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https://www.readbyqxmd.com/read/28346348/vitamin-d-in-chronic-kidney-disease-and-dialysis-patients
#1
REVIEW
Guillaume Jean, Jean Claude Souberbielle, Charles Chazot
Vitamin D deficiency (<20 ng/mL) and insufficiency (20-29 ng/mL) are common among patients with chronic kidney disease (CKD) or undergoing dialysis. In addition to nutritional and sunlight exposure deficits, factors that affect vitamin D deficiency include race, sex, age, obesity and impaired vitamin D synthesis and metabolism. Serum 1,25(OH)₂D levels also decrease progressively because of 25(OH)D deficiency, together with impaired availability of 25(OH)D by renal proximal tubular cells, high fibroblast growth factor (FGF)-23 and decreased functional renal tissue...
March 25, 2017: Nutrients
https://www.readbyqxmd.com/read/28345770/effect-of-1-25-oh-2-d3-and-20-oh-d3-on-interleukin-1%C3%AE-stimulated-interleukin-6-and-8-production-by-human-gingival-fibroblasts
#2
V Nakashyan, D A Tipton, A Karydis, R Livada, S H Stein
BACKGROUND AND OBJECTIVE: Vitamin D-1,25(OH)2 D3 or 1,25D3-maintains healthy osseous tissue, stimulates the production of the antimicrobial peptide cathelicidin and has anti-inflammatory effects, but it can cause hypercalcemia. Evidence links diminished serum levels of 1,25D3 with increased gingival inflammation. Periodontitis progression is associated with increased local production of inflammatory mediators by immune cells and gingival fibroblasts. These include interleukin (IL)-6, a regulator of osteoclastic bone resorption, and the neutrophil chemoattractant IL-8, both regulated by signaling pathways, including NF-κB and MAPK/AP-1...
March 27, 2017: Journal of Periodontal Research
https://www.readbyqxmd.com/read/28338532/is-severe-hypercalcemia-immediately-life-threatening
#3
Camille Guimard, Eric Batard, Frédéric Lavainne, David Trewick
OBJECTIVE: Severe hypercalcemia is often considered an emergency because of a potential risk of cardiac arrest or coma. However, there is little evidence to support this. The aim of our study was to assess whether severe hypercalcemia (Ca>4 mmol/l or 16 mg/dl) was associated with immediately life-threatening cardiac arrhythmias or neurological complications in patients admitted to the Emergency Department (ED). METHODS: A retrospective observational study was carried out over a 5-year period (2008-2012)...
March 23, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28336828/-disorders-caused-by-mutations-in-calcium-sensing-receptor-and-related-diseases
#4
Toshimi Michigami
Sensing of extracellular calcium(Ca2+)levels involves the Ca-sensing receptor(CaSR), its downstream signaling molecule Gα11, and the adaptor-related protein complex 2(AP2)that plays a role in clathrin-dependent endocytosis of CaSR. Inactivating mutations in CaSR cause familial hypocalciuric hypercalcemia type 1(FHH1)and neonatal severe hyperparathyroidism(NSHPT), while activating mutations lead to autosomal dominant hypocalcemia type 1(ADH1)and Bartter syndrome type Ⅴ. Recent studies have identified that inactivating mutations in Gα11 and σ-subunit of AP2(AP2σ)also cause FHH, and these conditions have been classified as FHH2 and FHH3, respectively...
2017: Clinical Calcium
https://www.readbyqxmd.com/read/28336826/-etiology-and-pathogenesis-of-primary-hyperparathyroidism
#5
Mika Yamauchi, Toshitsugu Sugimoto
Primary hyperparathyroidism(pHPT)is a frequent endocrine disease in which abnormal calcium(Ca)regulation leads to hypercalcemia. The most frequent cause of pHPT in more than 80% of patients is an adenoma, followed by hyperplasia in about 15%, and cancer in 1~5%. Although most cases of pHPT are sporadic, a few are familial(hereditary), and this is known as familial hyperparathyroidism(FHPT). Gene abnormalities that affect cyclin D1 signaling(CCND1, CDC73, CDKN1B), Wnt/β-catenin signaling(MEN1), and calcium-sensing receptor signaling(CaSR, GNA11, AP2S1)play a role in the etiology and pathogenesis of pHPT...
2017: Clinical Calcium
https://www.readbyqxmd.com/read/28336823/-regulatory-mechanism-of-calcium-metabolism
#6
Keiichi Ozono
It is often difficult for terrestrial animals to take enough calcium. To maintain serum or extracellular calcium levels is very important for muscle and nerve function. Two major regulators to increase the serum calcium levels are parathyroid hormone(PTH)and vitamin D. PTH binds to the G protein coupling receptor, PTH1R, and increases intracellular cAMP levels. Impirement in the PTH signalling causes many diseases such as pseudohypoparathyroidism and acrodysostosis with hormone resistance. Vitamin D is activated to 1,25-dihydroxyvitamin D[1,25(OH)2D]by two steps of hydroxylation which occurs in the Liver and Kidney...
2017: Clinical Calcium
https://www.readbyqxmd.com/read/28334546/-parathyroid-cancer
#7
Ivana Ságová, Matej Stančík, Peter Kentoš, Dušan Pavai, Daniela Kantárová, Anton Vaňuga, Peter Vaňuga
Parathyroid cancer is a rare endocrine malignancy, representing less than 1 % of all cases of primary hyperparathyroidism. The exact etiology of the disease remains unknown. Known risk factors include neck irradiation, end stage renal failure, genetic factors, particularly the the HPRT2/CDCT73 gene mutation. The clinical picture is often indolent, yet progressive with a trend of local invasion and metastasis formation in advanced disease. The clinical picture includes symptoms of severe and resistant hypercalcemia, requiring intensive therapy often with the need of dialysis...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28332096/efficacy-and-safety-of-paricalcitol-in-children-with-stages-3-to-5-chronic-kidney-disease
#8
Nicholas J A Webb, Gary Lerner, Bradley A Warady, Katherine M Dell, Larry A Greenbaum, Gema Ariceta, Bernd Hoppe, Peter Linde, Ho-Jin Lee, Ann Eldred, Matthew B Dufek
BACKGROUND: Elevated intact parathyroid hormone (iPTH) levels can contribute to morbidity and mortality in children with chronic kidney disease (CKD). We evaluated the pharmacokinetics, efficacy, and safety of oral paricalcitol in reducing iPTH levels in children with stages 3-5 CKD. METHODS: Children aged 10-16 years with stages 3-5 CKD were enrolled in two phase 3 studies. The stage 3/4 CKD study characterized paricalcitol pharmacokinetics and compared the efficacy and safety of paricalcitol with placebo followed by an open-label period...
March 22, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28324108/hypoparathyroidism-less-severe-hypocalcemia-with-treatment-with-vitamin-d2-compared-to-calcitriol
#9
Elizabeth A Streeten, Yasaman Mohtasebi, Manige Konig, Lisa Davidoff, Kathleen Ryan
Context: Options for chronic treatment of hypoparathyroidism include calcitriol, recombinant human parathyroid hormone and high dose vitamin D (D2). D2 is used in a minority because of fear of prolonged hypercalcemia and renal toxicity. There is a paucity of recent data about D2 use in hypoparathyroidism. Objective: Compare renal function, hypercalcemia and hypocalcemia in patients with hypoparathyroidism treated chronically with either D2 or calcitriol. Design, setting, patients: A retrospective study of patients with hypoparathyroidism treated at University of Maryland Hospital...
January 23, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28324001/cyp3a4-induction-by-rifampin-an-alternative-pathway-for-vitamin-d-inactivation-in-patients-with-cyp24a1-mutations
#10
Colin Patrick Hawkes, Dong Li, Hakon Hakonarson, Kevin E Meyers, Kenneth Thummel, Michael A Levine
Context: The P450 enzyme CYP24A1 is the principal inactivator of vitamin D metabolites. Biallelic loss-of-function mutations in CYP24A1 are associated with elevated serum levels of 1,25-dihydroxyvitamin D3 with consequent hypercalcemia and hypercalciuria, and represent the most common form of idiopathic infantile hypercalcemia (IIH). Current management strategies for this condition include a low calcium diet, reduced dietary vitamin D intake and limited sunlight exposure. CYP3A4 is a P450 enzyme that inactivates many drugs and xenobiotics and may represent an alternative pathway for inactivation of vitamin D metabolites...
March 3, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28317080/the-critical-role-of-imaging-in-the-management-of-multiple-myeloma
#11
REVIEW
Shahzad Raza, Siyang Leng, Suzanne Lentzsch
Multiple myeloma (MM) is characterized by abnormal proliferation of plasma cells in the bone marrow leading to symptoms of anemia, renal failure, hypercalcemia, and bone lesions. Bone imaging is critical for the diagnosis, staging, assessment for the presence and extent of bone lesions, and initial treatment of MM. Skeletal survey is the preferred initial imaging modality due to its availability and low cost. However, it has poor sensitivity and patients with occult myeloma may escape detection, delaying their diagnosis and treatment...
March 20, 2017: Current Hematologic Malignancy Reports
https://www.readbyqxmd.com/read/28304097/improved-screening-test-for-idiopathic-infantile-hypercalcemia-confirms-residual-levels-of-serum-24-25-oh-2-d3-in-affected-patients
#12
Martin Kaufmann, Nicole Morse, Billy Joe Molloy, Donald P Cooper, Karl-Peter Schlingmann, Arnaud Molin, Marie Laure Kottler, J Christopher Gallagher, Laura Armas, Glenville Jones
BACKGROUND: CYP24A1 mutations are now accepted as a cause of idiopathic infantile hypercalcemia (IIH). A rapid LC-MS/MS-based blood test enabling measurement of the 25-OH-D3 :24,25-(OH)2 D3 ratio (R) can identify IIH patients on the basis of reduced C24-hydroxylation of 25-OH-D3 by CYP24A1 in vivo. While values of this ratio are significantly elevated in IIH, somewhat surprisingly, serum 24,25-(OH)2 D3 remains detectable. The current study explores possible explanations for this including: residual CYP24A1 enzyme activity in individuals with certain CYP24A1 genotypes, expression of alternative C24-hydroxylases, and the possibility of isobaric contamination of the 24,25-(OH)2 D3 peak on LC-MS/MS...
March 17, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28301321/giant-parathyroid-adenoma-associated-with-severe-hypercalcemia-in-an-adolescent-patient
#13
Kinyas Kartal, Nurcihan Aygun, Mujdat Bankaoglu, Alper Ozel, Mehmet Uludag
BACKGROUND: The objective of this study is to bring attention to the importance of differential diagnosis in adolescent patients with skeletal involvement and hypercalcemia. CASE: A 17-year-old male patient with a complaint of severe leg pain was admitted to our hospital. Seven months before he had a fracture of his distal humerus after falling on to his left shoulder and was treated conservatively. Five months previously, he had a rupture of his quadriceps tendon...
March 16, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28299319/clinical-epidemiology-of-mineral-bone-disorder-markers-in-prevalent-hemodialysis-patients-in-the-xinjiang-uyghur-autonomous-region-in-china
#14
Ying-Ping Sun, Wen-Jun Yang, Su-Hua Li, Yuan-Yuan Han, Jian Liu
We investigated the clinical epidemiology of mineral bone disorder markers in prevalent hemodialysis (HD) patients in Xinjiang, the largest province in China. Data were obtained from 59 hospitals. A total of 3725 patients tracked from January 1 to December 31, 2014, were enrolled. Serum calcium (Ca) levels, phosphorus (P) levels, and intact parathyroid hormone (iPTH) levels were analyzed. Serum Ca levels were lower compared to the International Dialysis Outcomes and Practice Patterns Study (DOPPS4) and the Chinese DOPPS...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28294593/effect-of-vitamin-d-replacement-in-primary-hyperparathyroidism-with-concurrent-vitamin-d-deficiency-a-systematic-review-and-meta-analysis
#15
Huai Heng Loh, Lee Ling Lim, Anne Yee, Huai Seng Loh, Shireene R Vethakkan
INTRODUCTION: We conducted a meta-analysis to assess the effects of vitamin D replacement on biochemical and skeletal parameters in subjects with mild primary hyperparathyroidism (PHPT) and coexistent vitamin D deficiency. EVIDENCE ACQUISITION: A systematic search of all English-language medical literature published from 1980 till May 2016 using Pubmed, Embase and Ovid was performed. Nine observational studies were evaluated after fulfilling the inclusion and exclusion criteria...
March 14, 2017: Minerva Endocrinologica
https://www.readbyqxmd.com/read/28290865/-chronic-reno-cardial-continuum-in-glomerulonephritis
#16
I T Murkamilov, R R Kaliev, A Sh Sarybaev, J Sh Imanakunova, B F Imanov, A A Ibragimov, N T Davidova
OBJECTIVES: To elucidate main risk factors contributing to development of cardiovascular pathology at the predialysis stage of chronic glomerulonephritis. MATERIALS AND METHODS: We examined 173 patients (90 men, 83 women, age 15-70, mean age 36.8+/-12.9 years) at predialysis stage of chronic glomerulonephritis. Cardiovascular pathology (coronary heart disease, disturbances of cardiac rhythm, left ventricular hypertrophy, chronic heart failure) was found in 88 patients...
September 2016: Kardiologiia
https://www.readbyqxmd.com/read/28288043/prognostic-value-of-pretreatment-metabolic-tumor-volume-and-total-lesion-glycolysis-using-18f-fdg-pet-ct-in-patients-with-metastatic-renal-cell-carcinoma-treated-with-anti-vascular-endothelial-growth-factor-targeted-agents
#17
Sang Hyun Hwang, Arthur Cho, Mijin Yun, Young Deuk Choi, Sun Young Rha, Won Jun Kang
PURPOSE: The aim of this study was to evaluate the prognostic value of pretreatment metabolic tumor volume (MTV) and total lesion glycolysis (TLG) using F-FDG PET/CT in patients with metastatic renal cell carcinoma (RCC) after treatment with anti-vascular endothelial growth factor-targeted agents. METHODS: Fifty-six patients with metastatic RCC who underwent F-FDG PET/CT for staging and recurrence evaluation were retrospectively enrolled. SUVmax, MTV, and TLG were measured using F-FDG PET/CT in all patients...
March 10, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28286629/impact-of-crab-symptoms-in-survival-of-patients-with-symptomatic-myeloma-in-novel-agent-era
#18
Aya Nakaya, Shinya Fujita, Atsushi Satake, Takahisa Nakanishi, Yoshiko Azuma, Yukie Tsubokura, Masaaki Hotta, Hideaki Yoshimura, Kazuyoshi Ishii, Tomoki Ito, Shosaku Nomura
The acronym CRAB summarizes the most typical clinical manifestations of multiple myeloma, these being hypercalcemia, renal failure, anemia, and bone disease. CRAB can be used to distinguish between active, symptomatic multiple myeloma and monoclonal gammopathy of undermined significance or smoldering myeloma. The distinction is relevant not only for classification and diagnosis but also for therapy. CRAB factors influence the prognosis of multiple myeloma. However, it is unclear whether the presence of CRAB factors has an influence on the prognosis of myeloma treated with novel agents...
February 23, 2017: Hematology Reports
https://www.readbyqxmd.com/read/28282819/management-of-mixed-type-congenital-mesoblastic-nephroma-case-series-and-review-of-the-literature
#19
J Daniel, A Ruzic, J Dalland, V Miller, M Hanna
Congenital mesoblastic nephroma (CMN) is the most common renal tumor of infancy; however, it occurs infrequently with an incidence of 1 : 125,000. The cellular and classical variants are the most common subtypes of tumors, with a mixed variant occurring infrequently. We describe two cases of mixed variant CMN, which presented within days of each other differing in their clinical behavior. The first case followed a typical course, previously described in the literature, while the other deviated significantly...
March 4, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28278719/restoration-of-renal-function-in-patients-with-newly-diagnosed-multiple-myeloma-is-not-associated-with-improved-survival-a-population-based-study
#20
Joost C de Vries, Berdien Oortgiesen, Marc H Hemmelder, Eric van Roon, Robby E Kibbelaar, Nic Veeger, Mels Hoogendoorn
Renal impairment (RI) in patients with multiple myeloma (MM) is associated with poor prognosis. In this population-based cohort study, we assessed the effects of renal response, evaluated according to the IMWG-criteria, on overall survival (OS) in patients with newly diagnosed MM with RI at presentation. All included patients were diagnosed between January 2005 and January 2014 with MM and RI in Friesland, a province of the Netherlands. Of the 131 included patients, 61% achieved renal response. Using a time-varying exposure Cox model, no difference in OS between renal response and non-response was observed (HR = 1...
February 14, 2017: Leukemia & Lymphoma
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