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By Venkatesh Ariyamuthu Transplant Nephrologist at UT Southwestern Medical Center
https://www.readbyqxmd.com/read/28298956/phosphorus-regulation-in-chronic-kidney-disease
#1
REVIEW
Wadi N Suki, Linda W Moore
Serum phosphorus levels stay relatively constant through the influence of multiple factors-such as parathyroid hormone, fibroblast growth factor 23, and vitamin D-on the kidney, bone, and digestive system. Whereas normal serum phosphorus ranges between 3 mg/dL to 4.5 mg/dL, large cross-sectional studies have shown that even people with normal kidney function are sometimes found to have levels ranging between 1.6 mg/dL and 6.2 mg/dL. While this may partially be due to diet and the factors mentioned above, total understanding of these atypical ranges of serum phosphorus remains uncertain...
October 2016: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28167928/clinical-review-of-antidiabetic-drugs-implications-for-type-2-diabetes-mellitus-management
#2
REVIEW
Arun Chaudhury, Chitharanjan Duvoor, Vijaya Sena Reddy Dendi, Shashank Kraleti, Aditya Chada, Rahul Ravilla, Asween Marco, Nawal Singh Shekhawat, Maria Theresa Montales, Kevin Kuriakose, Appalanaidu Sasapu, Alexandria Beebe, Naveen Patil, Chaitanya K Musham, Govinda Prasad Lohani, Wasique Mirza
Type 2 diabetes mellitus (T2DM) is a global pandemic, as evident from the global cartographic picture of diabetes by the International Diabetes Federation (http://www.diabetesatlas.org/). Diabetes mellitus is a chronic, progressive, incompletely understood metabolic condition chiefly characterized by hyperglycemia. Impaired insulin secretion, resistance to tissue actions of insulin, or a combination of both are thought to be the commonest reasons contributing to the pathophysiology of T2DM, a spectrum of disease originally arising from tissue insulin resistance and gradually progressing to a state characterized by complete loss of secretory activity of the beta cells of the pancreas...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28429550/parathyroid-hormone-targets-in-chronic-kidney-disease-and-managing-severe-hyperparathyroidism
#3
Carmel M Hawley, Stephen G Holt
Appropriate targets for parathyroid hormone (PTH) in patients with chronic kidney disease (CKD) stages 3-5D are controversial, as are the means by which these targets might be achieved. Secondary hyperparathyroidism is linked to symptoms like bone pain and itch, in addition to less clinically overt issues like bone fragility as well as vascular and soft tissue calcification which may lead to adverse hard endpoints, particularly fracture and death. Recognized therapies for managing a rising PTH include vitamin D analogues, with or without calcimimetic (where available), in addition to management of serum mineral concentrations with diet, binders and dialysis...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28456346/management-of-gout-and-hyperuricemia-in-ckd
#4
Ana Beatriz Vargas-Santos, Tuhina Neogi
Hyperuricemia and gout, the clinical manifestation of monosodium urate crystal deposition, are common in patients with chronic kidney disease (CKD). Although the presence of CKD poses additional challenges in gout management, effective urate lowering is possible for most patients with CKD. Initial doses of urate-lowering therapy are lower than in the non-CKD population, whereas incremental dose escalation is guided by regular monitoring of serum urate levels to reach the target level of <6mg/dL (or <5mg/dL for patients with tophi)...
April 26, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28366517/risks-of-adverse-events-in-advanced-ckd-the-chronic-renal-insufficiency-cohort-cric-study
#5
Morgan E Grams, Wei Yang, Casey M Rebholz, Xue Wang, Anna C Porter, Lesley A Inker, Edward Horwitz, James H Sondheimer, L Lee Hamm, Jiang He, Matthew R Weir, Bernard G Jaar, Tariq Shafi, Lawrence J Appel, Chi-Yuan Hsu
BACKGROUND: People with advanced chronic kidney disease are at risk for the development of end-stage renal disease (ESRD), but also many other adverse outcomes, including cardiovascular disease (CVD) events and death. Determination of risk factors that explain the variability in prognosis and timing of these adverse outcomes can aid patient counseling and medical decision making. STUDY DESIGN: Prospective research cohort. SETTING & PARTICIPANTS: 1,798 participants with estimated glomerular filtration rates (eGFRs)<30mL/min/1...
March 30, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27636773/biomarkers-for-predicting-outcomes-in-chronic-kidney-disease
#6
Lekha Tummalapalli, Girish N Nadkarni, Steven G Coca
PURPOSE OF REVIEW: Current biomarkers for chronic kidney disease (CKD) are limited by lack of sensitivity and inability to prognosticate CKD progression. Significant recent research has better characterized novel biomarker candidates that are associated with CKD progression and cardiovascular mortality in CKD. This review discusses the most significant advances within the past year. RECENT FINDINGS: We discuss biomarkers for outcomes in CKD under two categories: emerging (defined as having been validated in an independent cohort), which include serum cystatin C, serum β-trace protein, β2-microglobulin, soluble urokinase-type plasminogen activator receptor, soluble tumor necrosis factor receptors 1/2, urinary monocyte chemotactic protein-1, neutrophil gelatin-associated lipocalin, kidney injury molecule-1, and fibroblast growth factor-23; and novel (which have shown associations in smaller observational studies but have not been validated yet), which include indoxyl sulfate, p-cresyl sulfate, trimethylamine-N-oxide, IL-18, Klotho, markers of endothelial dysfunction, vimentin, and procollagen type III N-terminal propeptide...
November 2016: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/27532915/clinical-manifestations-of-kidney-disease-among-us-adults-with-diabetes-1988-2014
#7
Maryam Afkarian, Leila R Zelnick, Yoshio N Hall, Patrick J Heagerty, Katherine Tuttle, Noel S Weiss, Ian H de Boer
IMPORTANCE: Diabetic kidney disease is the leading cause of chronic and end-stage kidney disease in the United States and worldwide. Changes in demographics and treatments may affect the prevalence and clinical manifestations of diabetic kidney disease. OBJECTIVE: To characterize the clinical manifestations of kidney disease among US adults with diabetes over time. DESIGN, SETTING, AND PARTICIPANTS: Serial cross-sectional studies of adults aged 20 years or older with diabetes mellitus participating in National Health and Nutrition Examination Surveys from 1988 through 2014...
August 9, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27646424/timed-urine-collections-for-albumin-and-protein-the-king-is-dead-long-live-the-king
#8
EDITORIAL
Roger A Rodby
No abstract text is available yet for this article.
December 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27618882/the-hypoxia-response-pathways-hats-off
#9
M Celeste Simon
No abstract text is available yet for this article.
October 27, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27609359/effect-of-mineralocorticoid-receptor-antagonists-on-proteinuria-and-progression-of-chronic-kidney-disease-a-systematic-review-and-meta-analysis
#10
Gemma Currie, Alison H M Taylor, Toshiro Fujita, Hiroshi Ohtsu, Morten Lindhardt, Peter Rossing, Lene Boesby, Nicola C Edwards, Charles J Ferro, Jonathan N Townend, Anton H van den Meiracker, Mohammad G Saklayen, Sonia Oveisi, Alan G Jardine, Christian Delles, David J Preiss, Patrick B Mark
BACKGROUND: Hypertension and proteinuria are critically involved in the progression of chronic kidney disease. Despite treatment with renin angiotensin system inhibition, kidney function declines in many patients. Aldosterone excess is a risk factor for progression of kidney disease. Hyperkalaemia is a concern with the use of mineralocorticoid receptor antagonists. We aimed to determine whether the renal protective benefits of mineralocorticoid antagonists outweigh the risk of hyperkalaemia associated with this treatment in patients with chronic kidney disease...
September 8, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27643001/os-19-03-treatment-with-patiromer-resulted-in-decreases-in-aldosterone-in-patients-with-chronic-kidney-disease-and-hyperkalemia-on-raas-inhibitors-results-from-opal-hk
#11
Matthew Weir, George L Bakris, Coleman Gross, Martha R Mayo, Dahlia Garza, Jinwei Yuan, Lance Berman, Gordon H Williams
OBJECTIVE: Elevated serum aldosterone can be vasculotoxic and facilitates cardiorenal damage. Renin-angiotensin-aldosterone inhibitors (RAASi) reduce serum aldosterone levels and/or block its effects but can cause hyperkalemia (HK). Patiromer, a nonabsorbed potassium binder, decreases serum potassium (K) in CKD patients on RAASi. We examined the effect of patiromer on serum aldosterone levels, plasma renin activity (PRA), systolic (SBP) and diastolic blood pressure (DBP), and urinary albumin-to-creatinine ratio (UACR) in CKD patients on RAASi with HK (serum K 5...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27528553/the-relatively-poor-correlation-between-random-and%C3%A2-24-hour-urine-protein-excretion-in-patients-with%C3%A2-biopsy-proven-glomerular-diseases
#12
Marie C Hogan, Heather N Reich, Peter J Nelson, Sharon G Adler, Daniel C Cattran, Gerald B Appel, Debbie S Gipson, Matthias Kretzler, Jonathan P Troost, John C Lieske
Random urine protein creatinine ratios are used to estimate 24-hour urine protein excretion, which is considered a diagnostic gold standard. However, few studies are available of the sensitivity and specificity of this estimation in patients with glomerular proteinuria. To clarify this, we measured the urine protein and creatinine centrally in random and 24-hour urine collections at biopsy and longitudinally every 6 months in individuals participating in the Nephrotic Syndrome Study Network (NEPTUNE) cohort with glomerular disease...
November 2016: Kidney International
https://www.readbyqxmd.com/read/27457514/2016-updated-eular-evidence-based-recommendations-for-the-management-of-gout
#13
REVIEW
P Richette, M Doherty, E Pascual, V Barskova, F Becce, J Castañeda-Sanabria, M Coyfish, S Guillo, T L Jansen, H Janssens, F Lioté, C Mallen, G Nuki, F Perez-Ruiz, J Pimentao, L Punzi, T Pywell, A So, A K Tausche, T Uhlig, J Zavada, W Zhang, F Tubach, T Bardin
BACKGROUND: New drugs and new evidence concerning the use of established treatments have become available since the publication of the first European League Against Rheumatism (EULAR) recommendations for the management of gout, in 2006. This situation has prompted a systematic review and update of the 2006 recommendations. METHODS: The EULAR task force consisted of 15 rheumatologists, 1 radiologist, 2 general practitioners, 1 research fellow, 2 patients and 3 experts in epidemiology/methodology from 12 European countries...
January 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/27470878/sodium-glucose-cotransporter-2-inhibitors-in-the-treatment-of-diabetes-mellitus-cardiovascular-and-kidney-effects-potential-mechanisms-and-clinical-applications
#14
REVIEW
Hiddo J L Heerspink, Bruce A Perkins, David H Fitchett, Mansoor Husain, David Z I Cherney
Sodium-glucose cotransporter-2 (SGLT2) inhibitors, including empagliflozin, dapagliflozin, and canagliflozin, are now widely approved antihyperglycemic therapies. Because of their unique glycosuric mechanism, SGLT2 inhibitors also reduce weight. Perhaps more important are the osmotic diuretic and natriuretic effects contributing to plasma volume contraction, and decreases in systolic and diastolic blood pressures by 4 to 6 and 1 to 2 mm Hg, respectively, which may underlie cardiovascular and kidney benefits...
September 6, 2016: Circulation
https://www.readbyqxmd.com/read/27380495/patiromer-a-review-in-hyperkalaemia
#15
REVIEW
E S Kim, Emma D Deeks
Patiromer (Veltassa(™)) for oral suspension is a sodium-free potassium binder that is approved in the USA for the treatment of hyperkalaemia. In clinical trials, patiromer significantly reduced serum potassium levels from baseline to week 4 in patients with chronic kidney disease (CKD) and mild to severe hyperkalaemia (OPAL-HK), or CKD, mild to moderate hyperkalaemia and type 2 diabetes mellitus (AMETHYST-DN), who were receiving renin-angiotensin-aldosterone system inhibitors (RAASis; drugs that inhibit the renal excretion of potassium)...
August 2016: Clinical Drug Investigation
https://www.readbyqxmd.com/read/27440829/sglt2-inhibitors-and-the-diabetic-kidney
#16
Paola Fioretto, Alberto Zambon, Marco Rossato, Luca Busetto, Roberto Vettor
Diabetic nephropathy (DN) is the most common cause of end-stage renal disease worldwide. Blood glucose and blood pressure control reduce the risk of developing this complication; however, once DN is established, it is only possible to slow progression. Sodium-glucose cotransporter 2 (SGLT2) inhibitors, the most recent glucose-lowering oral agents, may have the potential to exert nephroprotection not only through improving glycemic control but also through glucose-independent effects, such as blood pressure-lowering and direct renal effects...
August 2016: Diabetes Care
https://www.readbyqxmd.com/read/27299675/empagliflozin-and-progression-of-kidney-disease-in-type-2-diabetes
#17
RANDOMIZED CONTROLLED TRIAL
Christoph Wanner, Silvio E Inzucchi, John M Lachin, David Fitchett, Maximilian von Eynatten, Michaela Mattheus, Odd Erik Johansen, Hans J Woerle, Uli C Broedl, Bernard Zinman
BACKGROUND: Diabetes confers an increased risk of adverse cardiovascular and renal events. In the EMPA-REG OUTCOME trial, empagliflozin, a sodium-glucose cotransporter 2 inhibitor, reduced the risk of major adverse cardiovascular events in patients with type 2 diabetes at high risk for cardiovascular events. We wanted to determine the long-term renal effects of empagliflozin, an analysis that was a prespecified component of the secondary microvascular outcome of that trial. METHODS: We randomly assigned patients with type 2 diabetes and an estimated glomerular filtration rate of at least 30 ml per minute per 1...
July 28, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27321965/intravenous-versus-oral-iron-supplementation-for-the-treatment-of-anemia-in-ckd-an-updated-systematic-review-and-meta-analysis
#18
REVIEW
Daniel Shepshelovich, Benaya Rozen-Zvi, Tomer Avni, Uzi Gafter, Anat Gafter-Gvili
BACKGROUND: Iron supplementation is crucial for the treatment of anemia of chronic kidney disease (CKD). Although intravenous (IV) iron is preferred for patients with CKD receiving dialysis (CKD stage 5D), the method of iron replacement for patients with CKD stages 3 to 5 is controversial. STUDY DESIGN: Systematic review and meta-analysis. A search was performed until October 2015 of MEDLINE, Cochrane Library, conference proceedings in nephrology, and reference lists of included trials...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27230070/new-agents-in-treatment-of-hyperkalemia-an-opportunity-to-optimize-use-of-raas-inhibitors-for-blood-pressure-control-and-organ-protection-in-patients-with-chronic-kidney-disease
#19
REVIEW
Anjay Rastogi, Farid Arman, Setareh Alipourfetrati
PURPOSE OF REVIEW: The overactive renin-angiotensin-aldosterone system (RAAS) plays an important part in many pathologic conditions including hypertension, heart failure, and renal disease. Hyperkalemia, a potentially life-threatening side effect of RAAS inhibitors, limits their use. The recent introduction of new hyperkalemia treatments provides opportunities to take full benefit of RAAS inhibitors. RECENT FINDINGS: Optimizing RAAS inhibition is an important therapeutic goal, particularly in chronic kidney disease...
July 2016: Current Hypertension Reports
https://www.readbyqxmd.com/read/27012910/how-does-sprint-systolic-blood-pressure-intervention-trial-direct-hypertension-treatment-targets-for-ckd
#20
EDITORIAL
Sandra J Taler
No abstract text is available yet for this article.
July 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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