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https://www.readbyqxmd.com/read/28584909/a-review-of-phosphate-binders-in-chronic-kidney-disease-incremental-progress-or-just-higher-costs
#1
REVIEW
Wendy L St Peter, Lori D Wazny, Eric Weinhandl, Katie E Cardone, Joanna Q Hudson
As kidney disease progresses, phosphorus retention also increases, and phosphate binders are used to treat hyperphosphatemia. Clinicians prescribe phosphate binders thinking that reducing total body burden of phosphorus may decrease risks of mineral and bone disorder, fractures, cardiovascular disease, progression of kidney disease, and mortality. Recent meta-analyses suggest that sevelamer use results in lower mortality than use of calcium-containing phosphate binders. However, studies included in meta-analyses show significant heterogeneity, and exclusion or inclusion of specific studies alters results...
June 5, 2017: Drugs
https://www.readbyqxmd.com/read/28577750/-strategies-aiming-to-control-hyperphosphatemia-in-chronic-kidney-disease
#2
Pablo Antonio Ureña Torres
Chronic kidney disease is known to be associated with phosphate retention. The mechanisms are complex and the early increase in serum phosphate levels in chronic kidney disease is not strictly related to the dietary phosphate load or to the degree of phosphate retention. It also implicates the activity of intestinal sodium-phosphate cotransporters, the degree of bone turnover and the retention and/or phosphate release from the skeleton, and the feedback mechanisms regulating the phosphaturia. Indeed, the increase in serum phosphate levels is only a reflection of underlying complex mechanisms, and many important factors play a role including parathyroid hormone, vitamin D, fibroblast growth factor 23 (FGF23), and others...
April 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28577749/-modelling-of-phosphorus-transfers-during-haemodialysis
#3
Guillaume Chazot, Sandrine Lemoine, Laurent Juillard
Chronic kidney disease causes hyperphosphatemia, which is associated with increased cardiovascular risk and mortality. In patients with end-stage renal disease, haemodialysis allows the control of hyperphosphatemia. During a 4-h haemodialysis session, between 600 and 700mg of phosphate are extracted from the plasma, whereas the latter contains only 90mg of inorganic phosphate. The precise origin of phosphates remains unknown. The modelling of phosphorus transfers allows to predict the outcome after changes in dialysis prescription (duration, frequency) with simple two-compartment models and to describe the transfers between the different body compartments with more complex models...
April 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28533541/development-of-a-novel-chronic-kidney-disease-mouse-model-to-evaluate-the-progression-of-hyperphosphatemia-and-associated-mineral-bone-disease
#4
Takashi Tani, Hideo Orimo, Akira Shimizu, Shuichi Tsuruoka
Medial arterial calcification (MAC) and renal osteodystrophy are complications of mineral bone disease (MBD) associated with chronic kidney disease (CKD). Our aim was to develop a novel mouse model to investigate the clinical course of CKD-MBD. Eight-week-old C57BL/6 J male mice were assigned to the following groups: the control group, fed a standard chow for 6 or 12 weeks; the CKD-normal phosphorus (NP) group, fed a chow containing 0.2% adenine, with normal (0.8%) phosphorus, for 6 or 12 weeks; and the CKD-high phosphorus (HP) group, fed 6 weeks with the 0...
May 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28531397/most-consumed-processed-foods-by-patients-on-hemodialysis-alert-for-phosphate-containing-additives-and-the-phosphate-to-protein-ratio
#5
Marcela T Watanabe, Raphael M Araujo, Barbara P Vogt, Pasqual Barretti, Jacqueline C T Caramori
BACKGROUND AND AIMS: Hyperphosphatemia is common in patients with chronic kidney disease (CKD) stages IV and V because of decreased phosphorus excretion. Phosphatemia is closely related to dietary intake. Thus, a better understanding of sources of dietary phosphate consumption, absorption and restriction, particularly inorganic phosphate found in food additives, is key to prevent consequences of this complication. Our aims were to investigate the most commonly consumed processed foods by patients with CKD on hemodialysis, to analyze phosphate and protein content of these foods using chemical analysis and to compare these processed foods with fresh foods...
August 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28515448/involvement-of-vascular-aldosterone-synthase-in-phosphate-induced-osteogenic-transformation-of-vascular-smooth-muscle-cells
#6
Ioana Alesutan, Jakob Voelkl, Martina Feger, Denise V Kratschmar, Tatsiana Castor, Sobuj Mia, Michael Sacherer, Robert Viereck, Oliver Borst, Christina Leibrock, Meinrad Gawaz, Makoto Kuro-O, Stefan Pilz, Andreas Tomaschitz, Alex Odermatt, Burkert Pieske, Carsten A Wagner, Florian Lang
Vascular calcification resulting from hyperphosphatemia is a major determinant of mortality in chronic kidney disease (CKD). Vascular calcification is driven by aldosterone-sensitive osteogenic transformation of vascular smooth muscle cells (VSMCs). We show that even in absence of exogenous aldosterone, silencing and pharmacological inhibition (spironolactone, eplerenone) of the mineralocorticoid receptor (MR) ameliorated phosphate-induced osteo-/chondrogenic transformation of primary human aortic smooth muscle cells (HAoSMCs)...
May 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28455644/treatment-of-pediatric-chronic-kidney-disease-mineral-and-bone-disorder
#7
REVIEW
Mark R Hanudel, Isidro B Salusky
PURPOSE OF REVIEW: In this paper, we review the pathogenesis and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD), especially as it relates to pediatric CKD patients. RECENT FINDINGS: Disordered regulation of bone and mineral metabolism in CKD may result in fractures, skeletal deformities, and poor growth, which is especially relevant for pediatric CKD patients. Moreover, CKD-MBD may result in extra-skeletal calcification and cardiovascular morbidity...
April 28, 2017: Current Osteoporosis Reports
https://www.readbyqxmd.com/read/28445887/use-of-phosphorus-binders-among-non-dialysis-chronic-kidney-disease-patients-and-mortality-outcomes
#8
Simran K Bhandari, In-Lu A Liu, Dean A Kujubu, Trung Huynh, Hind Behayaa, Csaba P Kovesdy, Kamyar Kalantar-Zadeh, Steven J Jacobsen, John J Sim
BACKGROUND: Whether the benefits of phosphorus binders extend to those without end stage renal disease is uncertain. Among a large diverse non-dialysis chronic kidney disease (CKD) population with hyperphosphatemia, we sought to evaluate phosphorus binder use and compare mortality risk between patients prescribed and not prescribed binders. METHODS: A retrospective cohort study within an integrated health system (January 1, 1998 - December 31, 2012) among CKD patients (age ≥18) was performed...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28419560/fibroblast-growth-factor-23-concentration-in-dogs-with-chronic-kidney-disease
#9
L M Harjes, V J Parker, K Dembek, G S Young, L H Giovaninni, M M Kogika, D J Chew, R E Toribio
BACKGROUND: Chronic kidney disease (CKD) is associated with hyperphosphatemia, decreased vitamin D metabolite concentrations, and hyperparathyroidism. This syndrome is known as CKD-mineral bone disorder (CKD-MBD). Recently, it has been shown that an increase in fibroblast growth factor-23 (FGF-23) concentration is an early biomarker of CKD in people. It is an independent risk factor for both progression of renal disease and survival time in humans and cats with CKD. Information about FGF-23 in healthy dogs and those with CKD is lacking...
May 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28398983/effectiveness-of-educational-or-behavioral-interventions-on-adherence-to-phosphate-control-in-adults-receiving-hemodialysis-a-systematic-review
#10
Molly Milazi, Ann Bonner, Clint Douglas
BACKGROUND: People with end-stage kidney disease (ESKD) develop impaired excretion of phosphate. Hyperphosphatemia develops in ESKD as a result of the kidney's reduced ability to excrete ingested phosphate load and is characterized by high bone turnover and increased musculoskeletal morbidity including bone pain and muscle weakness. Increased serum phosphate levels are also associated with cardiovascular disease and associated mortality. These effects are significant considering that cardiovascular disease is the leading cause of death in ESKD, making phosphate control a crucial treatment goal...
April 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28301096/effects-of-tenapanor-on-cytochrome-p450-mediated-drug-drug-interactions
#11
Susanne Johansson, David P Rosenbaum, Marie Ahlqvist, Helen Rollison, Mikael Knutsson, Bergur Stefansson, Marie Elebring
Tenapanor (RDX5791, AZD1722) is an inhibitor of sodium/hydrogen exchanger isoform 3 in development for the treatment of constipation-predominant irritable bowel syndrome and the treatment of hyperphosphatemia in patients with chronic kidney disease on dialysis. We aimed to investigate whether tenapanor inhibits or induces cytochrome P450s (CYPs). In vitro experiments assessing the potential of tenapanor to affect various CYPs indicated that it could inhibit CYP3A4/5 (IC50 0.4-0.7 μM). An open-label, phase 1 clinical study (NCT02140268) evaluated the pharmacokinetics of the CYP3A4 substrate midazolam when administered with and without tenapanor...
March 16, 2017: Clinical Pharmacology in Drug Development
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
#12
MULTICENTER STUDY
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/28194884/long-term-safety-and-efficacy-of-bixalomer-in-hyperphosphatemic-patients-with-chronic-kidney-disease-not-on-dialysis
#13
Tadao Akizawa, Junko Tsukada, Chisato Kameoka, Kentarou Kuroishi, Yusuke Yamaguchi
Bixalomer, a metal-free, nonabsorbable phosphate binder, is approved in Japan to treat hyperphosphatemia in dialysis patients. Bixalomer is effective and has a favorable safety profile in predialysis patients with hyperphosphatemia. This study examined the long-term effectiveness and safety of bixalomer in predialysis patients with hyperphosphatemia. This was a 48-week, multicenter, open-label, phase 3 study in Japanese predialysis patients with hyperphosphatemia. Patients received bixalomer at an initial dose of 1500 mg/day, which was titrated to a maximum of 7500 mg/day depending on patients' serum phosphorus responses to bixalomer...
February 14, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28183805/klotho-expression-in-long-bones-regulates-fgf23-production-during-renal-failure
#14
Jovana Kaludjerovic, Hirotaka Komaba, Tadatoshi Sato, Reinhold G Erben, Roland Baron, Hannes Olauson, Tobias E Larsson, Beate Lanske
Circulating levels of bone-derived fibroblast growth factor 23 (FGF23) increase early during acute and chronic kidney disease and are associated with adverse outcomes. Membrane-bound Klotho acts as a permissive coreceptor for FGF23, and its expression was recently found in osteoblasts/osteocytes. We hypothesized that Klotho in bone cells is part of an autocrine feedback loop that regulates FGF23 expression during renal failure. Thus, we induced renal failure in mice with targeted deletion of Klotho in long bones...
February 9, 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/28178182/effects-of-magnesium-on-the-phosphate-toxicity-in-chronic-kidney-disease-time-for-intervention-studies
#15
REVIEW
Yusuke Sakaguchi, Takayuki Hamano, Yoshitaka Isaka
Magnesium, an essential mineral for human health, plays a pivotal role in the cardiovascular system. Epidemiological studies in the general population have found an association between lower dietary magnesium intake and an elevated risk of cardiovascular events. In addition, magnesium supplementation was shown to improve blood pressure control, insulin sensitivity, and endothelial function. The relationship between magnesium and cardiovascular prognosis among patients with chronic kidney disease (CKD) has been increasingly investigated as it is becoming evident that magnesium can inhibit vascular calcification, a prominent risk of cardiovascular events, which commonly occurs in CKD patients...
February 6, 2017: Nutrients
https://www.readbyqxmd.com/read/28159782/effect-of-tenapanor-on-serum-phosphate-in-patients-receiving-hemodialysis
#16
Geoffrey A Block, David P Rosenbaum, Maria Leonsson-Zachrisson, Magnus Åstrand, Susanne Johansson, Mikael Knutsson, Anna Maria Langkilde, Glenn M Chertow
Hyperphosphatemia is common among patients with CKD stage 5D and is associated with morbidity and mortality. Current guidelines recommend lowering serum phosphate concentrations toward normal. Tenapanor is a minimally absorbed small molecule inhibitor of the sodium/hydrogen exchanger isoform 3 that functions in the gut to reduce sodium and phosphate absorption. This randomized, double-blind, placebo-controlled trial assessed the effects of tenapanor on serum phosphate concentration in patients with hyperphosphatemia receiving hemodialysis...
February 3, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28114891/diet-in-chronic-kidney-disease-in-a-mediterranean-african-country
#17
Khawla Kammoun, Hanen Chaker, Hichem Mahfoudh, Nouha Makhlouf, Faical Jarraya, Jamil Hachicha
BACKGROUND: Mediterranean diet is characterized by low to moderate consumption of animal protein and high consumption of fruits, vegetables, bread, beans, nuts, seeds and other cereals. It has been associated with reduced risk of cardiovascular disease. However, it is not suitable for chronic kidney disease because of high potassium intake. DISCUSSION: Tunisia is an emerging Mediterranean country with limited resources, a high prevalence of chronic hemodialysis treatment and high dialysis expenditures...
January 23, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28064444/phosphate-binders-and-targets-over-decades-do-we-have-it-right-now
#18
Morgan Marcuccilli, Michel Chonchol, Anna Jovanovich
In advanced renal disease, the kidney is unable to maintain phosphate balance due to decreased urinary excretion as well as the imbalance of the bone metabolic axis. It is well established that hyperphosphatemia is associated with increased cardiovascular events and mortality in patients with chronic kidney disease (CKD). However, there are no randomized controlled trials that demonstrate a clear benefit on hard outcomes in lowering serum phosphate levels to recommended targets in the CKD or dialysis population...
March 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28045952/predictive-factors-of-one-year-mortality-in-a-cohort-of-patients-undergoing-urgent-start-hemodialysis
#19
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/28009416/sleep-quality-and-risk-factors-of-atherosclerosis-in-predialysis-chronic-kidney-disease
#20
Ibrahim Guney, Yavuz S S Akgul, Vedat Gencer, Harun Aydemir, Uysaler Aslan, Samil Ecirli
INTRODUCTION: Chronic kidney disease (CKD) patients have more frequent sleep disorders and cardiovascular disease than normals. Since arterial stiffness as a risk factor of atherosclerosis can be evaluated with pulse wave velocity (PWV), we aimed to investigate the prevalance of sleep quality (SQ) and the relationship between SQ and risk factors of atherosclerosis and whether there is a relationship between SQ and PWV (the indicator of arterial stiffness) in predialysis CKD patients. METHODS: This cross-sectional study was carried out in CKD patients followed at the Nephrology Department in Konya, Turkey, between November 2014 and March 2015...
January 13, 2017: International Journal of Artificial Organs
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