading to the formation of concretions. Sevelamer crystals (SC) have been associated with gastrointestinal (GI) mucosal injury. We describe three new cases of GI lesions associated with SC and review previously reported cases. METHODS: We describe three new cases of GI lesions associated with SC and review previously reported cases...
August 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28811853/effects-of-sevelamer-hydrochloride-on-uremic-toxins-serum-indoxyl-sulfate-and-p-cresyl-sulfate-in-hemodialysis-patients
#17
Cheng-Jui Lin, Chi-Feng Pan, Chih-Kuang Chuang, Hsuan-Liang Liu, Sung-Fa Huang, Han-Hsiang Chen, Chih-Jen Wu
BACKGROUND: Beside the phosphate binding effect, non-calcium non-aluminum phosphate binder, namely sevelamer hydrochloride (SH), has many other effects in dialysis patients. It can absorb many other compounds, decrease low-density lipoprotein cholesterol (LDL-C) level, and attenuate the progression of vascular calcification; it has been reported to have anti-inflammatory effect. However, it is not clear whether it has any effect on uremic toxins, i.e. serum indoxyl sulfate (IS) and p-cresyl sulfate, (PCS) in hemodialysis (HD) patients...
September 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28801122/deoxycholic-acid-a-metabolite-of-circulating-bile-acids-and-coronary-artery-vascular-calcification-in-ckd
#18
Anna Jovanovich, Tamara Isakova, Geoffrey Block, Jason Stubbs, Gerard Smits, Michel Chonchol, Makoto Miyazaki
BACKGROUND: Vascular calcification is common among patients with chronic kidney disease (CKD), and it is associated with all-cause and cardiovascular disease mortality. Deoxycholic acid, a metabolite of circulating bile acids, is elevated in CKD and induces vascular mineralization and osteogenic differentiation in animal models. STUDY DESIGN: Cohort analysis of clinical trial participants. SETTING & PARTICIPANTS: 112 patients with moderate to severe CKD (estimated glomerular filtration rate, 20-45mL/min/1...
August 9, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28777915/comparative-efficacy-and-safety-of-phosphate-binders-in-hyperphosphatemia-patients-with-chronic-kidney-disease
#19
Xiuqin Yang, Qingning Bai, Yanguo Li, Haijun Liu, Haiying Guo, Xiaolei Zhang
BACKGROUND: In this study, we coordinated a network meta-analysis to establish the efficacy and safety of different agents used in the treatment of hyperphosphatemia patients with chronic kidney disease. METHODS: PubMed, CNKI, and Embase were systematically searched to retrieve relevant studies. Outcomes were presented by mean differences, odds ratios, and corresponding 95% credible intervals for continuous outcomes and binary outcomes, respectively. Each therapy was ranked according to the value of surface under the cumulative ranking curve...
August 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28760336/dietary-magnesium-supplementation-prevents%C3%A2-and%C3%A2-reverses-vascular-and-soft-tissue%C3%A2-calcifications-in-uremic-rats
#20
Juan M Diaz-Tocados, Alan Peralta-Ramirez, María E Rodríguez-Ortiz, Ana I Raya, Ignacio Lopez, Carmen Pineda, Carmen Herencia, Addy Montes de Oca, Noemi Vergara, Sonja Steppan, M Victoria Pendon-Ruiz de Mier, Paula Buendía, Andrés Carmona, Julia Carracedo, Juan F Alcalá-Díaz, Joao Frazao, Julio M Martínez-Moreno, Antonio Canalejo, Arnold Felsenfeld, Mariano Rodriguez, Escolástico Aguilera-Tejero, Yolanda Almadén, Juan R Muñoz-Castañeda
Although magnesium has been shown to prevent vascular calcification in vitro, controlled in vivo studies in uremic animal models are limited. To determine whether dietary magnesium supplementation protects against the development of vascular calcification, 5/6 nephrectomized Wistar rats were fed diets with different magnesium content increasing from 0.1 to 1.1%. In one study we analyzed bone specimens from rats fed 0.1%, 0.3%, and 0.6% magnesium diets, and in another study we evaluated the effect of intraperitoneal magnesium on vascular calcification in 5/6 nephrectomized rats...
November 2017: Kidney International
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