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CKD-MBD

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92 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/29993278/in-vivo-evidence-for-an-interplay-of-fgf23-klotho-pth-axis-on-the-phosphate-handling-in-renal-proximal-tubules
#1
Noriko Ide, Rui Ye, Marie Courbebaisse, Hannes Olauson, Michael J Densmore, Tobias Larsson, Jun-Ichi Hanai, Beate Lanske
Phosphate homeostasis is primarily maintained in the renal proximal tubules where the expression of sodium/phosphate co-transporters (Npt2a and Npt2c) is modified by the endocrine actions of both FGF23 and PTH. However, the specific contribution of each regulatory pathway in the proximal tubules has not been fully elucidated in vivo. We have previously demonstrated that proximal tubule-specific deletion of the FGF23 co-receptor Klotho results in mild hyperphosphatemia with little to no change in serum levels of FGF23, 1,25(OH)2D3, and PTH...
July 11, 2018: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/29989014/changes-with-lanthanum-carbonate-calcium-acetate-and-phosphorus-restriction-in-ckd-a-randomized-controlled-trial
#2
Csaba P Kovesdy, Jun Ling Lu, Barry M Wall, Geeta Gyamlani, Adnan Naseer, Angela Wallick, Zhongji Han, Fridtjof Thomas, L Darryl Quarles, Nabil Jarmukli
Introduction: Abnormal phosphorus homeostasis develops early in chronic kidney disease (CKD). It is unclear if its correction results in improved clinical outcomes in non-dialysis dependent CKD. Methods: We conducted a randomized controlled, parallel design clinical trial in 120 patients with estimated glomerular filtration rate 15 to 59 ml/min per 1.73 m2 and abnormal phosphorus homeostasis (serum phosphorus >4.6 mg/dl, parathyroid hormone [PTH] >70 pg/ml or tubular reabsorption of phosphorus [TRP] <80%)...
July 2018: KI Reports
https://www.readbyqxmd.com/read/29971211/stabilization-of-serum-alkaline-phosphatase-in-hemodialysis-patients-by-implementation-of-local-chronic-kidney-disease-mineral-bone-disorder-management-strategy-a-quality-improvement-study
#3
Kyubok Jin, Tae Hyun Ban, Ji Yong Jung, Ae Jin Kim, Yaerim Kim, So-Young Lee, Dong Ho Yang, Bum Soon Choi, Kook-Hwan Oh, Jieun Kim, Young Joo Kwon, Jong Wook Choi, Gheun-Ho Kim
Background: The aim of this study is to narrow the gap between global guidelines and local practices, we recently established domestic recommendations by adapting the international guidelines for management of chronic kidney disease-mineral bone disorder (CKD-MBD) in patients on maintenance hemodialysis (MHD). This study was undertaken to determine whether application of this guideline adaptation was associated with improved serum mineral profiles in patients with CKD-MBD. Methods: A total of 355 patients on MHD were enrolled from seven dialysis units...
June 2018: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/29959497/fgf23-klotho-axis-bone-fractures-and-arterial-stiffness-in-dialysis-a-case-control-study
#4
L-C Desbiens, A Sidibé, R-V Ung, C Fortier, M Munger, Y-P Wang, S-K Bisson, K Marquis, M Agharazii, F Mac-Way
We performed a case-control study on 130 age- and sex-matched hemodialysis patients. In multivariate analysis, we observed that FGF23 levels were associated with fracture incidence and that soluble α-klotho levels were associated with the aortic-brachial arterial stiffness ratio. INTRODUCTION: New bone markers such as sclerostin, Dickkopf-related protein 1 (DKK1), fibroblast growth factor-23 (FGF23), and α-klotho have been identified as potential key players in bone and vascular abnormalities of chronic kidney disease...
June 29, 2018: Osteoporosis International
https://www.readbyqxmd.com/read/29931675/correlations-between-plasma-strontium-concentration-components-of-calcium-and-phosphate-metabolism-and-renal-function-in-type-2-diabetes-mellitus
#5
Y S Van den Berkhof, C M Gant, R Maatman, A De Graaf, G J Navis, S J L Bakker, G D Laverman
BACKGROUND: Renal function decline in diabetic kidney disease is accompanied by calcium and phosphate metabolism alterations. Whereas Strontium (Sr2+ ) has many similarities with calcium, little is known about Sr2+ in this respect. We studied the association of plasma Sr2+ concentration and parameters associated with an altered calcium and phosphate metabolism in diabetic kidney disease. MATERIALS AND METHODS: Plasma Sr2+ concentration was measured in 450 patients included in the DIAbetes and LifEstyle Cohort Twente-1...
June 21, 2018: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28785559/hope-for-ckd-mbd-patients-new-diagnostic-approaches-for-better-treatment-of-ckd-mbd
#6
REVIEW
Berthold Hocher, Andreas Pasch
BACKGROUND: Chronic kidney disease-mineral and bone disorder (CKD-MBD) patients have a huge morbidity and mortality. Only relatively minor progress in therapeutic strategies has been made in the past decades. This is at least partially due to a lack of predictive diagnostic tools allowing personalized treatment of CKD-MBD patients. SUMMARY: In this review we describe recent progress in the diagnosis of disturbances of calcium and phosphate metabolism in patients with CKD-MBD, measuring biological active nonoxidized parathyroid hormone as well as the overall likelihood of a patient to get calcified...
July 2017: Kidney Diseases
https://www.readbyqxmd.com/read/29900589/mineral-and-bone-disorders-in-conventional-hemodialysis-challenges-and-solutions
#7
Takayuki Hamano
Despite the advent of cinacalcet and noncalcium-containing phosphate binders, controlling the progression of vascular calcification (VC) is still challenging. Recent reports demonstrate that carbamylation driven by high urea concentration aggravates VC, suggesting the importance of adequate dialysis in retarding its progression. Theoretically, other promising measures include the use of iron-based phosphate binders, vitamin K, and magnesium supplements, which should be investigated in future randomized controlled trials (RCTs), ideally with hard outcomes...
June 13, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29860419/acetate-free-citrate-acidified-bicarbonate-dialysis-improves-serum-calcification-propensity-a-preliminary-study
#8
Georg Lorenz, Christopher C Mayer, Quirin Bachmann, Sarah Stryeck, Matthias C Braunisch, Bernhard Haller, Javier Carbajo-Lozoya, Alina Schmidt, Simon Witthauer, Jasmin Abuzahu, Stephan Kemmner, Susanne Angermann, Naresh Koneru, Siegfried Wassertheurer, Richard Bieber, Uwe Heemann, Tobias Madl, Andreas Pasch, Christoph Schmaderer
Background: A novel in vitro test (T50 test) assesses ex vivo serum calcification propensity and predicts mortality in chronic kidney disease and haemodialysis (HD) patients. For the latter, a time-dependent decline of T50 was shown to relate to mortality. Here we assessed whether a 3-month switch to acetate-free, citrate-acidified, standard bicarbonate HD (CiaHD) sustainably improves calcification propensity. Methods: T50 values were assessed in paired midweek pre-dialysis sera collected before and 3 months after CiaHD in 78 prevalent European HD patients...
May 30, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29804564/-novel-hormones-related-to-the-calcium-and-phosphate-homeostasis-in-kidney-disease
#9
Maria Lerche Mace, Klaus Ølgaard, Eva Lewin
Calcium and phosphate levels are regulated by a complex interplay between parathyroid hormone (PTH), calcitriol, fibroblast growth factor 23 (FGF23) and its co-receptor αKlotho. Kidney failure causes severe disturbances in the mineral and bone homeostasis resulting in phosphate retention, hypocalcaemia and high plasma levels of FGF23 and PTH, and the patients develop fragile bones and vascular calcifications. Today's treatments aim to lower the levels of phosphate and PTH. Future studies need to clarify, if lowering the FGF23 level or supplementation with αKlotho will improve survival for patients with chronic kidney disease...
May 21, 2018: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29786179/-update-2017-of-the-kdigo-guidelines-on-chronic-kidney-disease-mineral-and-bone-disorder-ckd-mbd-what-are-the-real-changes
#10
Marzia Pasquali, Antonio Bellasi, Giuseppe Cianciolo, Carlo Massimetti, Maria Cristina Mereu, Luigi Morrone, Vincenzo Panuccio
Guidelines for the assessment, diagnosis and therapy of the alterations that characterize the CKD-MBD are an important support in the clinical practice of the nephrologist. Compared to the KDIGO guidelines published in 2009, the 2017 update made changes on some topics on which there was previously no strong evidence both in terms of diagnosis and therapy. The recommendations include the diagnosis of bone anomalies in CKD-MBD and the treatment of mineral metabolism abnormalities with particular regard to hyperphosphataemia, calcium levels, secondary hyperparathyroidism and anti-resorptive therapies...
May 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29677309/vitamin-d-calcium-or-combined-supplementation-for-the-primary-prevention-of-fractures-in-community-dwelling-adults-us-preventive-services-task-force-recommendation-statement
#11
David C Grossman, Susan J Curry, Douglas K Owens, Michael J Barry, Aaron B Caughey, Karina W Davidson, Chyke A Doubeni, John W Epling, Alex R Kemper, Alex H Krist, Martha Kubik, Seth Landefeld, Carol M Mangione, Michael Silverstein, Melissa A Simon, Chien-Wen Tseng
Importance: Because of the aging population, osteoporotic fractures are an increasingly important cause of morbidity and mortality in the United States. Approximately 2 million osteoporotic fractures occurred in the United States in 2005, and annual incidence is projected to increase to more than 3 million fractures by 2025. Within 1 year of experiencing a hip fracture, many patients are unable to walk independently, more than half require assistance with activities of daily living, and 20% to 30% of patients will die...
April 17, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29580635/prevention-and-treatment-of-hyperphosphatemia-in-chronic-kidney-disease
#12
REVIEW
Marc G Vervloet, Adriana J van Ballegooijen
Hyperphosphatemia has consistently been shown to be associated with dismal outcome in a wide variety of populations, particularly in chronic kidney disease (CKD). Compelling evidence from basic and animal studies elucidated a range of mechanisms by which phosphate may exert its pathological effects and motivated interventions to treat hyperphosphatemia. These interventions consisted of dietary modifications and phosphate binders. However, the beneficial effects of these treatment methods on hard clinical outcomes have not been convincingly demonstrated in prospective clinical trials...
May 2018: Kidney International
https://www.readbyqxmd.com/read/29525393/incidence-predictors-and-therapeutic-consequences-of-hypocalcemia-in-patients-treated-with-cinacalcet-in-the-evolve-trial
#13
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...
June 2018: Kidney International
https://www.readbyqxmd.com/read/29481620/vitamin-d-status-and-mortality-risk-among-patients-on-dialysis-a-systematic-review-and-meta-analysis-of-observational-studies
#14
Yuhui Zhang, Darsy Darssan, Elaine M Pascoe, David W Johnson, Haichen Pi, Jie Dong
Background: Vitamin D deficiency is highly prevalent in patients on dialysis. Although vitamin D deficiency is closely associated with cardiovascular disease (CVD) and high mortality in the general population, the relationship between serum 25-hydroxyvitamin D [25(OH)D] and all-cause and cardiovascular mortality in dialysis patients is uncertain. We aim to explore the relationship between serum 25(OH)D levels and all-cause and cardiovascular mortality in dialysis patients. Methods: This is a systematic review and meta-analysis of clinical studies among patients receiving maintenance dialysis...
February 21, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29459980/diagnosis-evaluation-prevention-and-treatment-of-chronic-kidney-disease-mineral-and-bone-disorder-synopsis-of-the-kidney-disease-improving-global-outcomes-2017-clinical-practice-guideline-update
#15
Markus Ketteler, Geoffrey A Block, Pieter Evenepoel, Masafumi Fukagawa, Charles A Herzog, Linda McCann, Sharon M Moe, Rukshana Shroff, Marcello A Tonelli, Nigel D Toussaint, Marc G Vervloet, Mary B Leonard
Description: The Kidney Disease: Improving Global Outcomes (KDIGO) 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) is a selective update of the prior CKD-MBD guideline published in 2009. The guideline update and the original publication are intended to assist practitioners caring for adults with CKD and those receiving long-term dialysis. Methods: Development of the guideline update followed an explicit process of evidence review and appraisal...
March 20, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29423205/ckd-mbd-kdigo-guidelines-how-difficult-is-reaching-the-target
#16
Mario Cozzolino
Patients with chronic kidney disease (CKD) are affected by mineral and bone disorder (MBD), resulting in abnormalities in serum calcium (Ca), phosphorous (P) and parathyroid hormone (PTH). Changes in mineral metabolism have also been associated with higher rates of both all-cause and cardiovascular-related mortality. The majority of haemodialysis patients are also deficient in the endogenous hormone 1,25-dihydroxyvitamin D (calcitriol), often contributing to increased secondary hyperparathyroidism (SHPT) and consequently to abnormal levels of Ca, P and PTH...
February 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29394451/pth-vitamin-d-and-the-fgf-23-klotho-axis-and-heart-going-beyond-the-confines-of-nephrology
#17
REVIEW
José Alberto Navarro-García, María Fernández-Velasco, Carmen Delgado, Juan F Delgado, Makoto Kuro-O, Luis M Ruilope, Gema Ruiz-Hurtado
BACKGROUND: Profound disturbances in mineral metabolism are closely linked to the progression of chronic kidney disease. However, increasing clinical and experimental evidence indicates that alterations in phosphate homoeostasis could have an even stronger impact on the heart. AIM: The aim of this review is to provide the reader with an update of how alterations in mineral metabolism are related to direct and indirect cardiotoxic effects beyond the nephrology setting...
April 2018: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/27324680/ckd-mineral-bone-disorder-in-stage-4-and-5-ckd-what-we-know-today
#18
REVIEW
Michal L Melamed, Rupinder Singh Buttar, Maria Coco
Patients with CKD stages 4 and 5 experience biochemical derangements associated with CKD-mineral bone disorder. Some of the key abnormalities are hyperparathyroidism, hyperphosphatemia, hypocalcemia, and metabolic acidosis. We review the available treatments for these conditions and the evidence behind the treatments. We conclude that there is greater evidence for treating hyperphosphatemia than hyperparathyroidism. Treatment of metabolic acidosis in small clinical trials appears to be safe. We caution the reader about side effects associated with some of these treatments that differ in patients with CKD Stages 4 and 5 compared with patients on dialysis...
July 2016: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/29107998/impact-of-surgical-parathyroidectomy-on-chronic-kidney-disease-mineral-and-bone-disorder-ckd-mbd-a-systematic-review-and-meta-analysis
#19
REVIEW
Mugurel Apetrii, David Goldsmith, Ionut Nistor, Dimitrie Siriopol, Luminita Voroneanu, Dragos Scripcariu, Marc Vervloet, Adrian Covic
For more than 6 decades, many patients with advanced chronic kidney disease (CKD) have undergone surgical parathyroidectomy (sPTX) for severe secondary hyperparathyroidism (SHPT) mainly based historical clinical practice patterns, but not on evidence of outcome.We aimed in this meta-analysis to evaluate the benefits and harms of sPTX in patients with SHPT. We searched MEDLINE (inception to October 2016), EMBASE and Cochrane Library (through Issue 10 of 12, October 2016) and website clinicaltrials.gov (October 2016) without language restriction...
2017: PloS One
https://www.readbyqxmd.com/read/29074819/continued-search-for-therapies-to-favorably-modify-phosphate-and-fgf23-levels-in-ckd
#20
EDITORIAL
Rupal Mehta, Tamara Isakova
No abstract text is available yet for this article.
December 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
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