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https://www.readbyqxmd.com/read/27900568/control-of-phosphate-balance-by-the-kidney-and-intestine
#1
REVIEW
Ichiro Kaneko, Sawako Tatsumi, Hiroko Segawa, Ken-Ichi Miyamoto
The prevention and correction of hyperphosphatemia are major goals of the treatment of chronic kidney disease (CKD)-bone mineral disorders, and thus, Pi balance requires special attention. Pi balance is maintained by intestinal absorption, renal excretion, and bone accretion. The kidney is mainly responsible for the plasma Pi concentration. In CKD, reduced glomerular filtration rate leads to various Pi metabolism abnormalities, and Pi absorption in the small intestine also has an important role in Pi metabolism...
November 30, 2016: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/27896908/bixalomer-in-hyperphosphatemic-patients-with-chronic-kidney-disease-not-on-dialysis-phase-3-randomized-trial
#2
Tadao Akizawa, Hideki Origasa, Chisato Kameoka, Junko Tsukada, Kentarou Kuroishi, Yusuke Yamaguchi
Currently, calcium- or metal-containing phosphate binders are available to treat hyperphosphatemia in predialysis patients with chronic kidney disease. Bixalomer, a non-calcium, metal-free phosphate binder, has not been studied in these patients. We evaluated the efficacy and safety of bixalomer versus placebo for treatment of hyperphosphatemia in Japanese predialysis patients with chronic kidney disease. This multicenter, randomized, double-blind, phase 3 trial, randomized eligible patients 1:1 to receive bixalomer or placebo for 12 weeks...
November 29, 2016: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/27837149/chronic-hyperphosphatemia-and-vascular-calcification-are-reduced-by-stable-delivery-of-soluble-klotho
#3
Julia M Hum, Linda M O'Bryan, Arun K Tatiparthi, Taryn A Cass, Erica L Clinkenbeard, Martin S Cramer, Manoj Bhaskaran, Robert L Johnson, Jonathan M Wilson, Rosamund C Smith, Kenneth E White
αKlotho (αKL) regulates mineral metabolism, and diseases associated with αKL deficiency are characterized by hyperphosphatemia and vascular calcification (VC). αKL is expressed as a membrane-bound protein (mKL) and recognized as the coreceptor for fibroblast growth factor-23 (FGF23) and a circulating soluble form (cKL) created by endoproteolytic cleavage of mKL. The functions of cKL with regard to phosphate metabolism are unclear. We tested the ability of cKL to regulate pathways and phenotypes associated with hyperphosphatemia in a mouse model of CKD-mineral bone disorder and αKL-null mice...
November 11, 2016: Journal of the American Society of Nephrology: JASN
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
#4
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/27803315/inhibition-of-gsk-3%C3%AE-increases-trabecular-bone-volume-but-not-cortical-bone-volume-in-adenine-induced-uremic-mice-with-severe-hyperparathyroidism
#5
Narihito Tatsumoto, Masaki Arioka, Shunsuke Yamada, Fumi Takahashi-Yanaga, Masanori Tokumoto, Kazuhiko Tsuruya, Takanari Kitazono, Toshiyuki Sasaguri
Patients with chronic kidney disease (CKD) are at increased risk for bone fractures compared with the general population. Repression of the Wnt/β-catenin signaling pathway is associated with bone abnormalities. Inhibition of glycogen synthase kinase (GSK)-3β, a critical component of the Wnt/β-catenin signaling pathway, increases bone volume through accumulation of β-catenin. It remains unknown whether inhibition of GSK-3β increases bone volume in CKD The present in vivo study examined the effects of GSK-3β inhibition on bone volume in CKD mice...
November 2016: Physiological Reports
https://www.readbyqxmd.com/read/27737389/cost-effectiveness-analysis-of-paricalcitol-versus-calcitriol-for-the-treatment-of-shpt-in-dialytic-patients-from-the-sus-perspective
#6
Fabiana Gatti de Menezes, Rodrigo Martins Abreu, Alexander Itria
Introduction: Secondary hyperparathyroidism (SHPT) is a consequence of chronic kidney disease. The treatment at the Brazilian Unified Heath System (SUS) is performed with calcitriol, a drug which favors hypercalcemia and/or hyperphosphatemia, hindering the control of SHPT. Another option is paricalcitol, which causes parathormone (PTH) suppression faster than calcitriol, with minor changes in calcium-phosphorus product and calcium and phosphorus serum levels. Objective: This study aims to develop a cost-effectiveness analysis of paricalcitol versus calcitriol for patients in dialytic treatment with SHPT, from the SUS perspective...
July 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/27737388/effectiveness-and-safety-of-a-6-month-treatment-with-paricalcitol-in-patients-on-hemodialysis-with-secondary-hyperparathyroidism
#7
Inés Olaizola, Hena Caorsi, Laura Fajardo, Alejandro Ferreiro, Nieves Campistrus, Deyanira Dolinsky, Alicia Petraglia, Pablo Ambrosoni
Introduction: The mineral bone disorder, particularly secondary hyperparathyroidism, in chronic kidney disease (CKD) has a systemic impact affecting not only bone metabolism. Therefore its correction is important to prevent cardiovascular, inflammatory and immune diseases. Objective: To assess the effectiveness and safety of intravenous paricalcitol administered over a 6 month period for the treatment of secondary hyperparathyroidism (SHPT) in patients undergoing conventional hemodialysis, with close follow-up of treatment response...
July 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/27733387/novel-developments-in-differentiating-the-role-of-renal-and-intestinal-sodium-hydrogen-exchanger-3
#8
Jessica Ann Dominguez Rieg, Samantha de la Mora Chavez, Timo Rieg
The Na(+)/H(+) exchanger isoform 3 (NHE3) facilitates Na(+) absorption and H(+) secretion and is expressed in the intestine, proximal tubule and thick ascending limb of the kidney. While the function of NHE3 for Na(+) and HCO3(-) (re)absorption has been defined using conventional NHE3 knockout mice (NHE3(-/-)), the recent generation of conditional NHE3 knockout mice started to give critical new insight into the role of this protein by allowing for temporal and spatial control of NHE3 expression. For example, in contrast to NHE3(-/-) mice, knockout of NHE3 in the S1 and S2 segments of the proximal tubule or along the entire tubule/collecting duct does not cause any lethality...
October 12, 2016: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/27725315/cardiac-actions-of-fibroblast-growth-factor-23
#9
Christian Faul
Fibroblast growth factors (FGF) are mitogenic signal mediators that induce cell proliferation and survival. Although cardiac myocytes are post-mitotic, they have been shown to be able to respond to local and circulating FGFs. While precise molecular mechanisms are not well characterized, some FGF family members have been shown to induce cardiac remodeling under physiologic conditions by mediating hypertrophic growth in cardiac myocytes and by promoting angiogenesis, both events leading to increased cardiac function and output...
October 7, 2016: Bone
https://www.readbyqxmd.com/read/27679712/fgf23-in-kidney-transplant-the-strange-case-of-doctor-jekyll-and-mister-hyde
#10
Giuseppe Cianciolo, Mario Cozzolino
During the last decade, a new view into the molecular mechanisms of chronic kidney disease-mineral bone disorder (CKD-MBD) has been proposed, with fibroblast growth factor 23 (FGF23) as a novel player in the field. Enhanced serum FGF23 levels cause a reduction in serum phosphate, together with calcitriol suppression and consequent hyperparathyroidism (HPT). In contrast, reduced serum FGF23 levels are associated with hyperphosphatemia, higher calcitriol levels and parathyroid hormone (PTH) suppression. In addition, serum FGF23 levels are greatly increased and positively correlated with serum phosphate levels in CKD patients...
October 2016: Clinical Kidney Journal
https://www.readbyqxmd.com/read/27666759/ligand-trap-of-the-activin-receptor-type-iia-inhibits-osteoclast-stimulation-of-bone-remodeling-in-diabetic-mice-with-chronic-kidney-disease
#11
Toshifumi Sugatani, Olga A Agapova, Yifu Fang, Alycia G Berman, Joseph M Wallace, Hartmut H Malluche, Marie-Claude Faugere, William Smith, Victoria Sung, Keith A Hruska
Dysregulation of skeletal remodeling is a component of renal osteodystrophy. Previously, we showed that activin receptor signaling is differentially affected in various tissues in chronic kidney disease (CKD). We tested whether a ligand trap for the activin receptor type 2A (RAP-011) is an effective treatment of the osteodystrophy of the CKD-mineral bone disorder. With a 70% reduction in the glomerular filtration rate, CKD was induced at 14 weeks of age in the ldlr-/- high fat-fed mouse model of atherosclerotic vascular calcification and diabetes...
September 22, 2016: Kidney International
https://www.readbyqxmd.com/read/27651467/the-efficacy-and-safety-of-sevelamer-and-lanthanum-versus-calcium-containing-and-iron-based-binders-in-treating-hyperphosphatemia-in-patients-with-chronic-kidney-disease-a-systematic-review-and-meta-analysis
#12
Steven Habbous, Sebastian Przech, Rey Acedillo, Sisira Sarma, Amit X Garg, Janet Martin
BACKGROUND: It remains unclear which phosphate binders should be preferred for hyperphosphatemia management in chronic kidney disease (CKD). METHODS: We performed a systematic review and meta-analysis of randomized trials comparing sevelamer or lanthanum with other phosphate binders in CKD. RESULTS: Fifty-one trials (8829 patients) were reviewed. Compared with calcium-based binders, all-cause mortality was nonsignificantly lower with sevelamer {risk ratio [RR] 0...
September 20, 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27647184/mineral-and-bone-disorder-and-its-association-with-cardiovascular-parameters-in-chinese-patients-with-chronic-kidney-disease
#13
Chu Zhou, Fang Wang, Jin-Wei Wang, Lu-Xia Zhang, Ming-Hui Zhao
BACKGROUND: Mineral and bone disorder (MBD), especially hyperphosphatemia, is an independently risk factor for adverse prognosis in patients with chronic kidney disease (CKD). However, CKD-MBD among Chinese population was poorly studied. This study aimed to investigate the status of MBD and its association with cardiovascular parameters in Chinese patients with predialysis CKD. METHODS: Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE) is a prospective multicenter cohort study involving predialysis CKD patients in China...
2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27643443/treating-hyperphosphatemia-current-and-advancing-drugs
#14
Markus Ketteler, Orfeas Liangos, Patrick H Biggar
INTRODUCTION: Hyperphosphatemia is a hallmark of advanced chronic kidney disease (CKD) and associated with adverse outcomes. Preclinical and epidemiological studies strongly support a causal relationship between hyperphosphatemia and mortality as well as cardiovascular complications, especially including vascular, valvular and soft-tissue calcifications. Thus, appropriate phosphate lowering is considered to play a major role in health and longevity of CKD patients. In this respect, phosphate binders are the most powerful therapeutic option, while dietary phosphate restriction and intensified dialysis are valuable supportive approaches...
October 2016: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/27628245/the-cerebrovascular-chronic-kidney-disease-connection-perspectives-and-mechanisms
#15
Wei Ling Lau, Branko N Huisa, Mark Fisher
Chronic kidney disease (CKD) is an independent risk factor for the development of cerebrovascular disease, particularly small vessel disease which can manifest in a variety of phenotypes ranging from lacunes to microbleeds. Small vessel disease likely contributes to cognitive dysfunction in the CKD population. Non-traditional risk factors for vascular injury in uremia include loss of calcification inhibitors, hyperphosphatemia, increased blood pressure variability, elastinolysis, platelet dysfunction, and chronic inflammation...
September 14, 2016: Translational Stroke Research
https://www.readbyqxmd.com/read/27622885/fgf23-klotho-signaling-axis-in-the-kidney
#16
Reinhold G Erben, Olena Andrukhova
Fibroblast growth factor-23 (FGF23) is a bone-derived hormone protecting against the potentially deleterious effects of hyperphosphatemia by suppression of phosphate reabsorption and of active vitamin D hormone synthesis in the kidney. The kidney is one of the main target organs of FGF23 signaling. The purpose of this review is to highlight the recent advances in the area of FGF23-Klotho signaling in the kidney. During recent years, it has become clear that FGF23 acts independently on proximal and distal tubular epithelium...
September 10, 2016: Bone
https://www.readbyqxmd.com/read/27600818/nutritional-support-in-the-tertiary-care-of-patients-affected-by-chronic-renal-insufficiency-report-of-a-step-wise-personalized-pragmatic-approach
#17
Adamasco Cupisti, Claudia D'Alessandro, Biagio Di Iorio, Anna Bottai, Claudia Zullo, Domenico Giannese, Massimiliano Barsotti, Maria Francesca Egidi
BACKGROUND: Dietary treatment is helpful in CKD patients, but nutritional interventions are scarcely implemented. The main concern of the renal diets is its feasibility with regards to daily clinical practice especially in the elderly and co-morbid patients. This study aimed to evaluate the effects of a pragmatic, step-wise, personalized nutritional support in the management of CKD patients on tertiary care. METHODS: This is a case-control study. It included 823 prevalent out-patients affected by CKD stage 3b to 5 not-in-dialysis, followed by tertiary care in nephrology clinics; 305 patients (190 males, aged 70 ± 12 years) received nutritional support (nutritional treatment Group, NTG); 518 patients (281 males, aged 73 ± 13 years) who did not receive any dietary therapy, formed the control group (CG)...
September 6, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27588942/effectiveness-of-cinacalcet-in-patients-with-chronic-kidney-disease-and-secondary-hyperparathyroidism-not-receiving-dialysis
#18
Ariadna Pérez-Ricart, Maria Galicia-Basart, Maria Alcalde-Rodrigo, Alfons Segarra-Medrano, Josep-Maria Suñé-Negre, José-Bruno Montoro-Ronsano
BACKGROUND: Secondary hyperparathyroidism (SHPT) is a common complication in chronic kidney disease (CKD) patients. Cinacalcet could be a therapeutic option although its use is controversial in patients not receiving dialysis. Thus, the aim of this study is to assess the effectiveness and safety of cinacalcet in patients with CKD and SHPT without renal replacement treatment (RRT) and without renal transplantation (RT). METHODS: A retrospective observational study was conducted...
2016: PloS One
https://www.readbyqxmd.com/read/27461215/can-intestinal-phosphate-binding-or-inhibition-of-hydroxyapatite-growth-in-the-vascular-wall-halt-the-progression-of-established-aortic-calcification-in-chronic-kidney-disease
#19
Ellen Neven, Britt Opdebeeck, Annelies De Maré, Rida Bashir-Dar, Geert Dams, Rita Marynissen, Geert J Behets, Anja Verhulst, Bruce L Riser, Patrick C D'Haese
Vascular calcification significantly contributes to mortality in chronic kidney disease (CKD) patients. Sevelamer and pyrophosphate (PPi) have proven to be effective in preventing vascular calcification, the former by controlling intestinal phosphate absorption, the latter by directly interfering with the hydroxyapatite crystal formation. Since most patients present with established vascular calcification, it is important to evaluate whether these compounds may also halt or reverse the progression of preexisting vascular calcification...
November 2016: Calcified Tissue International
https://www.readbyqxmd.com/read/27393192/cost-effectiveness-of-phosphate-binders-among-patients-with-chronic-kidney-disease-not-yet-on-dialysis-a-long-way-to-go
#20
Rana Rizk
Hyperphosphatemia management is integral to the management of patients with chronic kidney disease. This mineral abnormality is associated with greater costs, but so is its management, especially with the use novel phosphate binders. The economic evaluation of these pharmaceutical agents is increasingly needed to provide evidence for value of money spent and inform resource allocation. Recently, Nguyen et al. explored the economical attractiveness of Sevelamer relative to Calcium Carbonate among patients with chronic kidney disease not yet on dialysis and concluded that the former was cost-effective...
2016: BMC Nephrology
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