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Hyperphosphatemia in CKD

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https://www.readbyqxmd.com/read/29903718/calcitriol-accelerates-vascular-calcification-irrespective-of-vitamin-k-status-in-a-rat-model-of-ckd-with-hyperphosphatemia-and-secondary-hyperparathyroidism
#1
Kristin M McCabe, Jason G Zelt, Martin Kaufmann, Kimberly Laverty, Emilie Ward, Henry Barron, Glenville Jones, Michael A Adams, Rachel M Holden
Patients with chronic kidney disease have a markedly increased risk for developing cardiovascular disease. Non-traditional risk factors, such as increased phosphate retention, and deficiencies in vitamins D and K metabolism, likely play key roles in the development of vascular calcification during CKD progression. Calcitriol (1,25-(OH)2-D3) is a key transcriptional regulator of Matrix Gla protein (MGP), a vitamin K dependent protein that inhibits vascular calcification. The objective of this study was to determine if calcitriol treatment could inhibit the development of vascular calcification and if this inhibition was dependent on vitamin K status in a rat model of CKD...
June 14, 2018: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/29858580/cisplatin-nephrotoxicity-as-a-model-of-chronic-kidney-disease
#2
Mingjun Shi, Kathryn L McMillan, Junxia Wu, Nancy Gillings, Brianna Flores, Orson W Moe, Ming Chang Hu
Cisplatin (CP)-induced nephrotoxicity is widely accepted as a model for acute kidney injury (AKI). Although cisplatin-induced chronic kidney disease (CKD) in rodent has been reported, the role of phosphate in the cisplatin-induced CKD progression is not described. In this study, we gave a single peritoneal injection of CP followed by high (2%) phosphate diet for 20 weeks. High dose CP (20 mg/Kg) led to high mortality; whereas a lower dose (10 mg/Kg) resulted in a full spectrum of AKI with tubular necrosis, azotemia, and 0% mortality 7 days after CP injection...
June 1, 2018: Laboratory Investigation; a Journal of Technical Methods and Pathology
https://www.readbyqxmd.com/read/29848117/admission-serum-phosphate-levels-predict-hospital-mortality
#3
Wisit Cheungpasitporn, Charat Thongprayoon, Michael A Mao, Wonngarm Kittanamongkolchai, Ankit Sakhuja, Stephen B Erickson
BACKGROUND: The aim of this study was to assess the relationship between admission serum phosphate levels and in-hospital mortality in all hospitalized patients. METHODS: All adult hospitalized patients who had admission serum phosphate available between years 2009 and 2013 were enrolled. Admission serum phosphate was categorized based on its distribution into six groups (<2.5, 2.5-3.0, 3.1-3.6, 3.7-4.2, 4.3-4.8 and ≥4.9 mg/dL). The odds ratio (OR) of in-hospital mortality by admission serum phosphate, using the phosphate category of 3...
May 30, 2018: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29796575/evaluation-of-prevalence-biochemical-profile-and-drugs-associated-with-chronic-kidney-disease-mineral-and-bone-disorder-in-11-dialysis-centers
#4
Rodrigo Reis Abrita, Beatriz Dos Santos Pereira, Neimar da Silva Fernandes, Renata Abrita, Rosalia Maria Nunes Henriques Huaira, Marcus Gomes Bastos, Natália Maria da Silva Fernandes
INTRODUCTION: The diagnosis and treatment of mineral and bone disorder of chronic kidney disease (CKD-MBD) is a challenge for nephrologists and health managers. The aim of this study was to evaluate the prevalence, biochemical profile, and drugs associated with CKD-MBD. METHODS: Cross-sectional study between July and November 2013, with 1134 patients on dialysis. Sociodemographic, clinical, and laboratory data were compared between groups based on levels of intact parathyroid hormone (iPTH) (< 150, 150-300, 301-600, 601-1000, and > 1001 pg/mL)...
January 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29782253/-mineral-and-bone-disorders-in-chronic-heart-failure
#5
E V Reznik, I G Nikitin
In many patients, chronic heart failure (CHF) is associated with chronic kidney disease (CKD). Virtually all patients with terminal CKD and many patients with early CKD display various disorders of mineral and bone metabolism (MBM) related with all-cause mortality and high risk of cardiovascular complications. This review addressed disorders of mineral and bone metabolism in patients with CHF, including hypocalcemia, hyperphosphatemia, vitamin D insufficiency/deficiency, secondary hyperparathyroidism, changed levels of FGF23 and Klotho, osteoporosis, osteopenia, their clinical and prognostic significance, and possibilities of their correction...
2018: Kardiologiia
https://www.readbyqxmd.com/read/29780355/therapeutic-interference-with-vascular-calcification-lessons-from-klotho-hypomorphic-mice-and-beyond
#6
REVIEW
Florian Lang, Christina Leibrock, Lisann Pelzl, Meinrad Gawaz, Burkert Pieske, Ioana Alesutan, Jakob Voelkl
Medial vascular calcification, a major pathophysiological process associated with cardiovascular disease and mortality, involves osteo-/chondrogenic transdifferentiation of vascular smooth muscle cells (VSMCs). In chronic kidney disease (CKD), osteo-/chondrogenic transdifferentiation of VSMCs and, thus, vascular calcification is mainly driven by hyperphosphatemia, resulting from impaired elimination of phosphate by the diseased kidneys. Hyperphosphatemia with subsequent vascular calcification is a hallmark of klotho-hypomorphic mice, which are characterized by rapid development of multiple age-related disorders and early death...
2018: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/29763365/effect-of-cross-linked-chitosan-iron-iii-on-vascular-calcification-in-uremic-rats
#7
Barbara Bruna Abreu de Castro, Wander Barros do Carmo, Paulo Giovani de Albuquerque Suassuna, Moises Carminatti, Julia Bianchi Brito, Wagner Vasques Dominguez, Ivone Braga de Oliveira, Vanda Jorgetti, Melani Ribeiro Custodio, Helady Sanders-Pinheiro
Cross-linked chitosan iron (III) is a chitin-derived polymer with a chelating effect on phosphorus, but it is untested in vascular calcification. We evaluated this compound's ability to reduce hyperphosphatemia and its effect on vascular calcification in uremic rats using an adenine-based, phosphorus-rich diet for seven weeks. We used a control group to characterize the uremia. Uremic rats were divided according the treatment into chronic kidney disease, CKD-Ch-Fe(III)CL (CKD-Ch), CKD-calcium carbonate, or CKD-sevelamer groups...
May 2018: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/29738034/evaluation-of-prevalence-biochemical-profile-and-drugs-associated-with-chronic-kidney-disease-mineral-and-bone-disorder-in-11-dialysis-centers
#8
Rodrigo Reis Abrita, Beatriz Dos Santos Pereira, Neimar da Silva Fernandes, Renata Abrita, Rosalia Maria Nunes Henriques Huaira, Marcus Gomes Bastos, Natália Maria da Silva Fernandes
INTRODUCTION: The diagnosis and treatment of mineral and bone disorder of chronic kidney disease (CKD-MBD) is a challenge for nephrologists and health managers. The aim of this study was to evaluate the prevalence, biochemical profile, and drugs associated with CKD-MBD. METHODS: Cross-sectional study between July and November 2013, with 1134 patients on dialysis. Sociodemographic, clinical, and laboratory data were compared between groups based on levels of intact parathyroid hormone (iPTH) (< 150, 150-300, 301-600, 601-1000, and > 1001 pg/mL)...
May 7, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29716795/metformin-prevents-the-development-of-severe-chronic-kidney-disease-and-its-associated-mineral-and-bone-disorder
#9
Ellen Neven, Benjamin Vervaet, Kerstin Brand, Ulrike Gottwald-Hostalek, Britt Opdebeeck, Annelies De Maré, Anja Verhulst, Jean-Daniel Lalau, Said Kamel, Marc E De Broe, Patrick C D'Haese
Chronic kidney disease (CKD) causes dysregulation of mineral metabolism, vascular calcification and renal osteodystrophy, an entity called 'CKD-Mineral and Bone Disorder' (CKD-MBD). Here we determine whether metformin, an anti-diabetic drug, exerts favorable effects on progressive, severe CKD and concomitant mineral metabolism disturbances. Rats with CKD-MBD, induced by a 0.25% adenine diet for eight weeks, were treated with 200 mg/kg/day metformin or vehicle from one week after CKD induction onward. Severe, stable CKD along with marked hyperphosphatemia and hypocalcemia developed in these rats which led to arterial calcification and high bone turnover disease...
April 28, 2018: Kidney International
https://www.readbyqxmd.com/read/29689558/fibulin-3-attenuates-phosphate-induced-vascular-smooth-muscle-cell-calcification-by-inhibition-of-oxidative-stress
#10
Trang T D Luong, Nadeshda Schelski, Beate Boehme, Manousos Makridakis, Antonia Vlahou, Florian Lang, Burkert Pieske, Ioana Alesutan, Jakob Voelkl
BACKGROUND/AIMS: Fibulin-3, an extracellular matrix glycoprotein, inhibits vascular oxidative stress and remodeling in hypertension. Oxidative stress is prevalent in chronic kidney disease (CKD) patients and is an important mediator of osteo-/chondrogenic transdifferentiation and calcification of vascular smooth muscle cells (VSMCs) during hyperphosphatemia. Therefore, the present study explored the effects of Fibulin-3 on phosphate-induced vascular calcification. METHODS: Experiments were performed in primary human aortic smooth muscle cells (HAoSMCs) treated with control or with phosphate without or with additional treatment with recombinant human Fibulin-3 protein or with hydrogen peroxide as an exogenous source of oxidative stress...
2018: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/29671909/should-phosphate-management-be-limited-to-the-kdigo-kdoqi-guidelines
#11
Sangeet Dhillon-Jhattu, Stuart M Sprague
Hyperphosphatemia is a common complication of CKD. Prior to development of overt hyperphosphatemia, there are several adaptive mechanisms that occur to maintain normal phosphorus equilibrium in patients with CKD. These include an early and progressive rise in fibroblast growth factor 23 (FGF 23), followed by an increase in parathyroid hormone (PTH) with a decrease in 1,25-dihydroxyvitamin D (1,25 Vit D). Over the last 20 years, a large number of studies have shown that hyperphosphatemia is a strong predictor of adverse clinical outcomes including increased incidence of vascular calcification, cardiovascular disease, and all-cause mortality in both individuals with CKD as well as those with normal kidney function...
April 19, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29614098/a-novel-calcimimetic-agent-evocalcet-mt-4580-khk7580-suppresses-the-parathyroid-cell-function-with-little-effect-on-the-gastrointestinal-tract-or-cyp-isozymes-in-vivo-and-in-vitro
#12
Takehisa Kawata, Shin Tokunaga, Miki Murai, Nami Masuda, Waka Haruyama, Youji Shoukei, Yutaka Hisada, Tetsuya Yanagida, Hiroshi Miyazaki, Michihito Wada, Tadao Akizawa, Masafumi Fukagawa
Cinacalcet hydrochloride (cinacalcet), an oral calcimimetic agent has been widely used for the management of secondary hyperparathyroidism (SHPT) in chronic kidney disease (CKD). In sharp contrast to vitamin D receptor activators, cinacalcet suppresses SHPT without inducing hypercalcemia or hyperphosphatemia. Nevertheless, some patients remain refractory to SHPT with this agent, as the dose cannot be sufficiently increased due to gastrointestinal symptoms. In order to resolve this issue, we have developed a newly synthesized calcimimetic agent, evocalcet (MT-4580/KHK7580)...
2018: PloS One
https://www.readbyqxmd.com/read/29582958/-ckd-mbd-in-peritoneal-dialysis
#13
Anna Rachele Rocca, Tania Gnerre Musto, Sandro Mazzaferro
CKD-MBD is a systemic disorder of the mineral and bone metabolism as a result of CKD. The clinical relevance of this syndrome has led to the identification of the biochemical targets to be achieved in order to improve the outcome of the patient. However, in hemodialysis (HD) and peritoneal dialysis (DP) patients, these targets are not reached. Hyperphosphatemia is a predictor of cardiovascular and all-cause mortality. In DP the removal of phosphorus (P) occurs by diffusion and convection, with a contribution of ultrafiltration of about 11%...
March 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29580635/prevention-and-treatment-of-hyperphosphatemia-in-chronic-kidney-disease
#14
REVIEW
Marc G Vervloet, Adriana J van Ballegooijen
Hyperphosphatemia has consistently been shown to be associated with dismal outcome in a wide variety of populations, particularly in chronic kidney disease (CKD). Compelling evidence from basic and animal studies elucidated a range of mechanisms by which phosphate may exert its pathological effects and motivated interventions to treat hyperphosphatemia. These interventions consisted of dietary modifications and phosphate binders. However, the beneficial effects of these treatment methods on hard clinical outcomes have not been convincingly demonstrated in prospective clinical trials...
May 2018: Kidney International
https://www.readbyqxmd.com/read/29566839/cost-effectiveness-of-first-line-sevelamer-and-lanthanum-versus-calcium-based-binders-for-hyperphosphatemia-of-chronic-kidney-disease
#15
COMPARATIVE STUDY
Steven Habbous, Sebastian Przech, Janet Martin, Amit X Garg, Sisira Sarma
BACKGROUND: Phosphate binders are used to treat hyperphosphatemia among patients with chronic kidney disease (CKD). OBJECTIVES: To conduct an economic evaluation comparing calcium-free binders sevelamer and lanthanum with calcium-based binders for patients with CKD. METHODS: Effectiveness data were obtained from a recent meta-analysis of randomized trials. Effectiveness was measured as life-years gained and translated to quality-adjusted life-years (QALYs) using utility weights from the literature...
March 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/29533151/comparison-of-renal-function-and-other-predictors-in-lacto-ovo-vegetarians-and-omnivores-with-chronic-kidney-disease
#16
Chou-Yueh Chang, Horng-Rong Chang, Hsing-Chun Lin, Han-Hsin Chang
Objective Vegetarian diets have been shown to increase the risk of certain nutritional deficiencies, such as iron. As a number of patients with chronic kidney disease (CKD) in Taiwan are lacto-ovo vegetarians, the aim of this study was to investigate the effects of different proportions and sources of protein in lacto-ovo vegetarian and omnivorous diets, as well as the influence of adequate dietary protein intake, on renal function and nutritional status of Taiwanese patients with stage 3 to stage 5 CKD. Methods This is a cross-sectional study...
March 13, 2018: Journal of the American College of Nutrition
https://www.readbyqxmd.com/read/29523679/parathyroidectomy-in-the-management-of-secondary-hyperparathyroidism
#17
REVIEW
Wei Ling Lau, Yoshitsugu Obi, Kamyar Kalantar-Zadeh
Secondary hyperparathyroidism develops in CKD due to a combination of vitamin D deficiency, hypocalcemia, and hyperphosphatemia, and it exists in nearly all patients at the time of dialysis initiation. There is insufficient data on whether to prefer vitamin D analogs compared with calcimimetics, but the available evidence suggests advantages with combination therapy. Calcium derangements, patient adherence, side effects, and cost limit the use of these agents. When parathyroid hormone level persists >800 pg/ml for >6 months, despite exhaustive medical interventions, monoclonal proliferation with nodular hyperplasia is likely present along with decreased expression of vitamin D and calcium-sensing receptors...
March 9, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29486729/phosphate-stimulates-myotube-atrophy-through-autophagy-activation-evidence-of-hyperphosphatemia-contributing-to-skeletal-muscle-wasting-in-chronic-kidney-disease
#18
Yue-Yue Zhang, Man Yang, Jin-Fang Bao, Li-Jie Gu, Hong-Lei Yu, Wei-Jie Yuan
BACKGROUND: Accelerated muscle atrophy is associated with a three-fold increase in mortality in chronic kidney disease (CKD) patients. It is suggested that hyperphosphatemia might contribute to muscle wasting, but the underlying mechanisms remain unclear. Although evidence indicates that autophagy is involved in the maintenance of muscle homeostasis, it is not known if high phosphate levels can result in activation of autophagy, leading to muscle protein loss. METHODS: Immortalized rat L6 myotubes were exposed to a high concentration of phosphate, with or without autophagy inhibition...
February 27, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29415929/-pharmacological-pharmaceutical-and-clinical-profiles-of-sucroferric-oxyhydroxide-p-tol-%C3%A2-chewable-tab-250-mg-500-mg-a-therapeutic-agent-for-hyperphosphatemia
#19
Satoshi Tatemichi, Fumiaki Nakagaki, Shoichi Yoshioka, Natsuko Shichiri
Sucroferric oxyhydroxide (P-TOL® chewable tablets, 250 and 500 mg) is a phosphate binder for oral use; it is composed of polynuclear iron (III)-oxyhydroxide, sucrose, and starches, and is currently indicated for alleviating hyperphosphatemia in patients with chronic kidney disease (CKD) on dialysis. The results of non-clinical pharmacological studies have suggested that P-TOL consistently decreases serum phosphorus levels in the aqueous environment at pH levels similar to those in the gastrointestinal tract, thereby suppressing the progression of secondary hyperparathyroidism, aberrant calcification, and abnormal bone metabolism associated with hyperphosphatemia...
2018: Nihon Yakurigaku Zasshi. Folia Pharmacologica Japonica
https://www.readbyqxmd.com/read/29409087/-chronic-kidney-disease-update-2018
#20
Markus Ketteler, Christoph Wanner
SGLT2-INHIBITION IN DIABETIC AND NON-DIABETIC KIDNEY DISEASE:  The CANVAS Program Collaborative Group study confirmed nephroprotective actions by canagliflocin comparable to empagliflozin as published in the EMPA-REG Outcome study. Treatment with Liraglutide (LEADER study) also suggests nephroprotection via albuminuria reduction a decreased eGFR decline in subgroups and depending on stages of diabetic nephropathy. KDIGO CKD-MBD GUIDELINE UPDATE 2017:  In July 2017, an update of the KDIGO (Kidney Disease: Improving Global Outcomes) 2009 guideline on diagnostic and treatment chronic kidney disease - mineral and bone disorders (CKD-MBD) was published...
February 2018: Deutsche Medizinische Wochenschrift
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