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Iran J Kidney Dis 2019 Mar;13(2):98-104

Division of Nephrology and Hypertension, Department of Medicine, University of California, Irvine, USA.

Introduction: Chronic kidney disease (CKD) promotes hypertrophy and fibrosis in heart, and increases the risk of cardiovascular mortality. Ferric citrate is a dietary phosphate binder used to control hyperphosphatemia in CKD patients. It has been shown to raise iron stores, improve anemia and secondary hyperparathyroidism, and decrease vascular calcification in CKD patients. Read More

Clin Kidney J 2019 Apr 19;12(2):294-299. Epub 2018 Sep 19.

Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan.

Background: A sub-analysis of a Phase III study was conducted to identify factors that might predict increased ferritin levels during long-term sucroferric oxyhydroxide (SO) treatment in hemodialysis patients.

Methods: The open-label, multicenter, Phase III study assessed the efficacy and safety of SO 750-3000 mg/day for 52 weeks in Japanese patients with chronic renal failure and hyperphosphatemia. A total of 125 of 161 patients from the Phase III trial, and who had data for ferritin levels after 28 weeks of SO treatment, were evaluated. Read More

Toxins (Basel) 2019 Apr 9;11(4). Epub 2019 Apr 9.

Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology, Dialysis and Renal Transplant Unit, S. Orsola Hospital, University of Bologna, 40138 Bologna, Italy.

Vascular calcification (VC) is common in dialysis and non-dialysis chronic kidney disease (CKD) patients, even in the early stage of the disease. For this reason, it can be considered a CKD hallmark. VC contributes to cardiovascular disease (CVD) and increased mortality among CKD patients, although it has not been proven. Read More

Nutr Diabetes 2019 Apr 3;9(1):14. Epub 2019 Apr 3.

Department of Nephrology, West China Hospital, Sichuan University, 610041, Chengdu, China.

Chronic kidney disease-mineral and bone disorder (CKD-MBD) is a common complication in patients experiencing end-stage renal disease (ESRD). It includes abnormalities in bone and mineral metabolism and vascular calcification. Hyperphosphatemia is a major risk factor leading to morbidity and mortality in patients with chronic kidney disease. Read More

Int J Artif Organs 2019 Mar 28:391398819837546. Epub 2019 Mar 28.

1 Division of Nephrology, Shanghai Pudong Hospital, Fudan University, Pudong Medical Center, Shanghai, China.

Introduction:: Patients with maintenance hemodialysis have experienced long-standing sleep disturbance. In this study, we attempted to explore whether long-term hemoperfusion could improve sleep and increase the overall survival in hemodialysis patients.

Methods:: A total of 158 patients, who underwent routine hemodialysis, were assessed in this study. Read More

Ren Fail 2019 Nov;41(1):72-79

a Dialysis Center , Konkuk University Medical Center , Seoul , Korea.

Background: Hypophosphatemia is common during continuous renal replacement therapy (CRRT) in critically ill patients and can cause generalized muscle weakness, prolonged respiratory failure, and myocardial dysfunction. This study aimed to investigate the efficacy and safety of adding phosphate to the dialysate and replacement solutions to treat hypophosphatemia occurring in intensive CRRT in critically ill patients.

Methods: We retrospectively analyzed 73 patients treated with intensive CRRT (effluent flow ≥35 ml/kg/hr) in the intensive care unit. Read More

Ann Transl Med 2019 Feb;7(3):55

Renal Division and Laboratory of Experimental Nephrology, Department of Health Sciences, University of Milan, Milan, Italy.

Int J Hypertens 2019 17;2019:9189362. Epub 2019 Feb 17.

Department of Nephrology, The Royal Melbourne Hospital, Parkville, Australia.

Chronic kidney disease (CKD) is associated with excess cardiovascular mortality, resulting from both traditional and nontraditional, CKD-specific, cardiovascular risk factors. Nontraditional risk factors include the entity Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) which is characterised by disorders of bone and mineral metabolism, including biochemical abnormalities of hyperphosphatemia and hyperparathyroidism, renal osteodystrophy, and vascular calcification. Increased arterial stiffness in the CKD population can be attributed amongst other influences to progression of vascular calcification, with significant resultant contribution to the cardiovascular disease burden. Read More

Rev Esp Patol 2019 Apr - Jun;52(2):112-116. Epub 2018 Jun 28.

Servicio de Anatomía Patológica, Hospital Fundación Jiménez Díaz, Madrid, España.

Lanthanum carbonate is a non-calcium phosphorus chelator used in the treatment of hyperphosphatemia associated with chronic renal disease. Deposits of lanthanum in the gastrointestinal wall have been recently described but its clinical significance is uncertain. We present a case of a 62-year-old male with chronic renal disease treated with lanthanum carbonate for 3 years, with deposits in his gastric mucosa, found on biopsy for dyspepsia. Read More

Mol Med Rep 2019 May 15;19(5):3622-3632. Epub 2019 Mar 15.

Department of Neonatology, The First People's Hospital of Jingmen, Jingmen, Hubei 448000, P.R. China.

Vascular calcification (VC) is highly prevalent in chronic kidney disease (CKD), especially in patients with end stage renal disease and is strongly associated with cardiovascular morbidity and mortality. Clinical observations have demonstrated that hyperphosphatemia and hyperglycemia can accelerate VC. Spironolactone (SPL) has been proven to improve cardiovascular outcomes in clinical trials and its protective effect on VC has been reported recently; however, the underlying mechanisms are not completely understood and require further investigation. Read More

Sci Rep 2019 Mar 19;9(1):4879. Epub 2019 Mar 19.

Institute of Life Sciences and Bioengineering, Graduate School of Life and Environmental Sciences, University of Tsukuba, Tsukuba, Ibaraki, 305-8572, Japan.

Phosphate binders and dialysis can have harmful side-effects during the treatments of hyperphosphatemia. Therefore, we evaluated the capability of intestinal bacteria (lactic acid bacteria and bifidobacteria) as phosphate-accumulating organisms (PAOs) for phosphate accumulation, with the aim of determining whether PAO-formulated food can prevent hyperphosphatemia in the early stages. However, methods for estimating microbial phosphate-accumulation capacities require significant improvements regarding specificity, cost, and simplicity. Read More

Cell Mol Life Sci 2019 Mar 18. Epub 2019 Mar 18.

Institute for Physiology and Pathophysiology, Johannes Kepler University Linz, Altenberger Strasse 69, 4040, Linz, Austria.

Medial vascular calcification has emerged as a putative key factor contributing to the excessive cardiovascular mortality of patients with chronic kidney disease (CKD). Hyperphosphatemia is considered a decisive determinant of vascular calcification in CKD. A critical role in initiation and progression of vascular calcification during elevated phosphate conditions is attributed to vascular smooth muscle cells (VSMCs), which are able to change their phenotype into osteo-/chondroblasts-like cells. Read More

Case Rep Nephrol 2019 4;2019:4890287. Epub 2019 Feb 4.

Division of Pulmonary and Critical Care Medicine, Pikeville Medical Center, USA.

Acute hyperuricemia most commonly occurs in patients who experience tumor lysis syndrome. Hyperuricemia along with other electrolyte abnormalities like hyperkalemia, hypocalcemia, and hyperphosphatemia leads to acute kidney injury (AKI) due to acute uric acid nephropathy which is associated with significant morbidity. High risk patients are thus closely monitored for signs of these laboratory abnormalities. Read More

Vet Clin Pathol 2019 Mar 12;48(1):89-95. Epub 2019 Mar 12.

Centro Veterinario Los Sauces, Madrid, Spain.

Two pet rabbits were presented with an acute decrease in appetite and activity. Rabbit 1 showed severe hypothermia, bradycardia, arrhythmias, a heart murmur, dyspnea, occlusion of the nares with secretions, icterus, dehydration, and gaseous gastrointestinal dilation. The urine was dark yellow. Read More

J Am Soc Nephrol 2019 Apr 7;30(4):641-652. Epub 2019 Mar 7.

Division of Nephrology, Stanford University School of Medicine, Stanford, California.

Background: Guidelines recommend reducing elevated serum phosphate in patients with CKD. Tenapanor, a minimally absorbed inhibitor of gastrointestinal sodium/hydrogen exchanger 3 (NHE3), reduces paracellular phosphate transport.

Methods: In this phase 3 randomized, double-blind trial, we randomly assigned patients with hyperphosphatemia receiving maintenance hemodialysis to receive twice-daily oral tenapanor (3, 10, or 30 mg [the latter down-titrated, if needed]) for 8 weeks. Read More

J Ren Nutr 2019 Mar 4. Epub 2019 Mar 4.

Division of Nephrology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana; Department of Medicine, Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana. Electronic address:

Phosphate binders are commonly prescribed in patients with end-stage kidney disease to prevent and treat hyperphosphatemia. These binders are usually associated with gastrointestinal distress, may bind molecules other than phosphate, and may alter the gut microbiota, altogether having systemic effects unrelated to phosphate control. Sevelamer is the most studied of the available binders for nonphosphate-related effects including binding to bile acids, endotoxins, gut microbiota-derived metabolites, and advanced glycation end products. Read More

Pediatr Nephrol 2019 Mar 6. Epub 2019 Mar 6.

Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany.

Background: Paediatric dialysis patients still suffer from high morbidity rates. To improve this, quality assurance programs like the German QiNKid (Quality in Nephrology for Children)-Registry have been developed. In our study, the significance of underlying renal disease on a range of clinical and laboratory parameters impacting morbidity and mortality was analysed. Read More

Biomed Pharmacother 2019 Mar 7;111:909-916. Epub 2019 Jan 7.

Department of Pharmacology, College of Pharmacy, Inner Mongolian Medical University, Jinshan Street, Hohhot 010110, Inner Mongolia Autonomous Region, China. Electronic address:

This study is to determine the pharmacological effects of nano-lanthanum hydroxide (nano-LH) in the treatment of hyperphosphatemia, in comparison with other phosphate binders. Rat models of chronic renal failure and hyperphosphatemia were induced by adenine, which were treated with nano-LH (0.15, 0. Read More

Carbohydr Polym 2019 May 19;212:378-386. Epub 2019 Feb 19.

School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.

Current phosphate binders used for hyperphosphatemia treatment need large daily dose which make patients' compliance worse and the therapeutic efficacy may not conform the expectation. In this study, three polyacid modified iron-based chitosan derivatives were developed as an oral phosphate binding agent to improve phosphorus adsorption efficacy. The result showed that modification of chitosan by citric acid (CA) could facilitate the conjugation of iron by two folds (272. Read More

Sudan J Paediatr 2018 ;18(2):42-47

Department of Clinical Biochemistry, Klatovy Hospital, Klatovy, Czech Republic.

Neonatal hypocalcemia is defined as serum calcium (S-Ca) < 2.0 mmol/l in full-term newborns and <1.75 mmol/l in preterm newborns. Read More

Indian J Endocrinol Metab 2018 Nov-Dec;22(6):735-739

Department of Biochemistry, GGS Medical College, Faridkot, Punjab, India.

Parathyroid hormone (PTH) is the main regulator of calcium, phosphate, magnesium, sodium, and potassium homeostasis. Therefore, this study was conducted to evaluate the relationship between PTH and aforementioned minerals in end-stage renal disease (ESRD) patients.

Aim: The aim of this study was to estimate serum intact parathormone (iPTH) and other biochemical parameters in ESRD patients and to find correlation between serum iPTH and biochemical parameters in the study group. Read More

Dent J (Basel) 2019 Feb 11;7(1). Epub 2019 Feb 11.

School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, N2L 3G1, Canada.

An association between periodontal disease and cancer has been established in recent studies, but no common etiology has been identified in the hopes of reducing the global burden of these non-communicable diseases. This perspective article hypothesizes that the determinant mediating the association of periodontal disease with cancer is dysregulated phosphate metabolism. Phosphate, an essential dietary micronutrient, is dysregulated in chronic kidney disease, and both cancer and periodontal disease are associated with chronic kidney disease. Read More

Ann Pediatr Cardiol 2019 Jan-Apr;12(1):10-17

Department of Clinical Pathology, Tanta Faculty of Medicine, Tanta, Egypt.

Background: Cardiovascular morbidity (CVM) is the main etiology of mortality in children and adolescents with chronic kidney disease (CKD). CKD associated cardiovascular mortality is more common in children with diastolic cardiac dysfunction which was considered as an early indicator for death, while increased left ventricular mass (LVM) is a strong independent risk factor for these patients. Vitamin D deficiency was previously studied as one of the risk factors for CVM. Read More

Clin Cancer Res 2019 Feb 11. Epub 2019 Feb 11.

Memorial Sloan Kettering Cancer Center, New York, New York.

To investigate tolerability, efficacy, and pharmacokinetics/pharmacodynamics of Debio 1347, a selective FGFR inhibitor. This was a first-in-human, multicenter, open-label study in patients with advanced solid tumors harboring gene alterations. Eligible patients received oral Debio 1347 at escalating doses once daily until disease progression or intolerable toxicity. Read More

J Bras Nefrol 2019 Feb 4. Epub 2019 Feb 4.

NephroCare Lumiar, Lisboa, Portugal.

Introduction: Hyperphosphatemia is a serious consequence of chronic kidney disease and has been associated with an increased risk for cardiovascular disease. Controlling serum phosphorus levels in patients on dialysis is a challenge for the clinicians and implies, in most cases, the use of phosphate binders (PB). Part of the reason for this challenge is poor adherence to treatment because of the high pill burden in this patient group. Read More

J Trace Elem Med Biol 2019 Mar 8;52:1-5. Epub 2018 Nov 8.

Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China. Electronic address:

The present study aims to assess arsenic accumulation and explore its association with renal function and biomarkers of CVD risk in chronic kidney disease patients receiving continuous ambulatory peritoneal dialysis (CAPD). The serum was collected from 87 CAPD patients and 26 healthy subjects between 2015 and 2016. The arsenic concentration was measured by inductively coupled plasma mass spectrometer. Read More

Nephron 2019 Feb 7:1-12. Epub 2019 Feb 7.

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

Background: Hyperphosphatemia is a major accelerator of complications in chronic kidney disease and dialysis, and phosphate (Pi) binders have been shown to regulate extracellular Pi levels. Research on hyperphosphatemia in mouse models is scarce, and few models display hyperphosphatemia induced by glomerular injury, despite its relevance to human glomerular disease conditions. In this study, we investigated the involvement of hyperphosphatemia in kidney disease progression using a mouse model in which hyperphosphatemia is induced by focal segmental glomerulosclerosis (FSGS). Read More

BMC Nephrol 2019 Feb 4;20(1):37. Epub 2019 Feb 4.

Manchester Academic Health Science Center, Manchester, UK.

Background: Hyperphosphataemia in dialysis subjects is associated with increased mortality. However cause and effect has not been proven, and the ideal phosphate target range is unknown despite KDOQI's call for studies over 12 years ago. The design and conduct of a randomized controlled trial is challenging because maintaining two groups within differing target ranges of serum phosphate has not been achieved over a long follow-up of 1 year, in a trial setting, before. Read More

Am J Case Rep 2019 Feb 3;20:146-150. Epub 2019 Feb 3.

Department of Hemato-Oncology, Chosun University Hospital, Gwangju, South Korea.

BACKGROUND Tumor lysis syndrome (TLS) is an oncologic emergency resulting from the massive destruction of tumor cells after cytotoxic chemotherapy for chemosensitive malignancies with a high tumor burden. Its clinical manifestations include severe electrolyte disturbances, metabolic acidosis, acute renal failure secondary to urate deposition in the kidney, heart, and skeletal muscle, and nervous system dysfunction. We report an extremely rare case of spontaneous TLS (STLS) in idiopathic primary myelofibrosis (PMF). Read More

Ter Arkh 2018 Jun;90(6):48-54

I.M. Sechenov First Moscow State Medical University, Ministry of Health (Sechenov University), Moscow, Russia.

Aim: Aim of the study was to explore the role of the FGF-23/sKlotho/sclerostin ratio disturbance in the determining of cardiovascular risk in end stage renal disease (ESRD) patients, receiving treatment with regular hemodialysis (НD) or hemodiafiltration (НDF) online in Russia.

Materials And Methods: 42 patients with ESRD, at the age of 18-55 years, treated with HD or HDF on line for at least 6 months, were examined. 22 (52. Read More

J Cell Physiol 2019 Jan 31. Epub 2019 Jan 31.

Department of Nephrology, The First Hospital of China Medical University, Shenyang, P. R. China.

Pathological calcification represents an event that consequently leads to a distinct elevation in the morbidity and mortality of patients with chronic kidney disease (CKD) in addition to strengthening its correlation with hyperphosphatemia. Epigenomic regulation by specific microRNAs (miRNAs) is reported to be involved in ectopic calcification. However, the finer molecular mechanisms governing this event remain unclear. Read More

Colomb Med (Cali) 2018 Dec 30;49(4):288-291. Epub 2018 Dec 30.

Complejo Asistencial Universitario de León, Servicio de Nefrología, León, España.

Introduction: Calciphylaxis is an infrequent disease that almost exclusively affects patients with chronic kidney disease, although cases have been observed in patients without renal function impairment. The diagnosis is mainly made by clinical manifestations and subsequently confirmed by radiological and histological study. The optimal treatment is not known, although there is a consensus that a multifactorial approach is required. Read More

Am J Kidney Dis 2019 Apr 25;73(4):542-551. Epub 2019 Jan 25.

Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address:

Careful dietary management that reduces high phosphate intake is recommended to slow the progression of chronic kidney disease (CKD) and prevent complications of CKD and may help reduce chronic disease risks such as incident CKD associated with high phosphate intake in the healthy general population. For patients treated with maintenance dialysis, control of serum phosphorus levels is considered a marker of good care and requires a coordinated plan that limits dietary phosphate intake, uses oral phosphate binders, and provides an adequate dialysis prescription. Even with traditional thrice-weekly hemodialysis or peritoneal dialysis, use of phosphate binders, and a concerted effort to limit dietary phosphate intake, adequately controlled serum phosphorus levels are not possible in all dialysis patients. Read More

Pflugers Arch 2019 Jan 26. Epub 2019 Jan 26.

Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Fahrstr. 17, D-91054, Erlangen, Germany.

Fibroblast growth factor 23 (FGF23) levels are elevated in patients with acute kidney injury (AKI). The consequences on renal Ca, Mg, and P regulatory mechanisms are unknown. We hypothesized that renal ischemia-reperfusion (I/R) injury alters the expression of important renal Ca, Mg, and P transport proteins. Read More

J Ren Nutr 2019 Jan 21. Epub 2019 Jan 21.

University of California Irvine, School of Medicine, Orange, California. Electronic address:

Objective: The high pill burden of many phosphate binders (PBs) may contribute to increased prevalence of hyperphosphatemia and poor nutritional status observed among patients undergoing maintenance hemodialysis therapy. We examined the real-world effectiveness of sucroferric oxyhydroxide (SO), a PB with low pill burden, in managing serum phosphorus in patients with prevalent hemodialysis over a 1-year period.

Design: Historical cohort analyses of de-identified electronic medical records. Read More

Calcif Tissue Int 2019 Jan 23. Epub 2019 Jan 23.

Department of Clinical Nutrition and Food Management, Institute of Biomedical Sciences, University of Tokushima Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan.

Inorganic phosphate (Pi) is an essential nutrient for maintaining various biological functions, particularly during growth periods. Excess intake of dietary Pi increases the secretion of fibroblast growth factor 23 (FGF23) and parathyroid hormone to maintain plasma Pi levels. FGF23 is a potent phosphaturic factor that binds to the α-klotho/FGFR complex in the kidney to promote excretion of Pi into the urine. Read More

Best Pract Res Clin Endocrinol Metab 2018 12 28;32(6):927-939. Epub 2018 Sep 28.

Department of Surgery and Translational Medicine, University of Florence, Bone Metabolic Diseases Unit, University Hospital of Florence, Italy. Electronic address:

The clinical manifestations of hypoparathyroidism are variable and can involve almost any organ system. The main clinical features of the hypoparathyroidism are typically signs or symptoms due to neuromuscular irritability owing to low serum calcium level. In addition to hypocalcemia, hyperphosphatemia can contribute to long-term complications, including extra-skeletal calcifications. Read More

Metabolism 2019 Jan 19. Epub 2019 Jan 19.

Paris Descartes University of Medicine, Necker-Enfants Malades Institute, INSERM U1151, France; Functional Exploration Department, Necker-Enfants Malades Hospital, AP-HP, Paris, France.

Phosphate is a cornerstone of several physiological pathways including skeletal development, bone mineralization, membrane composition, nucleotide structure, maintenance of plasma pH, and cellular signaling. The kidneys have a key role in phosphate homeostasis with three hormones having important functions in renal phosphate handling or intestinal absorption: parathyroid hormone (PTH), fibroblast growth factor 23 (FGF23), and 1-25-dihydroxyvitamin D (1,25(OH)2D). FGF23 is mainly synthesized by osteocytes; it is a direct phosphaturic factor that also inhibits 1,25(OH)2D and PTH. Read More

Expert Rev Pharmacoecon Outcomes Res 2019 Jun 21;19(3):287-298. Epub 2019 Jan 21.

a Pharmacoepidemiology-Pharmacovigilance, Pharmacy Programme , Department of Life and Health Sciences, School of Science and Engineering , University of Nicosia, Nicosia , Cyprus.

Introduction: End-stage renal disease is associated with significant comorbidity and mortality. Among its implications, hyperphosphatemia constitutes a consistent and independent risk factor. The use of benchmark treatment, low-cost calcium-based binders declined due to a potential calcification effect on coronary arteries. Read More

Exp Ther Med 2019 Jan 28;17(1):863-868. Epub 2018 Nov 28.

Neonatology Department, The First People's Hospital of Jingmen, Jingmen, Hubei 448000, P.R. China.

Vascular calcification (VC) is common in patients with diabetes and/or chronic kidney disease (CKD). It is strongly associated with cardiovascular morbidity and mortality. Hyperphosphatemia caused by CKD induces the transformation of vascular smooth muscle cells (VSMCs) into chondrocytes or osteoblast-like cells. Read More

Nutrients 2019 Jan 12;11(1). Epub 2019 Jan 12.

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

Vascular calcification is a critical complication in patients with chronic kidney disease (CKD) because it is predictive of cardiovascular events and mortality. In addition to the traditional mechanisms associated with endothelial dysfunction and the osteoblastic transformation of vascular smooth muscle cells (VSMCs), the regulation of calcification inhibitors, such as calciprotein particles (CPPs) and matrix vesicles plays a vital role in uremic vascular calcification in CKD patients because of the high prevalence of vitamin K deficiency. Vitamin K governs the gamma-carboxylation of matrix Gla protein (MGP) for inhibiting vascular calcification, and the vitamin D binding protein receptor is related to vitamin K gene expression. Read More

Front Horm Res 2019 19;51:147-159. Epub 2018 Nov 19.

Pseudohypoparathyroidism (PHP), pseudo-PHP, acrodysostosis, and progressive osseous heteroplasia are heterogeneous disorders characterized by physical findings, differently associated in each subtype, including short bones, short stature, a stocky build, ectopic ossifications (features associated with Albright's hereditary osteodystrophy), as well as laboratory abnormalities consistent with hormone resistance, such as hypocalcemia, hyperphosphatemia, and elevated parathyroid hormone (PTH) and thyroid-stimulating hormone levels. All these disorders are caused by impairments in the cAMP-mediated signal transduction pathway and, in particular, in the PTH/PTHrP signaling pathway: the main subtypes of PHP and related disorders are caused by de novo or autosomal dominantly inherited inactivating genetic mutations, and/or epigenetic, sporadic, or genetic-based alterations within or upstream of GNAS, PRKAR1A, PDE4D, and PDE3A. Here we will review the impressive progress that has been made over the past 30 years on the pathophysiology of these diseases and will describe the recently proposed novel nomenclature and classification. Read More

Front Horm Res 2019 19;51:109-126. Epub 2018 Nov 19.

The regulation of plasma calcium levels is essential for the normal physiologic function of every cell. Parathyroid hormone (PTH) is the principal regulator of serum calcium and phosphate homeostasis. PTH is synthesized and secreted by the parathyroid chief cells in the parathyroid glands primarily in response to a decline in serum calcium levels. Read More

Nephrol Ther 2019 Mar 11;15(1):29-34. Epub 2019 Jan 11.

NephroCare Tassin-Charcot, 69110 Sainte-Foy-Lès-Lyon, France.

Introduction: Despite a better management of hyperphosphatemia in haemodialysis patients observed during the past years, most of them remain insufficiently treated and exposed to bone and cardiovascular complications that are associated with this biological abnormality. The availability of calcium-free phosphate binders among therapeutical options is confirmed to significantly reduce serum phosphate levels without the risk of excess exposure to calcium. Currently sucroferric oxyhydroxyde (SO) is the only iron-based phosphate binder available in France. Read More

Lancet 2019 01;393(10167):168

Department of Orthopaedics, All India Institute of Medical Sciences, Bhopal, India.

Adv Exp Med Biol 2019;1133:75-81

Department of Pediatrics and Nephrology, Warsaw Medical University, Warsaw, Poland.

The incidence of urolithiasis in infants is unknown. The aim of this study was to investigate clinical characteristics, nutrition, calcium, phosphate, 25-hydroxyvitamin D (25(OH)D), alkaline phosphate, and parathyroid hormone in infants with urolithiasis. There were 32 infants (23 boys and 9 girls) of the mean age of 6. Read More

Pediatr Emerg Care 2019 Jan 7. Epub 2019 Jan 7.

We present a case of a 20-month-old girl who presented to the emergency department with anorexia, progressive weakness, and lethargy who was found to have severe hypercalcemia (20.7 mg/dL) and vitamin D hypervitaminosis. Further questioning revealed that this was secondary to a subacute toxic ingestion of "L'il Critters" calcium and vitamin D3 gummy vitamins that were being administered by the patient's mother multiple times a day for several weeks or even months. Read More

Kidney Res Clin Pract 2018 Dec 31;37(4):420-421. Epub 2018 Dec 31.

Department of Inter-Organ Communication Research in Kidney Disease, Osaka University Graduate School of Medicine, Suita, Japan.

J Clin Endocrinol Metab 2019 Apr;104(4):1325-1335

Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India.

Context: Patients with hypoparathyroidism are treated with vitamin D and calcium. PTH is an emerging option because of its physiological action. It is important to assess the efficacy and shortcomings of conventional therapy. Read More

Semin Nephrol 2019 01;39(1):41-56

Division of Nephrology, Department of Medcine, New York Medical College, Valhalla, NY.

Dysregulated mineral metabolism is a nearly universal sequalae of acute kidney injury (AKI). Abnormalities in circulating mineral metabolites observed in patients with AKI include hypocalcemia, hyperparathyroidism, hyperphosphatemia, decreased vitamin D metabolite levels, and increased fibroblast growth factor 23 levels. We review the pathophysiology of dysregulated mineral metabolism in AKI with a focus on calcium, phosphate, parathyroid hormone, and vitamin D metabolites. Read More