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    [Tetany secondary to phosphate enema toxicity, case report].
    Rev Chil Pediatr 2017 Jun;88(3):383-387
    Área de Cuidados Críticos, Hospital Padre Hurtado, Chile.
    Phosphate enemas are frequently used in the treatment of constipation. Errors in dosage and administration can lead to severe complications.

    Objective: To report a case of severe toxicity of phosphate enemas in a child with no risk factors. Read More

    Can adverse effects of excessive vitamin D supplementation occur without developing hypervitaminosis D?
    J Steroid Biochem Mol Biol 2017 Jul 19. Epub 2017 Jul 19.
    Department of Applied Oral Sciences, Forsyth Institute, Cambridge, MA, USA; Department of Preventive & Community Dentistry, School of Dentistry, University of Rwanda College of Medicine & Health Sciences, Kigali, Rwanda; Department of Oral Health Policy & Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA; Department of Pathology, Lake Erie College of Osteopathic Medicine, Lake Erie, PA, USA. Electronic address:
    Vitamin D is a fat-soluble hormone that has endocrine, paracrine and autocrine functions. Consumption of vitamin D-supplemented food & drugs have increased significantly in the last couple of decades due to campaign and awareness programs. Despite such wide use of artificial vitamin D supplements, serum levels of 25 hydroxyvitamin D [25(OH)D] does not always reflect the amount of uptake. Read More

    Initiation of Sevelamer and Mortality among Hemodialysis Patients Treated with Calcium-Based Phosphate Binders.
    Clin J Am Soc Nephrol 2017 Jul 19. Epub 2017 Jul 19.
    Arbor Research Collaborative for Health, Ann Arbor, Michigan.
    Background And Objectives: Prior studies have shown that sevelamer attenuates progression of arterial calcification and may reduce the risk of death compared with calcium-based phosphate binders. In clinical practice, however, sevelamer is used not only as an alternative but also as an add-on therapy in patients already being treated with calcium-based phosphate binders. We analyzed the Dialysis Outcomes and Practice Patterns Study (DOPPS) data to test the hypothesis that the initiation of sevelamer is associated with improved survival in patients on hemodialysis treated with calcium-based phosphate binders. Read More

    Iron-based phosphate binders: a paradigm shift in the treatment of hyperphosphatemic anemic CKD patients?
    J Nephrol 2017 Jul 17. Epub 2017 Jul 17.
    Department of Nephrology and Dialysis, Alessandro Manzoni Hospital, ASST Lecco, Via dell'Eremo 9/11, 23900, Lecco, Italy.
    The partial correction of anemia and the normalization of phosphate and blood pressure are the mainstay of treatment of patients with chronic kidney disease (CKD). Available anti-hypertensive drugs, erythropoiesis stimulating agents (ESAs) and iron supplements have resolved quite satisfactorily the goal of controlling hypertension and partially correcting anemia. Unfortunately, the treatment of hyperphosphatemia is still far from resolved. Read More

    [Phosphate binders : What are the recent evidences ?]
    Rev Med Suisse 2017 Feb;13(551):468-472
    Service de néphrologie, Département des spécialités de médecine interne, HUG, 1211 Genève 14.
    Hyperphosphatemia is a late complication of chronic kidney disease (CKD). It is a major non-traditional cardiovascular risk factor in CKD. The management of hyperphosphatemia is based on restriction of phosphate intake, phosphate binders and dialysis. Read More

    Chronic Kidney Disease (CKD): An Observational Study of Etiology, Severity and Burden of Comorbidities.
    Indian J Pediatr 2017 Jul 15. Epub 2017 Jul 15.
    Department of Pediatric Nephrology, St John's Medical College Hospital, Bangalore, 560034, India.
    Objectives: To study the etiology and burden of comorbidities across stages of chronic kidney disease (CKD).

    Methods: Children, 2-16 y of age with CKD Stages II- IV were recruited over 12 mo. The etiology, clinical presentation and severity of complications were studied. Read More

    Soluble ST2 does not change cardiovascular risk prediction compared to cardiac troponin T in kidney transplant candidates.
    PLoS One 2017 13;12(7):e0181123. Epub 2017 Jul 13.
    Division of Cardiology, Department of Medicine, Mayo Clinic, Phoenix, Arizona, United States of America.
    Background: Solubility of Tumorigenicity 2 (sST2) is a novel biomarker that better stratifies risk of cardiovascular events (CVE) compared to cardiac troponin T(cTnT) in heart failure. We assessed the association of sST2 with the composite outcome of CVE and/or mortality compared to cTnT in kidney transplant candidates.

    Methods: 200 kidney transplant candidates between 2010 and 2013 were included. Read More

    PA21, a novel phosphate binder, improves renal osteodystrophy in rats with chronic renal failure.
    PLoS One 2017 13;12(7):e0180430. Epub 2017 Jul 13.
    Pharmacology Research Laboratory, R&D., Kissei Pharmaceutical Co., Ltd., Azumino-City, Nagano-Pref., Japan.
    The effects of PA21, a novel iron-based and non-calcium-based phosphate binder, on hyperphosphatemia and its accompanying bone abnormality in chronic kidney disease-mineral and bone disorder (CKD-MBD) were evaluated. Rats with adenine-induced chronic renal failure (CRF) were prepared by feeding them an adenine-containing diet for four weeks. They were also freely fed a diet that contained PA21 (0. Read More

    The coronary artery calcification score and common iliac artery calcification score in non-dialysis CKD patients.
    Nephrology (Carlton) 2017 Jul 13. Epub 2017 Jul 13.
    Department of Nephrology, Ichiyokai Harada Hospital, 7-10 Kairoyama-cho, Saeki-ku, Hiroshima, 731-5134, Japan.
    Aim: Many studies have validated Agatston's coronary artery calcification score (CACS) for assessing vascular calcification (VC) in chronic kidney disease (CKD) patients. This study aimed to evaluate the CACS and common iliac artery calcification score (IACS) and to examine the variables related to each score.

    Methods: The subjects were 145 non-dialysis CKD patients. Read More

    Daboia (Vipera) palaestinae envenomation in horses: Clinical and hematological signs, risk factors for mortality and construction of a novel severity scoring system.
    Toxicon 2017 Jul 8;137:58-64. Epub 2017 Jul 8.
    Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel.
    Daboia palaestinae is the most common venomous snake in Israel and an important cause of envenomations in humans and animals. Although specific antivenom is produced from horses, little documentation exists regarding the characteristics of envenomed horses. This survey was constructed to describe the clinical, hematological and biochemical characteristics of D. Read More

    A Combined Deposition of Lanthanum and β2-Microglobulin-Related Amyloid in the Gastroduodenal Mucosa of Hemodialysis-Dependent Patients: An Immunohistochemical, Electron Microscopic, and Energy Dispersive X-Ray Spectrometric Analysis.
    Int J Surg Pathol 2017 Jul 1:1066896917718623. Epub 2017 Jul 1.
    1 Shimane University, Izumo, Shimane, Japan.
    Lanthanum carbonate (LC) is a new type of phosphate adsorbent used to treat patients with hyperphosphatemia caused by chronic kidney diseases. Recent studies have pointed out that lanthanum deposition can be found in the cytoplasm of histiocytes in the gastroduodenal mucosa of these patients. On the other hand, it is well known that patients on long-term hemodialysis can develop deposition of β2-microglobulin-related amyloid (Aβ2M) mainly around joints. Read More

    Gastric lanthanosis (lanthanum deposition) in dialysis patients treated with lanthanum carbonate.
    Pathol Int 2017 Jun 28. Epub 2017 Jun 28.
    Department of Diagnostic Pathology, Faculty of Medicine Oita University, Oita, Japan.
    Lanthanum carbonate (LaC) is used to prevent hyperphosphatemia in dialysis patients. It is commonly believed that there is little LaC absorption from the intestines. However, La deposition in the gastric mucosa, which we coined "gastric lanthanosis", was recently reported. Read More

    Cost-effectiveness of dedicated dietitians for hyperphosphatemia management among hemodialysis patients in Lebanon: results from the Nutrition Education for Management of Osteodystrophy trial.
    J Med Econ 2017 Jul 13:1-15. Epub 2017 Jul 13.
    a Department of Health Services Research , CAPHRI, Care and Public Health Research Institute, Maastricht University , Maastricht , The Netherlands.
    Aim: To assess the cost-effectiveness of nutrition education by dedicated dietitians (DD) for hyperphosphatemia management among hemodialysis patients.

    Materials And Methods: This was a trial-based economic evaluation in 12 Lebanese hospital-based units. In total, 545 prevalent patients were cluster randomized to DD, trained hospital dietitian (THD), and existing practice (EP) groups. Read More

    Nutritional status among peritoneal dialysis patients after oral supplement with ONCE dialyze formula.
    Int J Nephrol Renovasc Dis 2017 13;10:145-151. Epub 2017 Jun 13.
    Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok.
    Background: Malnutrition is an important problem in patients treated with long-term dialysis, and most dialysis patients have lower dietary energy and protein intake. This study was undertaken to examine whether orally administered Otsuka Nutrition Pharmaceutical (ONCE) dialyze formula (ODF) supplement would improve energy intake without mineral and electrolyte disturbances in patients with continuous ambulatory peritoneal dialysis (CAPD).

    Methods: The effects of ODF supplementation on nutrition markers including serum albumin and prealbumin concentrations and inflammatory stress in patients with chronic CAPD were evaluated. Read More

    How to assess the efficacy of phosphate binders.
    Nefrologia 2017 May - Jun;37(3):311-319
    Servicio de Nefrología, Hospital Infanta Cristina, Badajoz, España.
    Background And Aims: The efficacy of phosphate binders is difficult to be estimated clinically. This study analyzes the changes in serum phosphate and urinary phosphate excretion after the prescription of phosphate binders (PB) in patients with chronic kidney disease stage 4-5 pre-dialysis, and the usefulness of the ratio between total urinary phosphate and protein catabolic rate (Pu/PCR) for estimating the efficacy of PB.

    Methods: This retrospective observational cohort study included adult chronic kidney disease patients. Read More

    Executive summary of the 2017 KDIGO Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) Guideline Update: what's changed and why it matters.
    Kidney Int 2017 Jul;92(1):26-36
    Stanford University School of Medicine, Stanford, California, USA. Electronic address:
    The KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of CKD-MBD represents a selective update of the prior CKD-MBD Guideline published in 2009. This update, along with the 2009 publication, is intended to assist the practitioner caring for adults and children with chronic kidney disease (CKD), those on chronic dialysis therapy, or individuals with a kidney transplant. This review highlights key aspects of the 2017 CKD-MBD Guideline Update, with an emphasis on the rationale for the changes made to the original guideline document. Read More

    [Endocrine control of serum phosphate: from the discoveries of phosphatonins to novel therapies].
    Ann Endocrinol (Paris) 2016 Oct;77 Suppl 1:S36-S42
    AP-HP Department of Odontology, Bretonneau Hospital, and Reference Center for Rare Diseases of Calcium and Phosphorus Metabolism, and EA 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, School of Dentistry University Paris Descartes Sorbonne, 12 Rue de l'École de Médecine, 75006 Paris, France.
    Phosphate is absorbed through the gut, stored in the bone and reabsorbed through the proximal renal tubule. More importantly, PTH and FGF23 have been identified as the main phosphaturic factors that control the expression of the phosphate co-transporters NaPi-IIa et IIc. By allowing the adjustment of the urinary phosphate reabsorption, these two phosphatonins play a major role in bone and tooth mineralization and growth. Read More

    Hyperphosphatemia in a patient with spinal cord injury who received etidronate for the treatment of heterotopic ossification.
    Spinal Cord Ser Cases 2017 8;3:17032. Epub 2017 Jun 8.
    Department of Physical Medicine and Rehabilitation, Ege University School of Medicine, Izmir, Turkey.
    Introduction: Heterotopic ossification (HO) is defined as ectopic bone formation around peripheral joints and in soft tissues. HO is a common complication of diseases of the central nervous system, such as spinal cord injury (SCI) and traumatic brain injury. HO is seen in up to 50% of patients with SCI and typically occurs in the first 12 weeks after onset of injury. Read More

    All that glitters is not gold: A case of lanthanum carbonate aspiration.
    SAGE Open Med Case Rep 2017 2;5:2050313X17712642. Epub 2017 Jun 2.
    Department of General Surgery, University of Maryland Medical Center, Baltimore, MD, USA.
    Introduction: Foreign body aspiration is a significant cause of morbidity and mortality in elderly hospitalized patients. These are typically small items that patients have access to, including small coins.

    Case Presentation: This is a case report of a 75-year-old man recently bedridden from a large hemispheric stroke with sudden onset of hoarseness, cough and dysphagia. Read More

    Hypercalcemia due to Nasopharyngeal Carcinoma.
    JNMA J Nepal Med Assoc 2017 Jan-Mar;56(205):182-185
    Department of Pediatrics & Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal.
    Hypercalcemia is a rare metabolic disorder associated with hyperparathyroidism, malignancy and various other causes. Although common in adult malignancies, hypercalcemia is rare in pediatrics and purports poor prognosis. Nasopharyngeal carcinoma is rare with no reported hypercalcemic presentation. Read More

    A Phase 1 Study of LY2874455, an Oral Selective pan-FGFR Inhibitor, in Patients with Advanced Cancer.
    Target Oncol 2017 Aug;12(4):463-474
    Division of Cancer Medicine, Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, VIC, 3000, Australia.
    Background: We report here a phase 1 study of LY2874455, a potent oral selective pan-fibroblast growth factor receptor (FGFR) inhibitor.

    Objective: The primary objective was to determine the recommended phase 2 dosing (RP2D). Secondary objectives included determining toxicity, antitumor activity, pharmacokinetics (PK), and pharmacodynamic (PD) properties of LY2874455. Read More

    Treatment-naïve spontaneous tumor lysis syndrome in metastatic prostate adenocarcinoma: An unusual suspect.
    Am J Emerg Med 2017 May 26. Epub 2017 May 26.
    Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States. Electronic address:
    Tumor lysis syndrome (TLS) is a potentially fatal condition defined both by laboratory and clinical criteria. It is caused by the catabolism of tumor cells which leads to considerable release and elevated levels of phosphate, potassium and uric acid in the bloodstream. These electrolyte derangements predispose patients to renal tubule uric acid precipitation, acute kidney injury, arrhythmias, neuromuscular irritability and even seizures. Read More

    Real-world effectiveness of sucroferric oxyhydroxide in patients on chronic hemodialysis: A retrospective analysis of pharmacy data
    Clin Nephrol 2017 Aug;88(8):59-67
    Aims: Hyperphosphatemia has been associated with an increased risk of mortality in patients with end-stage renal disease. We sought to assess the real-world effectiveness of sucroferric oxyhydroxide (SO), an iron-based phosphate binder (PB), in control of serum phosphorus levels, and to determine the associated pill burden in hemodialysis patients.

    Materials And Methods: Adult, in-center hemodialysis patients first prescribed SO through a renal pharmacy service as part of routine clinical care between April 1, 2014 and March 31, 2015 were included in the analysis. Read More

    A Review of Phosphate Binders in Chronic Kidney Disease: Incremental Progress or Just Higher Costs?
    Drugs 2017 Jul;77(11):1155-1186
    Department of Clinical Pharmacy, College of Pharmacy, University of Tennessee, Memphis, USA.
    As kidney disease progresses, phosphorus retention also increases, and phosphate binders are used to treat hyperphosphatemia. Clinicians prescribe phosphate binders thinking that reducing total body burden of phosphorus may decrease risks of mineral and bone disorder, fractures, cardiovascular disease, progression of kidney disease, and mortality. Recent meta-analyses suggest that sevelamer use results in lower mortality than use of calcium-containing phosphate binders. Read More

    Serum Phosphorus and Risk of Cardiovascular Disease, All-Cause Mortality, or Graft Failure in Kidney Transplant Recipients: An Ancillary Study of the FAVORIT Trial Cohort.
    Am J Kidney Dis 2017 Jun 2. Epub 2017 Jun 2.
    Division of Hypertension and Kidney Diseases, Department of Medicine, Rhode Island Hospital, Providence, RI. Electronic address:
    Background: Mild hyperphosphatemia is a putative risk factor for cardiovascular disease [CVD], loss of kidney function, and mortality. Very limited data are available from sizable multicenter kidney transplant recipient (KTR) cohorts assessing the potential relationships between serum phosphorus levels and the development of CVD outcomes, transplant failure, or all-cause mortality.

    Study Design: Cohort study. Read More

    [Strategies aiming to control hyperphosphatemia in chronic kidney disease].
    Nephrol Ther 2017 Apr;13 Suppl 1:S95-S101
    Service de néphrologie-dialyse, Ramsay-Générale de santé, clinique du Landy, 21-23, rue du Landy, 93400 Saint-Ouen, France; Service des explorations fonctionnelles, hôpital Necker-Enfants-Malades, rue de Sèvres, 75015 Paris, France. Electronic address:
    Chronic kidney disease is known to be associated with phosphate retention. The mechanisms are complex and the early increase in serum phosphate levels in chronic kidney disease is not strictly related to the dietary phosphate load or to the degree of phosphate retention. It also implicates the activity of intestinal sodium-phosphate cotransporters, the degree of bone turnover and the retention and/or phosphate release from the skeleton, and the feedback mechanisms regulating the phosphaturia. Read More

    [Modelling of phosphorus transfers during haemodialysis].
    Nephrol Ther 2017 Apr;13 Suppl 1:S89-S93
    Service de néphrologie et exploration fonctionnelle rénale, hôpital Édouard-Herriot, hospices civils de Lyon, 5, place d'Arsonval, 69437 Lyon, France; Université Lyon 1, 43, boulevard du 11-Novembre-1918, 69100 Villeurbanne, France; Inserm U1060 OPeRa, Carmen, 59, boulevard Pinel, 69500 Bron, France. Electronic address:
    Chronic kidney disease causes hyperphosphatemia, which is associated with increased cardiovascular risk and mortality. In patients with end-stage renal disease, haemodialysis allows the control of hyperphosphatemia. During a 4-h haemodialysis session, between 600 and 700mg of phosphate are extracted from the plasma, whereas the latter contains only 90mg of inorganic phosphate. Read More

    [Sucroferric oxyhydroxide, a novel iron-based phosphate binder. Which current use in dialysis patients?]
    Nephrol Ther 2017 Apr;13 Suppl 1:S103-S108
    Service de néphrologie-dialyse, hôpital Docteur-Duchenne, BP 609, 62321 Boulogne-sur-Mer, France.
    International guidelines suggest lowering elevated phosphorus level to the normal range in patients on dialysis. Among the phosphate-lowering strategies, phosphate binder is frequently used in addition to dietary phosphate restriction and an adequate dialysis strategy. However, serum phosphate concentration higher than 1. Read More

    Long-Term Assessment of the Safety and Efficacy of PA21 (Sucroferric Oxyhydroxide) in Japanese Hemodialysis Patients With Hyperphosphatemia: An Open-Label, Multicenter, Phase III Study.
    J Ren Nutr 2017 May 24. Epub 2017 May 24.
    Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan.
    Objective: The objective of this article was to assess the safety and efficacy of long-term administration of PA21.

    Design And Methods: Phase III, open-label, long-term study in 15 sites in Japan.

    Subjects: Japanese hemodialysis patients (N = 161) with hyperphosphatemia aged ≥20 years undergoing stable maintenance hemodialysis 3 times weekly, for ≥12 weeks. Read More

    Two phosphAte taRGets in End-stage renal disease Trial (TARGET): A Randomized Controlled Trial.
    Clin J Am Soc Nephrol 2017 Jun 26;12(6):965-973. Epub 2017 May 26.
    Division of Nephrology, McMaster University, Hamilton, Ontario, Canada.
    Background And Objectives: Hyperphosphatemia is common among recipients of maintenance dialysis and is associated with a higher risk of mortality and cardiovascular events. A large randomized trial is needed to determine whether lowering phosphate concentrations with binders improves patient-important outcomes. To inform such an effort we conducted a pilot randomized controlled trial. Read More

    Development of a novel chronic kidney disease mouse model to evaluate the progression of hyperphosphatemia and associated mineral bone disease.
    Sci Rep 2017 May 22;7(1):2233. Epub 2017 May 22.
    Department of Nephrology, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan.
    Medial arterial calcification (MAC) and renal osteodystrophy are complications of mineral bone disease (MBD) associated with chronic kidney disease (CKD). Our aim was to develop a novel mouse model to investigate the clinical course of CKD-MBD. Eight-week-old C57BL/6 J male mice were assigned to the following groups: the control group, fed a standard chow for 6 or 12 weeks; the CKD-normal phosphorus (NP) group, fed a chow containing 0. Read More

    Most consumed processed foods by patients on hemodialysis: Alert for phosphate-containing additives and the phosphate-to-protein ratio.
    Clin Nutr ESPEN 2016 Aug 1;14:37-41. Epub 2016 Jun 1.
    Faculdade de Medicina de Botucatu, Departamento de Clínica Médica, Univ Estadual Paulista (UNESP), Botucatu, Sao Paulo, Brazil. Electronic address:
    Background And Aims: Hyperphosphatemia is common in patients with chronic kidney disease (CKD) stages IV and V because of decreased phosphorus excretion. Phosphatemia is closely related to dietary intake. Thus, a better understanding of sources of dietary phosphate consumption, absorption and restriction, particularly inorganic phosphate found in food additives, is key to prevent consequences of this complication. Read More

    Analysis of Hypo- and Hyperphosphatemia in an Intensive Care Unit Cohort.
    Anesth Analg 2017 Jun;124(6):1897-1905
    From the *Skåne University Hospital, Lund, Getingevägen 4, SE-22185 Lund, Sweden; and †Science & Registry Nordic, Annedalsvägen 9, SE-22764 Lund, Sweden.
    Background: Blood phosphate levels are vulnerable to fluctuations and changes in phosphate levels are often neglected. The aim of this study was to evaluate whether deviations in phosphate levels correlate to higher 180-day overall mortality or morbidity.

    Methods: Four thousand six hundred fifty-six patients with 19,467 phosphate values treated at the adult intensive care unit at Skåne University Hospital, Lund, Sweden during 2006-2014 were retrospectively divided into a control group and 3 study groups: hypophosphatemia, hyperphosphatemia, and a mixed group showing both hypo/hyperphosphatemia. Read More

    Circulating MicroRNA-125b Predicts the Presence and Progression of Uremic Vascular Calcification.
    Arterioscler Thromb Vasc Biol 2017 Jul 18;37(7):1402-1414. Epub 2017 May 18.
    From the Department of Medicine, National Taiwan University Hospital Jin-Shan Branch, New Taipei City (C.-T.C.); Graduate Institute of Toxicology (C.-T.C., Y.-P.L., P.-J.L., W.-J.C., Y.-M.L., C.-K.C., H.-W.C.), and Graduate Institute of Oncology (P.-J.L., W.-J.C.), College of Medicine, National Taiwan University, Taipei; Institute of Statistical Science, Academia Sinica, Taipei, Taiwan (Y.-P.L., S.-F.S., H.-Y.C., P.-J.L., W.-J.C.); School of Big Data Management, Soochow University, Taipei, Taiwan (H.-Y.Y.); Nephrology Division, Department of Internal Medicine (C.-T.C., J.-W.H., K.-Y.H.) and Department of Integrative Diagnostics and Therapeutics (C.-K.C.), National Taiwan University Hospital, Taipei; and Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu branch, Hsin-Chu County (K.-Y.H.).
    Objective: Vascular calcification (VC) is a major cause of mortality in patients with end-stage renal diseases. Biomarkers to predict the progression of VC early are in urgent demand.

    Approach And Results: We identified circulating, cell-free microRNAs as potential biomarkers using in vitro VC models in which both rat and human aortic vascular smooth muscle cells were treated with high levels of phosphate to mimic uremic hyperphosphatemia. Read More

    Involvement Of Vascular Aldosterone Synthase In Phosphate-Induced Osteogenic Transformation Of Vascular Smooth Muscle Cells.
    Sci Rep 2017 May 17;7(1):2059. Epub 2017 May 17.
    Department of Physiology, University of Tübingen, Tübingen, Germany.
    Vascular calcification resulting from hyperphosphatemia is a major determinant of mortality in chronic kidney disease (CKD). Vascular calcification is driven by aldosterone-sensitive osteogenic transformation of vascular smooth muscle cells (VSMCs). We show that even in absence of exogenous aldosterone, silencing and pharmacological inhibition (spironolactone, eplerenone) of the mineralocorticoid receptor (MR) ameliorated phosphate-induced osteo-/chondrogenic transformation of primary human aortic smooth muscle cells (HAoSMCs). Read More

    Differential regulation of renal Klotho and FGFR1 in normal and uremic rats.
    FASEB J 2017 May 17. Epub 2017 May 17.
    Instituto Maimónides para la Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain;
    In renal failure, hyperphosphatemia occurs despite a marked elevation in serum fibroblast growth factor (FGF)-23. Abnormal regulation of the FGFR1-Klotho receptor complex may cause a resistance to the phosphaturic action of FGF23. The purpose of the present study was to investigate the regulation of renal Klotho and FGF receptor (FEFR)-1 in healthy and uremic rats induced by 5/6 nephrectomy. Read More

    Activation of the Nrf2-ARE Signaling Pathway Prevents Hyperphosphatemia-Induced Vascular Calcification by Inducing Autophagy in Renal Vascular Smooth Muscle Cells.
    J Cell Biochem 2017 May 17. Epub 2017 May 17.
    Department of Nephrology, The First Hospital of China Medical University, Shenyang 110001, P.R. China.
    This study investigates the effect of nuclear factor erythroid 2-related factor 2-antioxidant response element (Nrf2-ARE) signaling pathway in vascular calcification (VC) via inducing Autophagy in renal vascular smooth muscle cells (VSMCs). VSMCs were assigned into six experimental groups: the normal control, high phosphorus, si-negative control (si-NC), Nrf2-siRNA, over-expressed Nrf2, and negative control (NC) groups. RT-PCR was applied to detect the mRNA expressions of the desired Nrf2-ARE signaling pathway-related genes (Nrf2, NQO-1, HO-1, γ-GCS). Read More

    Acute tumoral calcinosis due to severe hyperphosphatemia in a maintenance hemodialysis patient.
    CEN Case Rep 2016 Nov 24;5(2):203-208. Epub 2016 Jun 24.
    Division of Nephrology, Department of Internal Medicine, Saiseikai Shigaken Hospital, 2-4-1 Ohashi, Rittou, Shiga, 520-3046, Japan.
    We report the case of a maintenance hemodialysis patient with severe hyperphosphatemia (26.6 mg/dL) who developed acute tumoral calcinosis. The patient started receiving maintenance hemodialysis after being diagnosed with type 2 diabetes mellitus. Read More

    Tumor Lysis Syndrome: A Unique Solute Disturbance.
    Nurs Clin North Am 2017 Jun 7;52(2):309-320. Epub 2017 Apr 7.
    Department of Acute and Continuing Care, University of Texas Health Science Center at Houston, 6901 Bertner Avenue SON 654, Houston, TX 77030, USA.
    Tumor lysis syndrome (TLS) is a life-threatening disorder that is an oncologic emergency. Risk factors for TLS are well-known, but the current literature shows case descriptions of unexpected acute TLS. Solid tumors and untreated hematologic tumors can lyse under various circumstances in children and adults. Read More

    Effect of Vitamin D Supplementation on Delayed Hyperphosphatemia in Pediatric Acute Lymphoblastic Leukemia Patients During Induction Chemotherapy.
    J Pediatr Pharmacol Ther 2017 Mar-Apr;22(2):102-105
    Objectives: Vitamin D plays a role in maintaining bone health and calcium metabolism, but recent studies cast doubt on vitamin D supplementation's benefits in survivors of acute lymphoblastic leukemia (ALL). Vitamin D supplementation could increase serum phosphate through increased intestinal absorption of phosphate and suppression of parathyroid hormone, which would lead to decreased renal phosphate excretion. Because of the potential for renal injury during induction chemotherapy for ALL, Vitamin D supplementation's potential for increasing hyperphosphatemia could outweigh its suggested but unproven benefits. Read More

    Phosphate binders affect vitamin K concentration by undesired binding, an in vitro study.
    BMC Nephrol 2017 May 2;18(1):149. Epub 2017 May 2.
    Department of Nephrology, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
    Background: Vascular calcification is a major contributing factor to mortality in end stage renal disease (ESRD). Despite the efficacy of phosphate binders to improve hyperphosphatemia, data on vascular calcification are less clear. There seems to be a difference in attenuation or delay in progression between different binders. Read More

    Treatment of Pediatric Chronic Kidney Disease-Mineral and Bone Disorder.
    Curr Osteoporos Rep 2017 Jun;15(3):198-206
    Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
    Purpose Of Review: In this paper, we review the pathogenesis and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD), especially as it relates to pediatric CKD patients.

    Recent Findings: Disordered regulation of bone and mineral metabolism in CKD may result in fractures, skeletal deformities, and poor growth, which is especially relevant for pediatric CKD patients. Moreover, CKD-MBD may result in extra-skeletal calcification and cardiovascular morbidity. Read More

    Hyperphosphatemia, a Cause of High Anion Gap Metabolic Acidosis: Report of a Case and Review of the Literature.
    Am J Case Rep 2017 Apr 28;18:463-466. Epub 2017 Apr 28.
    Department of Nephrology, Jerry L Pettis VA Medical Center, Loma Linda, CA, USA.
    BACKGROUND Hyperphosphatemia is a common problem in patients with kidney failure. It is usually mild and rarely severe enough to cause metabolic acidosis on its own. Besides kidney failure, use of phosphate containing enemas, rhabdomyolysis, and tumor lysis syndrome are common causes of severe hyperphosphatemia. Read More

    Use of Phosphorus Binders among Non-Dialysis Chronic Kidney Disease Patients and Mortality Outcomes.
    Am J Nephrol 2017 27;45(5):431-441. Epub 2017 Apr 27.
    Division of Nephrology and Hypertension, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA.
    Background: Whether the benefits of phosphorus binders extend to those without end stage renal disease is uncertain. Among a large diverse non-dialysis chronic kidney disease (CKD) population with hyperphosphatemia, we sought to evaluate phosphorus binder use and compare mortality risk between patients prescribed and not prescribed binders.

    Methods: A retrospective cohort study within an integrated health system (January 1, 1998 - December 31, 2012) among CKD patients (age ≥18) was performed. Read More

    Phosphate imbalance in patients with heart failure.
    Heart Fail Rev 2017 May;22(3):349-356
    Department of Internal Medicine, School of Medicine, University of Ioannina, 451 10, Ioannina, Greece.
    Patients with heart failure often exhibit electrolyte abnormalities, such as hyponatremia or hypokalemia/hyperkalemia. Although not as common as the other electrolyte disturbances observed in patients with heart failure, phosphate imbalance is also of high importance in this population. The aim of this review is to present the mechanisms of low or high phosphate serum levels in patients with heart failure and its role in the pathogenesis and progression of heart dysfunction. Read More

    Idiopathic hypoparathyroidism with extensive intracranial calcification in children: First report from Saudi Arabia.
    Medicine (Baltimore) 2017 Apr;96(16):e6347
    aPediatric Hepatologist, Faculty of Medicine, Cairo University, Cairo, Egypt. Pediatric Hepatologist, Alhada Armed Forces Hospital, Taif, KSA bPediatric endocrinologist, Armed Forces Hospitals of Taif Region, Taif, KSA cPediatric neonatologist, Alhada Armed Forces Hospital, Taif, KSA dPediatric endocrinologist, Alhada Armed Forces Hospital, Taif, KSA ePediatrics, Children Hospital, Taif, KSA fPediatric Allergist and immunologist Alhada Armed Forces Hospital, Taif, KSA gPediatric Nephrologist, College of Medicine, Taif University, Taif, KSA hMedical intern, Taif University, Taif, KSA iPediatric Hematologist and Oncologist, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
    Rationale: Pediatric idiopathic hypoparathyroidism with extensive intracranial calcifications outside the basal ganglia (BG) is extremely rare with less than 10 cases worldwide.

    Patient Concerns: An 11-year-old Saudi male child presented with tetany with otherwise normal neurological and other body system examination diagnoses severe hypocalcemia for differential diagnosis.

    Interventions: Further investigations revealed hyperphosphatemia and undetectable serum intact parathyroid hormone. Read More

    Fibroblast Growth Factor-23 Concentration in Dogs with Chronic Kidney Disease.
    J Vet Intern Med 2017 May 17;31(3):784-790. Epub 2017 Apr 17.
    Veterinary Clinical Sciences, The Ohio State University, Columbus, OH.
    Background: Chronic kidney disease (CKD) is associated with hyperphosphatemia, decreased vitamin D metabolite concentrations, and hyperparathyroidism. This syndrome is known as CKD-mineral bone disorder (CKD-MBD). Recently, it has been shown that an increase in fibroblast growth factor-23 (FGF-23) concentration is an early biomarker of CKD in people. Read More

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