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CKD-MBD

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55 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/27867189/the-role-of-phosphate-in-kidney-disease
#1
REVIEW
Marc G Vervloet, Siren Sezer, Ziad A Massy, Lina Johansson, Mario Cozzolino, Denis Fouque
The importance of phosphate homeostasis in chronic kidney disease (CKD) has been recognized for decades, but novel insights - which are frequently relevant to everyday clinical practice - continue to emerge. Epidemiological data consistently indicate an association between hyperphosphataemia and poor clinical outcomes. Moreover, compelling evidence suggests direct toxicity of increased phosphate concentrations. Importantly, serum phosphate concentration has a circadian rhythm that must be considered when interpreting patient phosphate levels...
November 21, 2016: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/26951967/phosphate-homeostasis-parathyroid-hormone-and-fibroblast-growth-factor-23-in-stages-3-and-4-chronic-kidney-disease
#2
Kenneth R Phelps, Darius L Mason, Kim S Stote
AIMS: Increased concentrations of parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23) often coincide with normal serum phosphorus ([P]s) in chronic kidney disease (CKD). We hypothesized that the phosphate concentration ([P]f) in the cortical distal nephron (CDN) determines [PTH] and [FGF23] in this circumstance. METHODS: We studied 29 patients with CKD at 4 visits and 28 controls at 1 visit. Assuming GFR = creatinine clearance (Ccr), we examined the following regressions: [P]s on its determinants, EP/Ccr and TRP/Ccr (P excretion and reabsorption per volume of filtrate); [PTH] and [FGF23] on [P]s and EP/Ccr; and TRP/Ccr on [PTH] and [FGF23]...
May 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/26914677/association-between-hemodialysis-patient-outcomes-and-compliance-with-kdoqi-and-kdigo-targets-for-mineral-and-bone-metabolism
#3
Ljubica Djukanović, Nada Dimković, Jelena Marinković, Živka Djurić, Violeta Knežević, Tatjana Lazarević, Stanimir Ljubenović, Rodoljub Marković, Violeta Rabrenović
BACKGROUND: Increased mortality of hemodialysis (HD) patients is associated with chronic kidney disease-mineral and bone disorders (CKD-MBD), and therefore, their correction may improve patient survival. Differences in targets recommended by KDOQI and KDIGO CKD-MBD guidelines directed us to compare the relative numbers of patients achieving these targets and to examine possible associations between compliance with the targets and patient outcome. METHODS: A total of 1,744 patients (61...
2016: Nephron
https://www.readbyqxmd.com/read/26806832/changing-bone-patterns-with-progression-of-chronic-kidney-disease
#4
REVIEW
Tilman B Drüeke, Ziad A Massy
It is commonly held that osteitis fibrosa and mixed uremic osteodystrophy are the predominant forms of renal osteodystrophy in patients with chronic kidney disease. Osteitis fibrosa is a high-turnover bone disease resulting mainly from secondary hyperparathyroidism, and mixed uremic osteodystrophy is in addition characterized by a mineralization defect most often attributed to vitamin D deficiency. However, there is ancient and more recent evidence that in early chronic kidney disease stages adynamic bone disease characterized by low bone turnover occurs first, at least in a significant proportion of patients...
February 2016: Kidney International
https://www.readbyqxmd.com/read/26785065/optimal-management-of-bone-mineral-disorders-in-chronic-kidney-disease-and-end-stage-renal-disease
#5
REVIEW
Andrew L Lundquist, Sagar U Nigwekar
PURPOSE OF REVIEW: The review summarizes recent studies on chronic kidney disease-mineral bone disorders, with a focus on new developments in disease management. RECENT FINDINGS: The term chronic kidney disease-mineral bone disorder has come to describe an increasingly complex network of alterations in minerals and skeletal disorders that contribute to the significant cardiovascular morbidity and mortality seen in patients with chronic kidney disease and end stage renal disease...
March 2016: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/26759046/targeting-serum-calcium-in-chronic-kidney-disease-and-end-stage-renal-disease-is-normal-too-high
#6
W Charles O'Neill
Hypocalcemia is common in advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD), and it is standard practice to correct this back to the normal range, presumably to prevent symptomatic hypocalcemia and help control hyperparathyroidism. However, there are few studies to support this approach, and recent data suggest that this promotes vascular calcification and adynamic bone disease. Whether setting a lower target will improve outcomes has not been tested, but existing data suggest that this may have minimal risks and substantial potential benefits and should be explored...
January 2016: Kidney International
https://www.readbyqxmd.com/read/26392014/an-introduction-to-pth-phosphate-and-vitamin-d-current-issues-and-concerns
#7
Tamara Isakova
No abstract text is available yet for this article.
November 2015: Seminars in Dialysis
https://www.readbyqxmd.com/read/26356179/the-kidney-vascular-bone-axis-in-the-chronic-kidney-disease-mineral-bone-disorder
#8
REVIEW
Michael E Seifert, Keith A Hruska
The last 25 years have been characterized by dramatic improvements in short-term patient and allograft survival after kidney transplantation. Long-term patient and allograft survival remains limited by cardiovascular disease and chronic allograft injury, among other factors. Cardiovascular disease remains a significant contributor to mortality in native chronic kidney disease as well as cardiovascular mortality in chronic kidney disease more than doubles that of the general population. The chronic kidney disease (CKD)-mineral bone disorder (MBD) is a syndrome recently coined to embody the biochemical, skeletal, and cardiovascular pathophysiology that results from disrupting the complex systems biology between the kidney, skeleton, and cardiovascular system in native and transplant kidney disease...
March 2016: Transplantation
https://www.readbyqxmd.com/read/26312829/phosphate-as-a-cardiovascular-risk-factor-effects-on-vascular-and-endothelial-function
#9
Kathryn K Stevens, Rajan K Patel, Patrick B Mark, Christian Delles, Alan G Jardine
BACKGROUND: Hyperphosphataemia is a risk factor for accelerated cardiovascular disease in chronic kidney disease. The mechanism is poorly understood; it is unclear whether phosphate has direct effects or effects mediated via calcification or FGF23. We investigated direct effects of phosphate on endothelial function using myography to study rat and human blood vessels. In addition we assessed the effects of phosphate loading on endothelial function in a clinical study. METHODS: Resistance vessels from patients with (n=12) and without (n=13) chronic kidney disease were incubated in normal or high phosphate...
February 26, 2015: Lancet
https://www.readbyqxmd.com/read/26303319/pathophysiology-of-calcium-phosphorus-and-magnesium-dysregulation-in-chronic-kidney-disease
#10
REVIEW
Arnold J Felsenfeld, Barton S Levine, Mariano Rodriguez
Calcium, phosphorus, and magnesium homeostasis is altered in chronic kidney disease (CKD). Hypocalcemia, hyperphosphatemia, and hypermagnesemia are not seen until advanced CKD because adaptations develop. Increased parathyroid hormone (PTH) secretion maintains serum calcium normal by increasing calcium efflux from bone, renal calcium reabsorption, and phosphate excretion. Similarly, renal phosphate excretion in CKD is maintained by increased secretion of fibroblast growth factor 23 (FGF23) and PTH. However, the phosphaturic effect of FGF23 is reduced by downregulation of its cofactor Klotho necessary for binding FGF23 to FGF receptors...
November 2015: Seminars in Dialysis
https://www.readbyqxmd.com/read/26299086/alkaline-phosphatase-ipth-and-bone-turnover-markers-in-chinese-advanced-chronic-kidney-disease-patients
#11
COMPARATIVE STUDY
Yueming Liu, Qiang He
BACKGROUND: Clinicians may use several biochemical markers of bone turnover to assess or guide the care of patients with chronic kidney disease (CKD). The aims of this study are to describe changes and correlations of markers of bone remodeling in patients with different stages of CKD. METHODS: A total of 317 Chinese patients with advanced CKD (stage 3-5) were enrolled. We measured serum levels of intact-parathyroid hormone (iPTH), N-terminal midfragment (N-MID) osteocalcin, procollagen type 1 amino-terminal propeptide (P1NP), β-isomerized C-terminal telopeptide (β-CTx), total alkaline phosphatase (ALP), and 25-hydroxyvitamin D (25[OH]D)...
2015: Clinical Laboratory
https://www.readbyqxmd.com/read/26288182/sclerostin-osteocytes-and-chronic-kidney-disease-mineral-bone-disorder
#12
REVIEW
Rosa M A Moysés, Susan C Schiavi
Osteocytes respond to kidney damage by increasing production of secreted factors important to bone and mineral metabolism. These circulating proteins include the antianabolic factor, sclerostin, and the phosphaturic hormone, fibroblast growth factor 23 (FGF23). Elevated sclerostin levels correlate with increased FGF23, localized reduction in Wnt/β-catenin signaling in the skeleton and reduced osteoblast differentiation/activity. Decreased Wnt/β-catenin signaling occurs regardless of the overall changes in bone formation rates, suggesting that a reduction in the anabolic response may be a common feature of renal bone disorders but additional mechanisms may contribute to the diversity of osteodystrophy phenotypes...
November 2015: Seminars in Dialysis
https://www.readbyqxmd.com/read/26187196/altered-material-properties-are-responsible-for-bone-fragility-in-rats-with-chronic-kidney-injury
#13
Yoshiko Iwasaki, Junichiro J Kazama, Hideyuki Yamato, Aira Matsugaki, Takayoshi Nakano, Masafumi Fukagawa
Chronic kidney disease (CKD) is associated with an increased risk of fragility fractures, but the underlying pathophysiological mechanism remains obscure. We performed an in vivo experimental study to examine the roles of uremia and abnormal mineral/parathyroid metabolism in the development of bone metabolic abnormalities in uremic rats. Male Sprague-Dawley rats were divided into four groups, comprising sham operation (high turnover bone control=HTB-Cont), 5/6-nephrectomy (high turnover bone nephrectomized=HTB-Nx), thyroparathyroidectomy (low turnover bone control=LTB-Cont), and thyroparathyroidectomy plus 5/6 nephrectomy (low turnover bone nephrectomized=LTB-Nx), and maintained for 16 weeks...
December 2015: Bone
https://www.readbyqxmd.com/read/26050115/pathophysiology-of-the-chronic-kidney-disease-mineral-bone-disorder
#14
REVIEW
Keith A Hruska, Michael Seifert, Toshifumi Sugatani
PURPOSE OF REVIEW: The causes of excess cardiovascular mortality associated with chronic kidney disease (CKD) have been attributed in part to the CKD-mineral bone disorder syndrome (CKD-MBD), wherein, novel cardiovascular risk factors have been identified. The causes of the CKD-MBD are not well known and they will be discussed in this review RECENT FINDINGS: The discovery of WNT (portmanteau of wingless and int) inhibitors, especially Dickkopf 1, produced during renal repair and participating in the pathogenesis of the vascular and skeletal components of the CKD-MBD implied that additional pathogenic factors are critical, leading to the finding that activin A is a second renal repair factor circulating in increased levels during CKD...
July 2015: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/26050118/the-potential-use-of-antisclerostin-therapy-in-chronic-kidney-disease-mineral-and-bone-disorder
#15
REVIEW
Aline G Costa, John P Bilezikian, E Michael Lewiecki
PURPOSE OF REVIEW: Sclerostin is a regulator of the osteoanabolic canonical Wnt signaling pathway, and thus helps to govern rates of bone formation. The Wnt pathway is also recognized as playing an important role in the pathophysiology of the chronic kidney disease-mineral and bone disorder (CKD-MBD). It also may serve as an interface between bone and the vascular system. Pharmacological inhibition of sclerostin has shown promise as an osteoanabolic approach to the treatment of osteoporosis...
July 2015: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/26023015/klotho-fgf23-axis-in-ckd
#16
REVIEW
Ken Tsuchiya, Nobuo Nagano, Kosaku Nitta
The sequential bone disorders, serum parameter abnormalities and vascular calcification that are associated with chronic kidney disease (CKD) have come to be generally known as CKD-mineral bone disorder (MBD). Klotho, a causative protein of aging, and fibroblast growth factor 23 (FGF23), a bone-derived phosphaturic factor, have been reported to be involved in CKD-MBD, and their relationship to the pathophysiology of this disease is gradually being elucidated. Klotho functions as a cofactor of FGF receptors and has been reported to cause FGF23 action and specificity in the kidney...
2015: Contributions to Nephrology
https://www.readbyqxmd.com/read/26023011/importance-of-abnormal-bone-metabolism-in-the-acceleration-of-atherosclerosis-in-hemodialysis-patients
#17
Masaaki Inaba
Increases in serum calcium and phosphate are known as main risk factors for cardiovascular mortality in hemodialysis patients. However, increased phosphate, a definite mortality risk in the general population, should be more remarkable in hemodialysis patients, as their renal capacity to excrete phosphate into urine is negligible. Phosphate acts directly and indirectly to cause vascular injury by stimulating the apoptosis of vascular endothelial cells and the vascular calcification of vascular smooth muscle cells...
2015: Contributions to Nephrology
https://www.readbyqxmd.com/read/26005391/vitamin-d-in-the-patients-with-chronic-kidney-disease-when-to-whom-and-in-which-form
#18
REVIEW
Drasko Pavlovic, Dajana Katicic, Tonko Gulin, Josipa Josipovic
Alteration in vitamin D metabolism has a central role in the pathogenesis of secondary hyperparathyroidism (SHPT) and is also associated with increased cardiovascular morbidity and mortality in patients with chronic kidney disease (CKD). For more than sixty years, vitamin D, nutritional vitamin D (ergocalciferol, cholecalciferol or calcifediol) and nonselective vitamin D receptor (VDR) activators (calcitriol, alfacalcidol) have been used in the prevention and treatment of SHPT. In the last twenty years, selective VDR activators (paricalcitol, maxacalcitol) have been used to target SHPT...
April 2015: Materia Socio-medica
https://www.readbyqxmd.com/read/25975222/phosphate-binder-pill-burden-patient-reported-non-adherence-and-mineral-bone-disorder-markers-findings-from-the-dopps
#19
Rachel B Fissell, Angelo Karaboyas, Brian A Bieber, Ananda Sen, Yun Li, Antonio A Lopes, Takashi Akiba, Jürgen Bommer, Jean Ethier, Michel Jadoul, Ronald L Pisoni, Bruce M Robinson, Francesca Tentori
Because of multiple comorbidities, hemodialysis (HD) patients are prescribed many oral medications, including phosphate binders (PBs), often resulting in a high "pill burden." Using data from the international Dialysis Outcomes and Practice Patterns Study (DOPPS), we assessed associations between PB pill burden, patient-reported PB non-adherence, and levels of serum phosphorus (SPhos) and parathyroid hormone (PTH) using standard regression analyses. The study included data collected from 5262 HD patients from dialysis units participating in the DOPPS in 12 countries...
January 2016: Hemodialysis International
https://www.readbyqxmd.com/read/25947259/molecular-mechanisms-of-vascular-calcification-in-chronic-kidney-disease-the-link-between-bone-and-the-vasculature
#20
REVIEW
Chang Hyun Byon, Yabing Chen
Vascular calcification is highly prevalent in patients with chronic kidney disease (CKD) and increases mortality in those patients. Impaired calcium and phosphate homeostasis, increased oxidative stress, and loss of calcification inhibitors have been linked to vascular calcification in CKD. Additionally, impaired bone may perturb serum calcium/phosphate and their key regulator, parathyroid hormone, thus contributing to increased vascular calcification in CKD. Therapeutic approaches for CKD, such as phosphate binders and bisphosphonates, have been shown to ameliorate bone loss as well as vascular calcification...
August 2015: Current Osteoporosis Reports
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