Hyperphosphoremia

The risk of developing cardiovascular disease is greatly increased in patients undergoing renal replacement therapy and, notably, morbidity and mortality due to therapy is much higher in these patients than in the general population. Minimal alterations in renal function, as evidenced by reduced glomerular filtration rate and the presence of albuminuria, have been described as potent cardiovascular risk factors. The classic risk factors only partly explain this difference; hence, we must admit the existence of known and emerging factors associated with increased cardiovascular risk in patients with renal disease...

BACKGROUND: Fahr syndrome is defined by the presence at the brain base of strio-pallido-notched non-arteriosclerotic bilateral and symmetric calcifications. We report an observation of Fahr syndrome revealed by a growing pyodermitis in direct relation with hypocalcemia. OBSERVATION: A 17 year-old girl was admitted to the Dermatology Department for a growing pyodermitis of the large folds. The patient was known to be epileptic and had undergone surgery for a left eye cataract a year before...

BACKGROUND: Sevelamer is a non-absorbable phosphorus chelator that is not a source of aluminium, calcium or base. The clinical experience with sevelamer in peritoneal dialysis and in daily clinical practice is scarce. The aim of this study is to evaluate the results of therapy of hyperphosphoremia with sevelamer on serum phosphorus and phosphorus chelators requirements, in a peritoneal dialysis clinical practice. METHODS: Sevalamer 400 mg was prescribed to peritoneal dialysis patients with hyperphosphoremia who were treated with aluminium hydroxide or with calcium salts in the absence of hypocalcemia...

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No abstract text is available yet for this article.

No abstract text is available yet for this article.

Phosphorus is involved in the pathogenesis of hyperparathyroidism in Chronic Renal Failure (CRF) and in extra-osseous calcifications. Therefore, it is directly related with the morbi-mortality of these patients. The control of phosphorus is of the utmost importance and is often extremely difficult to achieve. A quick overview of the drugs that can bind phosphorus is given in this paper. Iron salts are beginning to come through as a viable possibility in the near future; nevertheless, calcium salts continue to be the most widespread...

We report the case of a 27-year old woman who presented hypocalcemia and hyperphosphoremia during her first pregnancy. Her phenotype was in favor of Albright's hereditary osteodystrophy: short stature, obesity, round face, brachymetacarpy and mental retardation. However, the diagnosis of pseudohypopara thyroidism type Ia was ruled out due to low PTH level (10 pg/ml). The patient's 22q11 microdeletion was suspected and identified because of the association of severe neonatal hypocalcemia, abnormal face and renal malformation in her children...

AIMS: To evaluate the efficacy of intravenous calcitriol as a means of significantly reducing plasma PTH in long-term hemodialysis with severe hyperparathyroidism. METHODS: EXPERIMENTAL DESIGN: prospective study. FOLLOW-UP: 12 months. SETTING: hospital hemodialysis centre. PATIENTS: 14 chronic hemodialysis patients, 6 males and 8 females, mean dialytic age 6.3 +/- 2.7 years, mean age 65...

OBJECTIVE: To analyze a series of uremic tumoral calcinosis (UTC) in patients receiving longterm dialysis therapy. METHODS: Twelve patients receiving longterm hemodialysis affected by tumoral calcinosis were analyzed. Clinical, radiological, and pathological features were evaluated and pathogenic factors were reviewed. RESULTS: The most common sites for UTC were the elbow, hip, hand, and wrist. The lesions were multiple (67%, n = 8), of large size, and symptomatic with joint mobility impairment (75%, n = 9) as well as nerve compression (33%, n = 4)...

INTRODUCTION: Subcutaneous and vascular calcifications are classical manifestations of pseudoxanthoma elasticum. Visceral calcifications sometimes associated with unbalanced phosphocalcium leels are uncommon. CASE REPORT: We observed pseudoxanthoma elasticum in a French Caribbean patient who had extensive acneiform skin lesions with transepidermal elimination. Multivisceral calcifications were associated hyperphosphoremia alone. DISCUSSION: The pathogenic sequence of phosphocalcium disorders in this disease are discussed on the basis of calcifications and hyperphosphoremia observed in this case and from data in the literature...

Control of hyperphosphoremia is crucial to the prevention of secondary hyperparathyroidism. Calcium salts of keto-amino acids (KAA) were employed as phosphate binders in hemodialysis patients. We wanted to assess the efficacy of these substances as quelating agents in patients under continuous ambulatory peritoneal dialysis (CAPD). Also, as an amino acid supplement, we determined their possible effect on some parameters related to nutritional status. We studied 13 patients (7 M; 6 F) with a mean age of 45.2 +/- 17 years and a mean time on CAPD of 18...

BACKGROUND: Type la pseudohypoparathyroidism is due to a molecular defect causing Gs protein deficiency. It is responsible for multi-hormonal resistance and skeletal abnormalities. Parathyroid hormone resistance can be subtle so that the diagnosis can be difficult in patients with atypical manifestations. CASE REPORT: A 10-year-old boy was first referred for growth retardation (height standard deviation score: -2.8). He had short metacarpals, and scaphocephaly. Laboratory findings revealed an elevation of plasma TSH (8,8 microU/mL) with normal thyroid hormone levels...

A patient with end-stage renal disease, hemodialysis treatment, severe secondary hyperparathyroidism and mandibular brown tumor received increasing doses of oral calcitriol (3.5 to 9 micrograms/week) and calcium carbonate (10 g/day). Nineteen months after the treatment, clinical, radiological and humoral improvement were observed. The present case demonstrates the effectiveness of medical parathyroidectomy for the control of severe secondary hyperparathyroidism--brown tumor--in chronic hemodialysed patients...

Secondary (renal) hyperparathyroidism appears in chronic renal failure, sometimes in patients on chronic dialysis. Other causes includes rickets and osteomalacia. These diseases are associated with poor calcium and vitamin D absorbtion from the small bowel. Two patients with chronic renal failure maintained on chronic haemodialysis from two and three years, respectively underwent subtotal parathyroidectomy: removal of three glands and preserving a half of a gland in situ. The diagnosis and surgical indication was made upon clinical (bone pain and severe itching), radiological (demineralisation, ectopic calcifications) and biochemical (hypercalcemia, hyperphosphoremia, increased values of alkaline phosphatases) arguments...

A 10 year old patient with acute respiratory insufficiency, dispnea, cough, temperature, cyanosis and hemoptisis is presented. Cranial X-rays and scanning revealed basal ganglia calcifications. Intense hypocalcemia and hyperphosphoremia were found as well as response to parathyroid hormone administration. A diagnosis of primary hypoparathyroidism and idiopathic pulmonary hemosiderosis was made. These two diseases are associated and related because of the autoimmune nature of both of them.

Several experiments have shown that deterioration of renal parenchyma after reduction of functional mass is affected by the protein content of the diet. The respective role of proteins and that of other nutrients particularly phosphorus which varies with proteins was never clearly separated. Three groups of 9 uremic rats U I, U II, U III, received three diets differing exclusively in their protein content, which was supplied by casein and was respectively 8%, 16% and 32%. Other nutrients were maintained identical, including energy and minerals...

Prospective study of parathyroid risk in a bulk of 502 consecutive bilateral thyroidectomies. Early post-operative hypocalcemia has been documented in 8,8% of the patients, but persisted in only 1,6% one year later. Late parathyroid risk of total thyroidectomy is 3,3% but increases twofold if neck dissection is simultaneously performed. Methods of this study probably misdiagnose a number of mild hypoparathyroidism. Lack of early hyperphosphoremia seems to be an optimizing criteria for aftermath. In Grave's disease, early post-operative hypocalcemia is more common (6,9%) but often subsides (definitive risk: 0,4%)...

Thirty-seven osteodystrophic and chronically haemodialyzed patients have been treated for 1-22 months by means of 1,25(OH)2D3. Under treatment a marked improvement of symptomatology and radiographic findings has been observed in the majority of cases; from the haematochemical viewpoint a rise of calcemia and phosphoremia, a fall in alkaline phosphatase and a variable course of PTH have been observed. Several episodes of asymptomatic hypercalcemia ceased with posology reduction; only 3 cases needed stopping the treatment for this reason, one of them definitively; 12/37 cases needed hypophosphoric diets and increase in oral aluminium hydroxide doses to control hyperphosphoremia...

Systematic study by high resolution real time ultrasonography of the parathyroïd glands unequivocally showed parathyroid hyperplasia in 13% of 60 patients on chronic hemodialysis. Hyperplasia was associated with greater severity of hyperparathyroidism, as demonstrated by subperiostal bone resorption and increased serum levels of alkaline phosphatase, parathormone and calcium. Correlation between ultrasonographic and surgical findings in 5 patients was excellent, and actual weights of removed hyperplastic glands were correlated to calculated volumes...