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Expert Rev Clin Pharmacol 2018 Dec 2. Epub 2018 Dec 2.

a Department of Neurology and Psychiatry , Assiut University Hospital , Assiut , Egypt.

Introduction: Uremic syndrome of chronic kidney disease (CKD) is a term used to describe clinical, metabolic and hormonal abnormalities associated with progressive kidney failure. It is a rapidly growing public health problem worldwide. Nervous system complications occur in every patient with uremic syndrome of CKD. Read More

Nutrients 2018 Dec 3;10(12). Epub 2018 Dec 3.

Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.

In chronic kidney disease (CKD), hyperphosphatemia induces fibroblast growth factor-23 (FGF-23) expression that disturbs renal 1,25-dihydroxy vitamin D (1,25D) synthesis; thereby increasing parathyroid hormone (PTH) production. FGF-23 acts on the parathyroid gland (PTG) to increase 1α-hydroxylase activity and results in increase intra-gland 1,25D production that attenuates PTH secretion efficiently if sufficient 25D are available. Interesting, calcimimetics can further increase PTG 1α-hydroxylase activity that emphasizes the demand for nutritional vitamin D (NVD) under high PTH status. Read More

Nephrol News Issues 2016 Aug;30(8):37-38

Chronic kidney disease is a complex disease, and one of its common complications is associated with hyperphosphatemia. This can lead to the development of severe hyperparathyroidism, soft tissue calcification, calcification of the lung, morbidity, and mortality. One of the mainstream therapies for managing hyperphosphatemia are phosphate binder medications (PBMs). Read More

Chin Med J (Engl) 2018 Dec;131(23):2792-2799

Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education, Beijing 100034, China.

Background: Hyperphosphatemia is a risk factor associated with mortality in patients on maintenance hemodialysis. Gut absorption of phosphate is the major source. Recent studies indicated that the intestinal flora of uremic patients changed a lot compared with the healthy population, and phosphorus is an essential element of bacterial survival and reproduction. Read More

Arch Pathol Lab Med 2018 Nov 30. Epub 2018 Nov 30.

From the Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis.

Tumor lysis syndrome (TLS) is an acute, life-threatening disease among adults and children that is associated with the initiation of cytoreductive therapy in the treatment of malignancy. A pattern of metabolic derangements occurs as a result of a massive release of intracellular contents into the systemic circulation. Characteristic findings include hyperuricemia, hyperphosphatemia, hyperkalemia, hypocalcemia, and uremia, all of which can lead to cardiac arrhythmia, seizures, renal failure, and sudden death. Read More

Clin Calcium 2018 ;28(12):1611-1618

Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine/The Institute of Medical Sciences, Tokai University, Isehara, Japan.

In patients with chronic kidney disease(CKD), mineral metabolism abnormalities such as hyperphosphatemia, decreased 1,25-dihydroxyvitamin D, and elevated parathyroid hormone develop as kidney function declines, which lead to vascular calcification and a variety of skeletal abnormalities, collectively termed renal osteodystrophy. Because CKD patients have increased risk of bone fractures, it is important to assess fracture risk by measuring bone mineral density and bone metabolism markers. In addition to management of secondary hyperparathyroidism, medications for osteoporosis could be a reasonable option for preventing fracture. Read More

Asia Pac J Clin Nutr 2018 ;27(6):1207-1215

Nephrology Division, Assaf Harofeh Medical Center, Zerifin, Affiliated to Sackler Faculty of Medicine Tel Aviv University, Israel.

Background And Objectives: The potential side effects of common phosphate binders are gastrointestinal in practice. We hypothesized that regular use of phosphate binders may be associated with decreased appetite, dietary intake and consequently, poor nutritional status.

Methods And Study Design: This was cross-sectional study of 78 patients (mean age 67. Read More

Curr Opin Nephrol Hypertens 2019 Jan;28(1):34-39

Division of Nephrology, St. Joseph's Healthcare Hamilton, McMaster University.

Purpose Of Review: Phosphate lowering toward the normal range is advocated and widely practiced in patients with end-stage renal disease receiving dialysis. This approach is guided by basic science data and large observational studies that have demonstrated a consistent association between hyperphosphatemia and adverse events, including cardiovascular morbidity and all-cause mortality. There has never been a clinical trial to assess the efficacy of phosphate lowering in maintenance dialysis recipients. Read More

Nephrol Ther 2018 Nov;14(6S):6S17-6S25

Service de néphrologie, hôpital Necker-Enfants malades, 149, rue de Sèvres 75015 Paris, France. Electronic address:

Metabolic complications of chronic kidney disease (CKD) are frequent; the aims of this review are to present a 2018 update for hyperkalemia, hyperphosphatemia and anemia. Hyperkalemia is defined by a plasma level above 5.0 mmol/L, after ruling out pre-analytical problems such as hemolysis. Read More

J Nephrol 2018 Nov 21. Epub 2018 Nov 21.

Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA.

Aims: Cardiovascular (CV) complications are common in chronic kidney disease (CKD). Numerous metabolic disturbances including hyperphosphatemia, high circulating calciprotein particles (CPP), hyperparathyroidism, metabolic acidosis, and magnesium deficiency are associated with, and likely pathogenic for CV complications in CKD. The goal of this feasibility study was to determine whether effervescent calcium magnesium citrate (EffCaMgCit) ameliorates the aforementioned pathogenic intermediates. Read More

Nutr Metab Cardiovasc Dis 2018 Sep 28. Epub 2018 Sep 28.

Department of Neuroscience, Reproductive Sciences and Dentistry, Division of Pharmacology, Federico II University of Naples, Italy; Federico II University Hospital, Naples, Italy.

Background And Aims: Here we describe a dietary intervention for hyperphosphatemia in dialysis patients based on the partial replacement of meat and fish, which are one of the main sources of alimentary phosphorous, with egg white, a virtually phosphorous-free protein source. This intervention aims to reduce phosphorous intake without causing protein wasting.

Patients And Methods: As many as 23 hyperphosphatemic patients (15 male and 8 female, mean age 53. Read More

Zhonghua Yi Xue Za Zhi 2018 Nov;98(42):3406-3410

Department of Nephrology, the First Hospital of Tsinghua University, Beijing 100016, China.

To investigate the effect of hyperphosphatemia on long-term patency of arteriovenous fistula (AVF) of patients with late fistula dysfunction/failure after reoperation. The study was carried out in the Department of Nephrology of the First Affiliated Hospital of Tsinghua University between March 2012 and March 2013. A total of 136 maintenance hemodialysis patients[73 males, 63 females, with an average age of (57. Read More

Tunis Med 2018 Aug - Sep;96(8-09):472-476

Background: Hypoparathyroidism is a rare pediatric endocrine disease, which is caused by low circulating levels of PTH or insensitivity to its action in the target tissues.

Aim: To report the clinical and biochemical characteristics and theoutcome of 8 patients with hypoparathyroidism.

Methods: We analyzed retrospectively the results of clinical, biochemical, radiological findings of patients with hypoparathyroidism diagnosed in pediatric department of Hedi Chaker Hospital during the period 1994-2013. Read More

Br J Cancer 2018 Nov 13. Epub 2018 Nov 13.

Winship Cancer Institute, Emory University, Atlanta, GA, USA.

Background: Next-generation sequencing has identified actionable genetic aberrations in intrahepatic cholangiocarcinomas (iCCA), including the fibroblast growth factor receptor 2 (FGFR2) fusions. Derazantinib (ARQ 087), an orally bioavailable, multi-kinase inhibitor with potent pan-FGFR activity, has shown preliminary therapeutic activity against FGFR2 fusion-positive iCCA.

Methods: This multicentre, phase 1/2, open-label study enrolled adult patients with unresectable iCCA with FGFR2 fusion, who progressed, were intolerant or not eligible to first-line chemotherapy (NCT01752920). Read More

J Clin Endocrinol Metab 2018 Nov 9. Epub 2018 Nov 9.

Nephrology, Bambino Gesù Children's Research Hospital.

Context: Type 1A Pseudohypoparathyroidism (PHP-1A) is characterized by target organ resistance to parathyroid hormone (PTH). Patients can show various dysmorphic features, but renal failure is not classically described.

Case Description: A female patient came to our attention at the age of seven years with characteristic signs of PTH resistance, namely hypocalcemia, hyperphosphatemia and high serum PTH levels. Read More

Ther Apher Dial 2018 Nov 8. Epub 2018 Nov 8.

Division of Nephrology, Department of Medicine, Showa University Fujigaoka Hospital.

The classic pathogenesis of secondary hyperparathyroidism (SHPT) began with the trade-off hypothesis based on parathyroid hormone (PTH) hypersecretion brought about by renal failure resulting from a physiological response to correct metabolic disorder of calcium, phosphorus, and vitamin D. In dialysis patients with failed renal function, physiological mineral balance control by PTH through the kidney fails and hyperparathyroidism progresses. In this process, many significant genetic findings have been established. Read More

Clin Exp Nephrol 2018 Nov 7. Epub 2018 Nov 7.

Department of Gastroenterology, Suwa Central Hospital, Chino, Nagano, Japan.

J Bone Miner Res 2018 Nov 5. Epub 2018 Nov 5.

Unit of Endocrinology and Diabetes, University Campus Bio-Medico, Rome, Italy.

Post-surgical hypoparathyroidism (hypoPT) increases fatigue and seems to affect the risk of mortality. Cardiovascular autonomic neuropathy (CAN) is an impairment of the cardiovascular autonomic system, a cause of increased mortality and associated with increased fatigability. The aim of this study is to evaluate CAN in hypoPT and its relationship with hypocalcemia, PTH levels and hyperphosphatemia. Read More

Endocrinol Metab Clin North Am 2018 12 12;47(4):865-888. Epub 2018 Oct 12.

Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, 50 Blossom street, Boston, MA 02114, USA; Pediatric Nephrology Unit, Massachusetts General Hospital, Harvard Medical School, 50 Blossom street, Boston, MA 02114, USA.

Pseudohypoparathyroidism (PHP) refers to a heterogeneous group of uncommon, yet related metabolic disorders that are characterized by impaired activation of the Gsα/cAMP/PKA signaling pathway by parathyroid hormone (PTH) and other hormones that interact with Gsa-coupled receptors. Proximal renal tubular resistance to PTH and thus hypocalcemia and hyperphosphatemia, frequently in presence of brachydactyly, ectopic ossification, early-onset obesity, or short stature are common features of PHP. Registries and large cohorts of patients are needed to conduct clinical and genetic research, to improve the still limited knowledge regarding the underlying disease mechanisms, and allow the development of novel therapies. Read More

Endocrinol Metab Clin North Am 2018 12 11;47(4):839-853. Epub 2018 Oct 11.

Department of Medicine, Division of Endocrinology, Indiana University School of Medicine, 1120 West Michigan Street Cl 365, Indianapolis, IN 46202, USA. Electronic address:

Hypocalcemia and hyperphosphatemia are the pathognomonic biochemical features of hypoparathyroidism, and result directly from lack of parathyroid hormone (PTH) action on the kidney. In the absence of PTH action, the renal mechanisms transporting calcium and phosphate reabsorption deregulate, resulting in hypocalcemia and hyperphosphatemia. Circulating calcium negatively regulates PTH secretion. Read More

Endocrinol Metab Clin North Am 2018 12 12;47(4):809-823. Epub 2018 Oct 12.

Division of Endocrinology and Diabetes, The Center for Bone Health, The Children's Hospital of Philadelphia, Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, 3615 Civic Center Boulevard, Abramson Research Building, Room 510A, Philadelphia, PA 19104, USA.

Hypoparathyroidism is characterized by hypocalcemia and hyperphosphatemia and is due to insufficient levels of circulating parathyroid hormone. Hypoparathyroidism may be an isolated condition or a component of a complex syndrome. Although genetic disorders are not the most common cause of hypoparathyroidism, molecular analyses have identified a growing number of genes that when defective result in impaired formation of the parathyroid glands, disordered synthesis or secretion of parathyroid hormone, or postnatal destruction of the parathyroid glands. Read More

Endocrinol Metab Clin North Am 2018 12 11;47(4):797-808. Epub 2018 Oct 11.

Calcium Disorders Clinic, McMaster University, 50 Charlton Ave East, Hamilton, Ontario L8N 4A6, Canada. Electronic address:

Hypoparathyroidism is a metabolic disorder characterized by hypocalcemia, hyperphosphatemia, and inadequate levels of or function of parathyroid hormone (PTH). The authors review the nonsurgical or medical causes of hypoparathyroidism. The most common of the nonsurgical causes is autoimmune destruction of the parathyroid. Read More

Endocrinol Metab Clin North Am 2018 12 11;47(4):771-782. Epub 2018 Oct 11.

Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, E18-A, 200 1st Street SW, Rochester, MN 55905, USA. Electronic address:

Until recently, very few studies have described the epidemiology of this rare disorder. Several large population-based studies have recently been published describing the prevalence and incidence of hypoparathyroidism in various countries. Some of these studies have described the epidemiology of both postsurgical and nonsurgical hypoparathyroidism. Read More

Nurs Clin North Am 2018 Dec 11;53(4):469-480. Epub 2018 Oct 11.

Austin Peay State University, School of Nursing, 601 College Street, Clarksville, TN 37043, USA.

The frontline nurse is confronted daily with patients that have some type of kidney dysfunction or disease. Some renal issues resolve themselves, some disorders can be reversed, and others are permanent. Major complications from kidney impairment discussed are fluid and electrolyte disequilibrium with common problems in volume overload, hyperkalemia, metabolic acidosis, hyperphosphatemia, and hormonal secretion. Read More

Clin J Am Soc Nephrol 2018 Oct 31. Epub 2018 Oct 31.

Renal Associates, PA, San Antonio, Texas.

Background And Objectives: Patiromer is a sodium-free, nonabsorbed, potassium-binding polymer that uses calcium as the counter-exchange ion and is approved for treatment of hyperkalemia. The 4-week TOURMALINE study in patients with hyperkalemia previously demonstrated that patiromer administered once daily reduces serum potassium similarly when given with or without food. We report a prespecified exploratory efficacy analysis as well as a efficacy and safety analysis of the TOURMALINE study on circulating markers of mineral metabolism. Read More

Curr Cardiol Rev 2018 Oct 31. Epub 2018 Oct 31.

Fundación Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz. Avenida Reyes Católicos 2, 28040, Madrid. Spain.

Vascular calcification is a pathologic phenomenon consisting of calcium phosphate crystal deposition in the vascular walls. Vascular calcification has been found to be a risk factor for cardiovascular diseases, due to its correlation with cardiovascular events and mortality, and it has been associated with aging, diabetes, and chronic kidney disease. Studies of vascular calcification have focused on phosphate homeostasis, primarily on the important role of hyperphosphatemia. Read More

Pflugers Arch 2018 Oct 20. Epub 2018 Oct 20.

Department of Neuroscience, Physiology and Pharmacology, Royal Free Campus, University College London, Rowland Hill Street, London, NW3 2PF, UK.

There has recently been significant interest in the concept of directly targeting intestinal phosphate transport to control hyperphosphatemia in patients with chronic kidney disease. However, we do not have a complete understanding of the cellular mechanisms that govern dietary phosphate absorption. Studies in the 1970s documented both active and passive pathways for intestinal phosphate absorption. Read More

Ann Card Anaesth 2018 Oct-Dec;21(4):455-459

Department of Cardiac Anaesthesiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India.

Background: Acute kidney injury (AKI) is a strong predictor of morbidity and mortality after cardiac surgery. Lack of valid early biomarkers for predicting AKI has hampered the ability to take therapeutic measures for preventive cause. Hyperphosphatemia that occurs in AKI due to renal excretion defect was not studied in this context and could be simple marker of AKI. Read More

Int J Nephrol 2018 19;2018:2138528. Epub 2018 Sep 19.

Clinical Research Centre, Serdang Hospital, Kajang 43000, Malaysia.

Background: Hyperphosphatemia in chronic kidney disease (CKD) patients is often treated with calcium carbonate (CaCO3) despite the fact that CaCO3 is associated with increased calcium load and potentially increased cardiovascular risk. Alternative treatments with noncalcium-based phosphate binders do not increase the calcium load but are more costly. This study analyzes the cost-effectiveness of sevelamer versus CaCO3 for the treatment of hyperphosphatemia in stage III-V predialysis CKD patients in Malaysia. Read More

J Vet Intern Med 2018 Nov 16;32(6):1977-1982. Epub 2018 Oct 16.

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio.

Background: Chronic kidney disease (CKD) is associated with morbidity and mortality in dogs. Plasma fibroblast growth factor-23 (FGF-23) concentration is an independent predictor of CKD progression and survival in cats and people with CKD.

Objectives: To investigate the relationship among FGF-23, parathyroid hormone (PTH), vitamin D metabolites, and other clinical variables with survival time in dogs with CKD. Read More

Chem Sci 2018 Oct 23;9(38):7483-7487. Epub 2018 Jul 23.

College of Chemistry , Chemical Engineering and Materials Science , Collaborative Innovation Center of Functionalized Probes for Chemical Imaging in Universities of Shandong , Key Laboratory of Molecular and Nano Probes , Ministry of Education , Institute of Biomedical Sciences , Shandong Normal University , Jinan 250014 , P. R. China . Email: ; Email:

Hyperphosphatemia is closely associated with the occurrence of multiple organ dysfunctions in patients with end-stage renal disease (ESRD). The application of phosphorus binders as an effective clinical approach for such diseases still suffers from serious side effects. Therefore, development of new phosphorus binders for the treatment of hyperphosphatemia remains a great challenge. Read More

Medicine (Baltimore) 2018 Oct;97(41):e12731

Department of Nephrology, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, China.

Background: Recent evidence has shown that nicotinamide treatment may have an impact on phosphorus metabolism in hemodialysis patients. Nevertheless, the treatment remains controversial. This study aimed to precisely estimate the efficacy and safety of nicotinamide on phosphorus, calcium and iPTH in hemodialysis patients. Read More

QJM 2018 Oct 9. Epub 2018 Oct 9.

Departament of internal medicine of H.U.Marqués de Valdecilla, Santader (España).

Tumor lysis syndrome (TLS) is an oncologic emergency. It's characterized by laboratory findings of hyperkaliemia, hyperuricemia, hyperphosphatemia, and hypocalcemia. Disruption is caused by massive tumor cell lysis in which the contents os the lysed tumor cells are released into bloodstream. Read More

Nephrology (Carlton) 2018 Oct;23 Suppl 4:88-94

Department of Medicine, Fu-Jen Catholic University Hospital, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan.

As the GFR loss aggravates, the disturbed mineral metabolism worsens the bone microstructure and remodelling - scenario, which is known as CKD-mineral bone disease (MBD). CKD-MBD is characterized by : (i) abnormal metabolism of calcium, phosphorus, parathyroid hormone (PTH), or vitamin D; (ii) abnormalities in bone turnover, mineralization, volume linear growth or strength; (iii) soft-tissue calcifications, either vascular or extra-osseous. Uremic vascular calcification and osteoporosis are the most common complications related to CKD-MBD. Read More

Ann Med Surg (Lond) 2018 Nov 19;35:51-54. Epub 2018 Sep 19.

Department of General Surgery, Shanghai Shu Guang Hospital, China.

Background: Secondary hyperparathyroidism(sHPT) is one of the most serious complications in long-term hemodialysis patients. Patients may suffer from metabolic bone diseases, severe atherosclerosis and undesirable cardiovascular events. Endoscopic parathyroidectomy with autotransplantation is a treatment option for those who do not respond to clinical management. Read More

Pediatr Nephrol 2018 Oct 5. Epub 2018 Oct 5.

Amsterdam UMC, Department of Pediatric Oncology, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.

Pediatr Nephrol 2018 Oct 5. Epub 2018 Oct 5.

Amsterdam UMC, Department of Pediatric Oncology, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.

J Pharmacol Exp Ther 2018 Dec 4;367(3):452-460. Epub 2018 Oct 4.

Division of Nephrology and Hypertension, Departments of Medicine (W.L.L., N.D.V., A.C.F.N., M.K.) and Molecular Biology and Biochemistry (W.E., J.P., K.W.), University of California, Irvine, California; Centre for Comparative Genomics and Evolutionary Bioinformatics Integrated Microbiome Resource, Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada (A.M.C., M.G.I.L.); and Department of Cardiology, Fukuoka University, Fukuoka, Japan (Y.S.)

In chronic kidney disease (CKD), the gut microbiome is altered and bacterial-derived uremic toxins promote systemic inflammation and cardiovascular disease. Ferric citrate complex is a dietary phosphate binder prescribed for patients with end-stage kidney disease to treat hyperphosphatemia and secondary hyperparathyroidism. Iron is an essential nutrient in both microbes and mammals. Read More

Int J Colorectal Dis 2018 Dec 2;33(12):1807-1808. Epub 2018 Oct 2.

Institute of Clinical Medicine, National Yang-Ming University School of Medicine, No. 201, Section 2, Shih-Pai Road, Taipei, 11217, Taiwan.

Purpose: Because of the increasing usage of lanthanum carbonate in dialysis patients, clinicians should be aware of its typical radiographic appearance.

Methods: A dialysis patient received a plain film and a computed tomography, both showing a "starry-sky" appearance in the nearly whole colon, and the radiological report mistakenly denoted it as barium.

Results: The patient denied any exposure to barium or radiocontrast medium. Read More

Aging Dis 2018 Oct 1;9(5):769-784. Epub 2018 Oct 1.

1System Biology Department, Alcala University, Alcalá de Henares, Madrid, Spain.

In mammalians, advancing age is associated with sarcopenia, the progressive and involuntary loss of muscle mass and strength. Hyperphosphatemia is an aging-related condition involved in several pathologies. The aim of this work was to assess whether hyperphosphatemia plays a role in the age-related loss of mass muscle and strength by inducing cellular senescence in murine myoblasts and to explore the intracellular mechanism involved in this effect. Read More

Bone 2018 Sep 25. Epub 2018 Sep 25.

The University of Chicago, Chicago, IL, United States. Electronic address:

Hypoparathyroidism is a rare endocrine disorder where deficiency (or lack of effect) of parathyroid hormone results in disordered mineral metabolism leading to hypocalcemia and hyperphosphatemia. Many patients with this disorder have physical, emotional and cognitive complaints suggestive of impaired quality of life (QOL). Several recent studies have demonstrated that hypoparathyroid patients treated with calcium and vitamin D (conventional therapy) have reduced QOL compared to either suitable controls or general population. Read More

J Am Coll Nutr 2018 Sep 26:1-12. Epub 2018 Sep 26.

b Latin American Society of Renal Nutrition, Mexico City, Mexico.

Objective: Hyperphosphatemia is a major contributor to poor outcomes among cases of chronic kidney disease. Considering that foods with high protein content are major sources of phosphorus, a more suitable dietary phosphorus measure is the phosphorus to protein ratio. However, Mexican phosphorus to protein ratio tables do not exist. Read More

Am J Physiol Cell Physiol 2018 Sep 26. Epub 2018 Sep 26.

McAllister Heart Institute, University of North Carolina at Chapel Hill, United States.

Background: Hyperphosphatemia, elevated level of inorganic phosphate (Pi) in serum, is associated with increased cardiovascular morbidities and mortality. The effects of high Pi on endothelial cells are not well studied. This study investigated high Pi-induced endothelial cell apoptosis and the role of microRNA-21. Read More

Atherosclerosis 2018 Nov 30;278:49-59. Epub 2018 Aug 30.

Research Institute and Department of Medicine, NYU Winthrop Hospital, NY, USA. Electronic address:

Mineral bone disease (MBD) is a common complication of chronic kidney disease (CKD) characterized by disruption of normal mineral homeostasis within the body. One or more of the following may occur: hypocalcemia, hyperphosphatemia, secondary hyperparathyroidism (SHPT), decreased vitamin D and vascular calcification (VC). The greater the decrease in renal function, the worse the progression of CKD-MBD. Read More

Nephrology (Carlton) 2018 Sep 21. Epub 2018 Sep 21.

Department of Internal Medicine, Saiyu Soka Hospital.

Background/aims: Hepcidin-25 (HEP-25) and erythroferrone (ERFE) are key regulators of iron homeostasis. Correlations among serum ferritin, ERFE, and HEP-25 levels and improvements in anemia have not been evaluated after administration of ferric citrate hydrate (FCH).

Methods: This retrospective observational study investigated 24 patients on hemodialysis with both anemia (hemoglobin [Hb] < 12 g/dL) and hyperphosphatemia (inorganic phosphorus ≥ 6 mg/dL). Read More

G Ital Nefrol 2018 Sep;35(5)

Presidio Ospedaliero San Paolo, ASST Santi Paolo e Carlo, Milano, Università degli Studi di Milano.

Several studies have evidenced the association between high serum phosphorus concentrations and adverse events especially in patients on dialysis. Recent K-DIGO guidelines suggest lowering elevated phosphate levels toward the normal range. This goal should be achieved by combining dietary counseling, optimizing dialysis procedures and prescribing phosphate binders. Read More

J Clin Invest 2018 Dec 29;128(12):5368-5373. Epub 2018 Oct 29.

Skeletal Disorders and Mineral Homeostasis Section, and.

Hyperphosphatemic familial tumoral calcinosis (HFTC)/hyperostosis-hyperphosphatemia syndrome (HHS) is an autosomal recessive disorder of ectopic calcification due to deficiency of or resistance to intact fibroblast growth factor 23 (iFGF23). Inactivating mutations in FGF23, N-acetylgalactosaminyltransferase 3 (GALNT3), or KLOTHO (KL) have been reported as causing HFTC/HHS. We present what we believe is the first identified case of autoimmune hyperphosphatemic tumoral calcinosis in an 8-year-old boy. Read More

Ann Thorac Surg 2018 Sep 12. Epub 2018 Sep 12.

Department of Surgery, Division of Thoracic Surgery. Electronic address:

Tumor lysis syndrome (TLS) is a life-threatening complication comprised of hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia attributed to release of intracellular contents. While traditionally associated with leukemia and lymphoma after chemotherapy, it is known to occur in solid malignancies. We herein report a rare case of this syndrome after resection of bulky carcinoid tumor of the lung. Read More

Acta Medica (Hradec Kralove) 2018;61(2):53-56

Department of Pediatrics, Pardubice Hospital, Czech Republic.

Calcium is essential for proper muscular function and metabolism. Myopathy with high creatinkinase activity can be a rare manifestation of hypocalcemia of various origin, such as vitamin D deficiency, hypoparathyroidism, pseudohypoparathyroidism (PHP). 16-year old previously healthy boy was admitted to intensive care unit with convulsions lasting for three minutes and a transient loss of consciousness. Read More

Kidney Blood Press Res 2018 13;43(5):1409-1424. Epub 2018 Sep 13.

Department of Molecular Nutrition, Institute of Biomedical Sciences, University of Tokushima Graduate School, Tokushima, Japan.

Background/aims: Hyperphosphatemia is a serious complication of late-stage chronic kidney disease (CKD). Intestinal inorganic phosphate (Pi) handling plays an important role in Pi homeostasis in CKD. We investigated whether intestinal alkaline phosphatase 3 (Akp3), the enzyme that hydrolyzes dietary Pi compounds, is a target for the treatment of hyperphosphatemia in CKD. Read More