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https://www.readbyqxmd.com/read/29748907/effect-of-combined-vitamin-d-receptor-activator-and-lanthanum-carbonate-on-serum-fibroblast-growth-factor-23-level-in-predialysis-patients-cvd-laf-study-design-and-method
#1
Eri Ito, Daijo Inaguma, Shigehisa Koide, Kazuo Takahashi, Hiroki Hayashi, Midori Hasegawa, Yukio Yuzawa
BACKGROUND: Whether vitamin D receptor activator (VDRA) use is beneficial in chronic kidney disease (CKD) is unclear, because it is possible that VDRA increases serum fibroblast growth factor 23 (FGF23) levels. We will conduct a randomized controlled trial in predialysis patients to determine the effect of VDRA alone or in combination with lanthanum carbonate (LC) on serum FGF23 levels. METHODS: This is a single-center, open-label, randomized controlled trial. Enrollment will commence February 1, 2018, using the following inclusion criteria: (1) age ≥ 20 years, (2) CKD with an estimated glomerular filtration rate of 10-45 mL/min/1...
May 10, 2018: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/29740667/benefits-and-safety-of-dietary-protein-for-bone-health-an-expert-consensus-paper-endorsed-by-the-european-society-for-clinical-and-economical-aspects-of-osteopororosis-osteoarthritis-and-musculoskeletal-diseases-and-by-the-international-osteoporosis-foundation
#2
REVIEW
R Rizzoli, E Biver, J-P Bonjour, V Coxam, D Goltzman, J A Kanis, J Lappe, L Rejnmark, S Sahni, C Weaver, H Weiler, J-Y Reginster
A summary of systematic reviews and meta-analyses addressing the benefits and risks of dietary protein intakes for bone health in adults suggests that dietary protein levels even above the current RDA may be beneficial in reducing bone loss and hip fracture risk, provided calcium intakes are adequate. Several systematic reviews and meta-analyses have addressed the benefits and risks of dietary protein intakes for bone health in adults. This narrative review of the literature summarizes and synthesizes recent systematic reviews and meta-analyses and highlights key messages...
May 8, 2018: Osteoporosis International
https://www.readbyqxmd.com/read/29737529/posttraumatic-headache-classification-by-symptom-based-clinical-profiles
#3
Sylvia Lucas, Andrew H Ahn
There are currently no accepted therapies for posttraumatic headache (PTH). In order to meet the urgent need for effective therapies for PTH, we must continue to address fundamental gaps in our understanding of the clinical course and impact of PTH. Here we examine the existing schema used to characterize the clinical characteristics of PTH, including the International Classification of Headache Disorders (ICHD). There remain unresolved questions about whether to classify patients based on the extent of brain injury or on clinical symptom profiles...
May 8, 2018: Headache
https://www.readbyqxmd.com/read/29733445/effects-of-treatment-with-an-angiotensin-2-receptor-blocker-and-or-vitamin-d3-on-parathyroid-hormone-and-aldosterone-a-randomized-placebo-controlled-trial
#4
Lise Sofie Bislev, Lene Langagergaard Rødbro, Jesper Nørgaard Bech, Erling Bjerregaard Pedersen, Lars Rolighed, Tanja Sikjaer, Lars Rejnmark
OBJECTIVE: Emerging evidence support a positive, bidirectional and clinical relevant interaction between parathyroid hormone (PTH) and the renin-angiotensin-aldosterone-system (RAAS). A beneficial effect of the widely used RAAS inhibitors might include a PTH lowering effect, as high PTH levels may be harmful to cardiovascular health. We aimed to investigate whether PTH levels are lowered by short-term treatment with an angiotensin 2 receptor blocker (valsartan) independently of co-administration of vitamin D3...
May 7, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29727008/pro-fhh-a-risk-equation-to-facilitate-the-diagnosis-of-parathyroid-related-hypercalcemia
#5
Jean-Philippe Bertocchio, Muriel Tafflet, Eugénie Koumakis, Gérard Maruani, Rosa Vargas-Poussou, Caroline Silve, Peter H Nissen, Stéphanie Baron, Caroline Prot-Bertoye, Marie Courbebaisse, Jean-Claude Souberbielle, Lars Rejnmark, Catherine Cormier, Pascal Houillier
Context: Parathyroid-related hypercalcemia is due to primary hyperparathyroidism (PHPT) or to familial hypocalciuric hypercalcemia (FHH). PHPT can lead to complications that necessitate parathyroidectomy. FHH is a rare genetic disease resembling PHPT; surgery is ineffective. A reliable method for distinguishing FHH from PHPT is needed. Objective: To develop an easy-to-use tool to predict if a patient has PHPT. Design: Retrospective analysis of two prospective cohorts...
May 2, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29723896/mineralocorticoid-receptor-blockers-and-aldosterone-to-renin-ratio-a-randomized-controlled-trial-and-observational-data
#6
Stefan Pilz, Christian Trummer, Nicolas Verheyen, Verena Schwetz, Marlene Pandis, Felix Aberer, Martin R Grübler, Andreas Meinitzer, Antonia Bachmann, Jakob Voelkl, Ioana Alesutan, Cristiana Catena, Leonardo A Sechi, Winfried März, Barbara Obermayer-Pietsch, Andreas Tomaschitz
Current guidelines recommend to withdraw mineralocorticoid receptor (MR) blocker treatment for at least 4 weeks when measuring the aldosterone to renin ratio (ARR) as a screening test for primary aldosteronism (PA). We aimed to evaluate the effect of MR blocker treatment on ARR and its components, plasma aldosterone concentration (PAC), and direct renin concentration (DRC). First, we performed a post-hoc analysis of the effect of eplerenone on parathyroid hormone levels in primary hyperparathyroidism (EPATH) study, a randomized controlled trial (RCT) in 110 patients with primary hyperparathyroidism (pHPT)...
May 3, 2018: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29707200/evaluation-of-portal-pressure-by-doppler-ultrasound-in-patients-with-cirrhosis-before-and-after-simvastatin-administration-a-randomized-controlled-trial
#7
Nadia Elwan, Raafat Salah, Manal Hamisa, Ebtsam Shady, Nehad Hawash, Sherief Abd-Elsalam
Background: Portal hypertension is one of the most frequent complications of cirrhosis. β-adrenergic blockers, with or without organic nitrates, are currently used as hypotensive agents. Statins such as simvastatin seem to be safe for patients with chronic liver diseases and exert multiple pleiotropic actions. This study aimed to assess PTH using Doppler ultrasound in patients with cirrhosis before and after simvastatin administration. Methods: This randomized controlled clinical trial was conducted on 40 patients with cirrhosis who were randomized into 2 groups: group I included 20 patients with cirrhosis who were administered 20 mg of simvastatin daily for 2 weeks and then 40 mg daily for another 2 weeks, and group II included 20 patients with cirrhosis who did not receive simvastatin as a control group...
2018: F1000Research
https://www.readbyqxmd.com/read/29691773/etelcalcetide-for-treating-secondary-hyperparathyroidism-an-evidence-review-group-evaluation-of-a-nice-single-technology-appraisal
#8
Micah Rose, Jonathan Shepherd, Petra Harris, Karen Pickett, Joanne Lord
The manufacturer of the calcimimetic drug etelcalcetide was invited to make an evidence submission as part of the National Institute for Health and Care Excellence (NICE) Single Technology Appraisal (STA) programme. Within this submission, they reported evidence on the clinical and cost effectiveness of etelcalcetide for the treatment of secondary hyperparathyroidism (SHPT) in patients with chronic kidney disease (CKD) on haemodialysis. The Southampton Health Technology Assessments Centre (SHTAC), part of the Wessex Institute at the University of Southampton, was the independent Evidence Review Group (ERG) commissioned to appraise the company's submission...
April 25, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29680147/discovery-and-development-of-calcimimetic-and-calcilytic-compounds
#9
Edward F Nemeth, Bradford C Van Wagenen, Manuel F Balandrin
The extracellular calcium receptor (CaR) is a G protein-coupled receptor (GPCR) and the pivotal molecule regulating systemic Ca2+ homeostasis. The CaR was a challenging target for drug discovery because its physiological ligand is an inorganic ion (Ca2+ ) rather than a molecule so there was no structural template to guide medicinal chemistry. Nonetheless, small molecules targeting this receptor were discovered. Calcimimetics are agonists or positive allosteric modulators of the CaR, while calcilytics are antagonists and all to date are negative allosteric modulators...
2018: Progress in Medicinal Chemistry
https://www.readbyqxmd.com/read/29677006/evidence-basis-for-integrated-management-of-mineral-metabolism-in-patients-with-end-stage-renal-disease
#10
Julia J Scialla
PURPOSE OF REVIEW: Treatment of mineral metabolism is a mainstay of dialysis care including some of its most widely used and costly pharmaceuticals. Although many mineral metabolites are associated with increased risk of mortality, cardiovascular disease, and other morbidities, few clinical trials are available to guide therapy and most focus on single drug approaches. In practice, providers manage many aspects of mineral metabolism simultaneously in integrated treatment approaches that incorporate multiple agents and changes in the dialysis prescription...
April 6, 2018: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29666919/prevalence-of-vitamin-d-insufficiency-and-evidence-for-disease-prevention-in-the-older-population
#11
REVIEW
Julia Kühn, Paula Trotz, Gabriele I Stangl
The prevalence of vitamin D insufficiency, usually assessed by the analysis of circulating 25-hydroxyvitamin D (25[OH])D), is very high in the aging German population. An important factor that reduces endogenous vitamin D synthesis in older persons is physical inactivity or care-dependency that limits the time spent outside. Additionally, it has been suggested that the age-dependent decline in the glomerular filtration rate is associated with a reduced production of bioactive calcitriol. As this phenomenon is not detectable by the assessment of 25(OH)D, it is necessary to analyze the level of parathyroid hormone as a marker of calcitriol function...
April 17, 2018: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/29665087/25-hydroxyvitamin-d-threshold-for-the-effects-of-vitamin-d-supplements-on-bone-density-secondary-analysis-of-a-randomized-controlled-trial
#12
Helen M Macdonald, Ian R Reid, Gregory D Gamble, William D Fraser, Jonathan C Tang, Adrian D Wood
Most trials of vitamin D supplementation have shown no benefits on bone density (BMD), though severe vitamin D deficiency causes osteomalacia which is associated with profound BMD deficits. Recently, the ViDA-BMD study from New Zealand demonstrated a threshold of baseline 25-hydroxyvitamin D (30 nmol/L) below which vitamin D supplementation did benefit BMD. We have now re-examined data from a similar trial in Aberdeen to determine whether a baseline 25-hydroxyvitamin D threshold of 30 nmol/L is also observed in that database...
April 17, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/29627829/effect-of-lanthanum-carbonate-on-all-cause-mortality-in-patients-receiving-maintenance-hemodialysis-a-meta-analysis-of-randomized-controlled-trials
#13
Fang Wang, Xiangxue Lu, Jingli Zhang, Ruifang Xiong, Han Li, Shixiang Wang
BACKGROUND/AIMS: Hyperphosphatemia is common in patients on hemodialysis. The efficacy of lanthanum carbonate (LC) in the treatment of hyperphosphatemia in these patients remains controversial. The objective of this meta-analysis was to evaluate the effect of LC on all-cause mortality in patients on maintenance hemodialysis. METHODS: We electronically searched the PubMed, EMBASE, and Cochrane Library databases for all randomized controlled trials (RCTs) comparing LC with other phosphate binders used in adult hemodialysis patients, including calcium carbonate, calcium acetate, and sevelamer...
March 29, 2018: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29615318/effect-of-vitamin-d-supplementation-on-anthropometric-indices-among-overweight-and-obese-women-a-double-blind-randomized-controlled-clinical-trial
#14
Sajjad Roosta, Mina Kharadmand, Farshad Teymoori, Mehdi Birjandi, Ahmad Adine, Ebrahim Falahi
AIMS: The aim of this study was to investigate effect of vitamin D supplementation on anthropometric indices among women with overweight and obesity. METHODS: This double blind randomize clinical trial was conducted on 66 overweight and obese women. Those in intervention group received oral supplement of vitamin D 50,000 IU (1250 mcg) per 25 day and in control group participants received placebo for 3 months. Anthropometric indices were measured before and after 3 months intervention...
March 27, 2018: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/29593281/long-term-effects-of-low-calcium-dialysates-on-the-serum-calcium-levels-during-maintenance-hemodialysis-treatments-a-systematic-review-and-meta-analysis
#15
Masahiro Yoshikawa, Osamu Takase, Taro Tsujimura, Etsuko Sano, Matsuhiko Hayashi, Tsuyoshi Takato, Keiichi Hishikawa
Hypercalcemia and hyperparathyroidism in patients receiving maintenance hemodialysis (MHD) can cause the progression of cardiovascular diseases (CVD) and mineral bone disorders (MBD). The KDIGO recommends the dialysates with a calcium (Ca) concentration of 1.25-1.5 mmol/L for MHD treatments, but the optimal concentration remains controversial. Here, we conducted a systematic review and a meta-analysis of seven randomized controlled trials examining a total of 622 patients to investigate the optimal concentration for MHD for 6 months or longer...
March 28, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29562597/effects-of-different-dietary-interventions-on-calcitriol-parathyroid-hormone-calcium-and-phosphorus-results-from-the-dash-trial
#16
Ahmed Hassoon, Erin D Michos, Edgar R Miller, Zeni Crisp, Lawrence J Appel
The "Dietary Approaches to Stop Hypertension" (DASH) diet, rich in fiber and low-fat dairy, effectively lowers blood pressure. DASH's effect on calcitriol and other markers of bone-mineral metabolism is unknown. This secondary analysis of the DASH trial aimed to determine the effect of dietary patterns on blood concentrations of calcitriol, parathyroid hormone (PTH), ionized calcium, and urinary excretion of calcium and phosphorus. Outcomes were available in 334 participants in the trial. After a 3-week run-in on the control diet, participants were randomized to control, fruits and vegetables (F&V), or DASH diets...
March 17, 2018: Nutrients
https://www.readbyqxmd.com/read/29558928/the-relationship-between-poor-nutritional-status-and-progression-of-aortic-calcification-in-patients-on-maintenance-hemodialysis
#17
Teppei Okamoto, Shingo Hatakeyama, Hirotake Kodama, Hirotaka Horiguchi, Yuka Kubota, Koichi Kido, Masaki Momota, Shogo Hosogoe, Yoshimi Tanaka, Tooru Takashima, Fumitada Saitoh, Tadashi Suzuki, Chikara Ohyama
BACKGROUND: Although aortic calcification has a significant negative impact on prognosis in patients on hemodialysis (HD), risk factors for aortic calcification progression remain unclear. The aim of this study was to investigate the relationship between malnutrition and aortic calcification progression in patients on HD. METHODS: Between April 2015 and October 2016, we treated 232 patients on HD. Of those, we retrospectively evaluated data from 184 patients who had had regular blood tests and computed tomography (CT) scans...
March 20, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29548300/the-combined-effect-of-parathyroid-hormone-1-34-and-whole-body-vibration-exercise-in-the-treatment-of-osteoporosis-pavos-study-protocol-for-a-randomized-controlled-trial
#18
Ditte Beck Jepsen, Jesper Ryg, Niklas Rye Jørgensen, Stinus Hansen, Tahir Masud
BACKGROUND: PaVOS is a randomized controlled trial (RCT) which aims to address the use of whole-body vibration exercise (WBV) in combination with parathyroid hormone 1-34 fragment teriparatide (PTH 1-34) treatment in patients with osteoporosis. PTH 1-34 is an effective but expensive anabolic treatment for osteoporosis. WBV has been found to stimulate muscle and bone growth. Animal studies have shown a beneficial effect on bone when combining PTH 1-34 with mechanical loading. A combined treatment with PTH 1-34 and WBV may potentially have beneficial effects on bone and muscles, and reduce fracture risk...
March 16, 2018: Trials
https://www.readbyqxmd.com/read/29547405/fracture-risk-and-treatment-in-chronic-kidney-disease
#19
Kelsey Connelly, David Collister, Navdeep Tangri
PURPOSE OF REVIEW: Chronic kidney disease (CKD) is associated with the development of mineral bone disorder (MBD), osteoporosis, and fragility fractures. The purpose of this review is to provide an update on recent findings in the diagnosis and treatment of osteoporosis in patients with CKD. RECENT FINDINGS: Multiple observational studies have shown that bone mineral density measurement using DEXA is equally predictive in CKD stages 1-3, as in the general population...
May 2018: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29525393/incidence-predictors-and-therapeutic-consequences-of-hypocalcemia-in-patients-treated-with-cinacalcet-in-the-evolve-trial
#20
Jürgen Floege, Kate Tsirtsonis, Jan Iles, Tilman B Drueke, Glenn M Chertow, Patrick Parfrey
The calcimimetic cinacalcet is used to treat secondary hyperparathyroidism in patients receiving dialysis, and asymptomatic hypocalcemia is often observed following its initiation. Here we investigated the incidence, predictors and therapeutic consequences of hypocalcemia by a post hoc analysis of the randomized, double-blind, placebo-controlled EValuation Of Cinacalcet Hydrochloride Therapy to Lower CardioVascular Events (EVOLVE) trial. Hypocalcemia was classified as mild (total serum calcium 8.0-8.39 mg/dL), moderate (7...
March 7, 2018: Kidney International
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