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https://www.readbyqxmd.com/read/28062938/mineral-metabolism-and-cardiovascular-disease-in-ckd
#1
REVIEW
Hideki Fujii, Nobuhiko Joki
The mineral bone disorder of CKD, called Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD), has a major role in the etiology and progression of cardiovascular disease in CKD patients. Since the main emphasis in CKD-MBD is on three categories (bone abnormalities, laboratory abnormalities, and vascular calcifications), we have routinely accepted ectopic cardiovascular calcifications as a central risk factor in the pathophysiology of CKD-MBD for cardiac events. However, recent compelling evidence suggests that some CKD-MBD-specific factors other than vascular calcification might contribute to the onset of cardiovascular disease...
January 6, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28052525/daily-variability-in-serum-levels-of-calciprotein-particles-and-their-association-with-mineral-metabolism-parameters-a-cross-sectional-pilot-study
#2
Hodaka Yamada, Makoto Kuro-O, San-E Ishikawa, Shunsuke Funazaki, Ikuyo Kusaka, Masafumi Kakei, Kazuo Hara
BACKGROUND: Calciprotein particles (CPPs), colloidal protein-mineral nanoparticles composed of solid-phase calcium phosphate and serum protein fetuin-A found in blood, are emerging as a novel component of chronic kidney disease-mineral and bone disorder (CKD-MBD). In this study, we examined daily variations in CPPs as well as their association with mineral metabolism parameters in normal individuals and early-stage CKD patients. METHODS: Twenty subjects (10 healthy adults, 10 diabetic patients) were enrolled...
January 4, 2017: Nephrology
https://www.readbyqxmd.com/read/28045985/association-of-ckd-mbd-markers-with-all-cause-mortality-in-prevalent-hemodialysis-patients-a-cohort-study-in-beijing
#3
Duo Li, Ling Zhang, Li Zuo, Cheng Gang Jin, Wen Ge Li, Jin-Bor Chen
The relationships between all-cause mortality and serum intact parathyroid hormone (iPTH), calcium, and phosphate are fairly diverse in patients on maintenance hemodialysis according to prior studies. This study evaluated the association of chronic kidney disease-mineral and bone disorder (CKD-MBD) markers with all-cause mortality in prevalent hemodialysis patients from 2007 to 2012 in Beijing, China. A cohort, involving 8530 prevalent hemodialysis patients who had undergone a 6-70 months follow-up program (with median as 40 months) was formed...
2017: PloS One
https://www.readbyqxmd.com/read/28045952/predictive-factors-of-one-year-mortality-in-a-cohort-of-patients-undergoing-urgent-start-hemodialysis
#4
Luciene P Magalhães, Luciene M Dos Reis, Fabiana G Graciolli, Benedito J Pereira, Rodrigo B de Oliveira, Altay A L de Souza, Rosa M Moyses, Rosilene M Elias, Vanda Jorgetti
BACKGROUND: Chronic kidney disease (CKD) affects 10-15% of adult population worldwide. Incident patients on hemodialysis, mainly those on urgent-start dialysis at the emergency room, have a high mortality risk, which may reflect the absence of nephrology care. A lack of data exists regarding the influence of baseline factors on the mortality of these patients. The aim of this study was to evaluate the clinical and laboratory characteristics of this population and identify risk factors that contribute to their mortality...
2017: PloS One
https://www.readbyqxmd.com/read/28012057/chronic-kidney-disease-and-fragility-fracture
#5
REVIEW
Junichiro James Kazama
Osteoporosis is defined simply as "a skeletal disorder characterized by compromised bone strength predisposing to an increased risk of fracture. Thus, any bone lesion that causes fragility fracture is osteoporosis, which has quite heterogeneous backgrounds. Chronic kidney disease-related bone and mineral disease (CKD-MBD) is defined as "a systemic disorder of mineral and bone metabolism due to CKD, which is manifested by abnormalities in bone and mineral metabolism and/or extra-skeletal calcification". Although CKD-MBD is one of the possible causes of osteoporosis, we do not have evidences that CKD-MBD is the only or crucial determinant of bone mechanical strength in CKD patients...
December 23, 2016: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28007671/magnesium-based-interventions-for-normal-kidney-function-and-chronic-kidney-disease
#6
Ziad A Massy, Ionut Nistor, Mugurel Apetrii, Vincent M Brandenburg, Jordi Bover, Pieter Evenepoel, David Goldsmith, Sandro Mazzaferro, Pablo Urena-Torres, Marc G Vervloet, Mario Cozzolino, Adrian Covic, On Behalf Of Ckd-Mbd Working Group Of Era-Edta
Magnesium (Mg) is one of the most important cations in the body, playing an essential role in biological systems as co-factor for more than 300 essential enzymatic reactions. In the general population, low levels of Mg are associated with a high risk of cardio-vascular disease (CVD). Despite the accumulating literature data, the effect of Mg administration on mortality in chronic kidney disease (CKD) patients has never been investigated as a primary end-point. We conducted a systematic search of studies assessing the benefits and harms of Mg in CKD (stages 1 to 5 and 5D), and considered all randomized controlled trials (RCTs) and quasi-RCTs evaluating Mg-based interventions in CKD...
December 22, 2016: Magnesium Research: Official Organ of the International Society for the Development of Research on Magnesium
https://www.readbyqxmd.com/read/28005175/research-on-kidney-and-mineral-metabolism-in-japan-past-present-and-future
#7
REVIEW
Masahide Mizobuchi, Hiroaki Ogata, Fumihiko Koiwa, Eriko Kinugasa, Tadao Akizawa
Since the identification of the kidney was the main site for the synthesis of calcitriol (1α, 25-dihydroxycholecalciferol), research on chronic kidney disease (CKD)-associated mineral metabolism disorders and their management has made rapid progress. Various active analogues of calcitriol have clinically become available for treating secondary hyperparathyroidism (SHPT), which is a representative mineral metabolism abnormality in CKD patients. A calcimimetic compound cinacalcet hydrochloride has also been developed for the medical management of SHPT through a different mechanism involving the calcium-sensing receptor...
December 22, 2016: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28003998/association-between-the-achievement-of-target-range-ckd-mbd-markers-and-mortality-in-prevalent-hemodialysis-patients-in-taiwan-by-using-the-kidney-disease-improving-global-outcomes-clinical-guidelines
#8
Ying Liu, Wen-Chin Lee, Ben-Chung Cheng, Lung-Chih Li, Chih-Hsiung Lee, Wen-Xiu Chang, Jin-Bor Chen
Background. This study evaluated the association between achieving target chronic kidney disease-mineral and bone disorder (CKD-MBD) marker levels and mortality in Taiwanese hemodialysis (HD) patients. Target levels were based on the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. Methods. We performed a retrospective medical record review of 1126 HD patients between 2009 and 2013. A logistic regression model was used to evaluate the relationship between achieving target marker levels and the risk for all-cause and cardiovascular (CV) mortality...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27976811/uremic-serum-impairs-osteogenic-differentiation-of-human-bone-marrow-mesenchymal-stromal-cells
#9
Elena Della Bella, Stefania Pagani, Gianluca Giavaresi, Irene Capelli, Giorgia Comai, Chiara Donadei, Maria Cappuccilli, Gaetano La Manna, Milena Fini
Chronic Kidney Disease - Mineral and Bone Disorder (CKD-MBD) is characterized by an increased fracture risk. Bone marrow mesenchymal stromal cells (BMSCs) may be involved in the pathogenesis of bone disease and, in view of their promising potential applications in bone tissue engineering, the effect of uremia on BMSCs regenerative potential represents a central issue. The present study evaluated in vitro the effect of a serum pool from hemodialysis patients on BMSCs to observe its influence on osteogenic differentiation...
December 14, 2016: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/27966253/treatment-of-a-soft-tissue-calcification-in-a-patient-receiving-peritoneal-dialysis
#10
Kristine Lindhard, Bo Broberg, Henrik Groenberg, Henrik Post Hansen
Chronic Kidney Disease patients suffer from Mineral and Bone Disorder (CKD-MBD) leading to increased vascular and soft-tissue calcification. The prevalence of soft tissue calcification in dialysis patients is not well described, and most cases describe such calcifications in hemodialysis patients. We describe a case of a massive soft tissue calcification in the right gluteal region in a peritoneal dialysis patient. The patient had severe pain and were disabled. The treatment was converted to an intensive hemodialysis regimen with a minimal calcium load and high dose of cinacalcet...
December 14, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27942882/clinical-features-of-ckd-mbd-in-japan-cohort-studies-and-registry
#11
REVIEW
Takayuki Hamano, Yusuke Sakaguchi, Naohiko Fujii, Yoshitaka Isaka
Randomized controlled trials (RCTs) are essential for evidence-based medicine; however, cohort studies and registries provide an important information about risk factors and, hence, shed light on the target of laboratory parameters. The uniqueness of the current Japanese CKD-MBD guidelines lies in the lower target range of intact parathyroid hormone levels than those used in other countries, which is based on analyses of the nationwide Japan Renal Data Registry. Cohort studies were also useful in exploring risk factors of renal outcome in predialysis patients...
December 9, 2016: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/27913900/bone-mineral-density-of-extremities-is-associated-with-coronary-calcification-and-biopsy-verified-vascular-calcification-in-living-donor-renal-transplant-recipients
#12
Zhimin Chen, Jia Sun, Mathias Haarhaus, Peter Barany, Lars Wennberg, Jonaz Ripsweden, Torkel B Brismar, Bengt Lindholm, Annika Wernerson, Magnus Söderberg, Peter Stenvinkel, Abdul Rashid Qureshi
Chronic kidney disease (CKD) mineral and bone disorders (CKD-MBD) may lead to low bone mineral density (BMD) and vascular calcification (VC), but links to the latter are unclear. Here we investigated associations between BMD, coronary artery calcium (CAC) scores, and histological signs of VC in end-stage renal disease (ESRD) patients undergoing living-donor kidney transplantation (LD-Rtx). In 66 ESRD patients (median age 45 years, 68% males), BMD (by dual-energy X-ray absorptiometry, DXA), CAC score (by computed tomography, CT; n = 54), and degree of VC score (graded by histological examination of epigastric artery specimens collected at LD-Rtx; n = 55) were assessed at the time of LD-Rtx...
December 2, 2016: Journal of Bone and Mineral Metabolism
https://www.readbyqxmd.com/read/27896453/management-of-phosphorus-load-in-ckd-patients
#13
REVIEW
Yutaka Taketani, Fumihiko Koiwa, Keitaro Yokoyama
Disturbances in mineral and bone metabolism play a critical role in the pathogenesis of cardiovascular complications in patients with chronic kidney disease (CKD). The term "renal osteodystrophy" has recently been replaced with "CKD-mineral and bone disorder (CKD-MBD)", which includes vascular calcification as well as bone abnormalities. In Japan, proportions of the aged and long-term dialysis patients are increasing which makes management of vascular calcification and parathyroid function increasingly more important...
November 28, 2016: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/27890549/novel-functions-of-circulating-klotho
#14
REVIEW
Julia M Hum, Linda O'Bryan, Rosamund C Smith, Kenneth E White
A significant portion of the key biological functions of αKlotho (αKL) and its cognate ligand Fibroblast growth factor-23 (FGF23) have been revealed through the study of rare diseases of mineral metabolism. These findings have far reaching implications for common disorders such as chronic kidney disease-mineral bone disorder (CKD-MBD). αKL's predominant effect on mineral homeostasis is through its actions in the kidney as a co-receptor for FGF23, however emerging data has shed light on its capacity to act as a circulating factor through the cleavage of the transmembrane form of αKL ('mKL') to produce 'cleaved KL' or 'cKL'...
November 23, 2016: Bone
https://www.readbyqxmd.com/read/27847254/vascular-calcification-in-ckd-mbd-roles-for-phosphate-fgf23-and-klotho
#15
REVIEW
Shunsuke Yamada, Cecilia M Giachelli
Vascular calcification (VC) is highly prevalent in aging, diabetes mellitus, and chronic kidney disease (CKD). VC is a strong predictor of cardiovascular morbidity and mortality in the CKD population. Complex pathological mechanisms are involved in the development of VC, including osteochondrogenic differentiation and apoptosis of vascular smooth muscle cells, instability and release of extracellular vesicles loaded calcium and phosphate, and elastin degradation. Elevated serum phosphate is a late manifestation of CKD, and has been shown to accelerate mineral deposition in both the vessel wall and heart valves...
November 12, 2016: Bone
https://www.readbyqxmd.com/read/27818277/comparison-of-the-effects-of-novel-vitamin-d-receptor-analog-vs-105-and-paricalcitol-on-chronic-kidney-disease-mineral-bone-disorder-in-an-experimental-model-of-chronic-kidney-disease
#16
Hideki Fujii, Yuriko Yonekura, Kentaro Nakai, Keiji Kono, Shunsuke Goto, Shinichi Nishi
When using vitamin D, the most important clinical problems are hypercalcemia, hyperphosphatemia, and vascular calcification. VS-105 is a novel vitamin D receptor (VDR) analog. In the present study, we compared the effects of VS-105 and paricalcitol on chronic kidney disease-mineral bone disorder (CKD-MBD) in a CKD rat model. We used male Sprague-Dawley (SD) rats and performed 5/6 nephrectomy at 8-9 weeks. At 10 weeks, the rats were classified into five groups and administered vehicle, low-dose paricalcitol (LP, 0...
November 3, 2016: Journal of Steroid Biochemistry and Molecular Biology
https://www.readbyqxmd.com/read/27814753/facility-level-ckd-mbd-composite-score-and-risk-of-adverse-clinical-outcomes-among-patients-on-hemodialysis
#17
Geoffrey A Block, Akeem A Yusuf, Mark D Danese, Heidi S Wirtz, Yan Hu, Thy P Do, Kerry Cooper, David T Gilbertson, Brian D Bradbury, Allan J Collins
BACKGROUND: Patients receiving hemodialysis with values outside of target levels for parathyroid hormone (PTH: 150-600 pg/mL), calcium (Ca: 8.4-10.2 mg/dL), and phosphate (P: 3.5-5.5 mg/dL) are at elevated morbidity and mortality risk. We examined whether patients receiving care in dialysis facilities where greater proportions of patients have at least two values out of target have a higher risk of adverse clinical outcomes. METHODS: The study cohort consisted of 39,085 prevalent hemodialysis patients in 1298 DaVita dialysis facilities as of September 1, 2009, followed from January 1, 2010, until an outcome, a censoring event, or December 31, 2010...
November 4, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27806914/micrornas-in-the-pathophysiology-of-ckd-mbd-biomarkers-and-innovative-drugs
#18
REVIEW
Valérie Metzinger-Le Meuth, Stéphane Burtey, Pierre Maitrias, Ziad A Massy, Laurent Metzinger
microRNAs comprise a novel class of endogenous small non-coding RNAs that have been shown to be implicated in both vascular damage and bone pathophysiology. Chronic kidney disease-mineral bone disorder (CKD-MBD) is characterized by vessel and bone damage secondary to progressive loss of kidney function. In this review, we will describe how several microRNAs have been implicated, in recent years, in cellular and animal models of CKD-MBD, and have been very recently shown to be deregulated in patients with CKD...
January 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/27804080/a-critical-appraisal-of-chronic-kidney-disease-mineral-and-bone-disorders-clinical-practice-guidelines-using-the-agree-ii-instrument
#19
REVIEW
Nigar Sekercioglu, Reem Al-Khalifah, Joycelyne Efua Ewusie, Rosilene M Elias, Lehana Thabane, Jason W Busse, Noori Akhtar-Danesh, Alfonso Iorio, Tetsuya Isayama, Juan Pablo Díaz Martínez, Ivan D Florez, Gordon H Guyatt
BACKGROUND: Patients with chronic kidney disease mineral and bone disorders (CKD-MBD) suffer high rates of morbidity and mortality, in particular related to bone and cardiovascular outcomes. The management of CKD-MBD remains challenging. The objective of this systematic survey is to critically appraise clinical practice guidelines (CPGs) addressing CKD-MBD. METHODS/DESIGN: Data sources included MEDLINE, EMBASE, the National Guideline Clearinghouse, Guideline International Network and Turning Research into Practice up to May 2016...
November 1, 2016: International Urology and Nephrology
https://www.readbyqxmd.com/read/27719736/regression-of-vascular-calcification-in-a-parathyroidectomized-patient-on-dialysis-with-untreated-hypocalcemia-over-12-year-follow-up%C3%A2
#20
Pablo Molina, José L Górriz, Sandra Beltrán, Belén Vizcaino, Luis M Pallardo
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...
December 2016: Clinical Nephrology
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