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    A 3-day diary of dietary protein and calorie intake by serum phosphate concentration and binder use in hemodialysis patients.
    Int J Artif Organs 2017 Nov 4. Epub 2017 Nov 4.
    Department of Internal Medicine and Diagnostic Support, Federal University of Bahia, Salvador, BA - Brazil.
    Introduction: The use of phosphate binders to control hyperphosphatemia may allow diets less restricted in protein and calories for maintenance hemodialysis (MHD) patients. The study compared intakes of protein, calorie and phosphate among MHD patients with different serum phosphate concentrations, taking into account binder use. The hypothesis was that low serum phosphate would be associated with low intakes of protein and calories only in patients not on binders. Read More

    Smooth Muscle-Selective Nuclear Factor-κB Inhibition Reduces Phosphate-Induced Arterial Medial Calcification in Mice With Chronic Kidney Disease.
    J Am Heart Assoc 2017 Nov 16;6(11). Epub 2017 Nov 16.
    Apheresis and Dialysis Center, School of Medicine, Keio University, Tokyo, Japan.
    Background: Hyperphosphatemia is a major factor promoting the formation of arterial medial calcification in chronic kidney disease (CKD). However, arterial medial calcification begins to occur during the early stages of CKD, when hyperphosphatemia is not yet apparent. It is predicted that other factors also play a role. Read More

    The Impact of Additives on the Phosphorus, Potassium, and Sodium Content of Commonly Consumed Meat, Poultry, and Fish Products Among Patients With Chronic Kidney Disease.
    J Ren Nutr 2017 Nov 14. Epub 2017 Nov 14.
    School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario. Electronic address:
    Objective: Patients with chronic kidney disease (CKD) are advised to limit their dietary intake of phosphorus and potassium as hyperphosphatemia and hyperkalemia are both associated with an increased risk of mortality. There is uncertainty concerning the actual content of these minerals in the Canadian food supply, as phosphorus and potassium are increasingly being used as food additives. This study aimed to determine the impact of food additives on the chemically analyzed content of phosphorus, potassium, sodium, and protein in commonly consumed meat, poultry, and fish products (MPFs). Read More

    Ferritin Elevation and Improved Responsiveness to Erythropoiesis-Stimulating Agents in Patients on Ferric Citrate Hydrate.
    Kidney Int Rep 2017 May 5;2(3):359-365. Epub 2017 Jan 5.
    Fukuoka Renal Clinic, Fukuoka, Japan.
    Introduction: In hemodialysis patients on ferric citrate hydrate, the increase in ferritin level is mainly due to the administration of the compound. We investigated possible other factors associated with ferritin level and how erythropoietin resistance index and erythropoiesis in those patients were affected. We looked at ferritin-elevating factors using data from a Japanese phase III long-term clinical trial of ferric citrate hydrate. Read More

    Spontaneous Tumor Lysis Syndrome due to Uterine Leiomyosarcoma with Lung Metastases.
    Case Rep Crit Care 2017 11;2017:4141287. Epub 2017 Sep 11.
    Division of Pulmonary-Critical Care Medicine, University of CT Health Center, Farmington, CT 06030, USA.
    Tumor lysis syndrome (TLS) is an oncologic emergency characterized by a combination of metabolic derangements (hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia) caused by rapid turnover from cell destruction in certain cancers. These metabolic derangements can lead to seizures, cardiac arrhythmias, renal failure, and death. TLS is usually seen after the initiation of chemotherapy for hematologic malignancies. Read More

    Effect of Npt2b deletion on intestinal and renal inorganic phosphate (Pi) handling.
    Clin Exp Nephrol 2017 Nov 11. Epub 2017 Nov 11.
    Department of Molecular Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-Cho, Tokushima, Tokushima, 770-8503, Japan.
    Background: Hyperphosphatemia is common in chronic kidney disease and is associated with morbidity and mortality. The intestinal Na(+)-dependent phosphate transporter Npt2b is thought to be an important molecular target for the prevention of hyperphosphatemia. The role of Npt2b in the net absorption of inorganic phosphate (Pi), however, is controversial. Read More

    Reoperation for persistent or recurrent secondary hyperparathyroidism.
    Acta Biomed 2017 Oct 23;88(3):325-328. Epub 2017 Oct 23.
    University of Palermo.
    Background: Secondary hyperparathyroidism is a common acquired disorder seen in chronic renal failure. Its pathophysiology is mainly due to hyperphosphatemia and vitamin D deficiency and resistance. When medical treatment fails, subtotal and total parathyroidectomy with autotransplantation are the standard procedures, although both are associated with high recurrence rates. Read More

    Endothelin A receptor blocker and calcimimetic in the adenine rat model of chronic renal insufficiency.
    BMC Nephrol 2017 Oct 27;18(1):323. Epub 2017 Oct 27.
    Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.
    Background: We studied whether endothelin receptor antagonist and calcimimetic treatments influence renal damage and kidney renin-angiotensin (RA) components in adenine-induced chronic renal insufficiency (CRI).

    Methods: Male Wistar rats (n = 80) were divided into 5 groups for 12 weeks: control (n = 12), 0.3% adenine (Ade; n = 20), Ade + 50 mg/kg/day sitaxentan (n = 16), Ade + 20 mg/kg/day cinacalcet (n = 16), and Ade + sitaxentan + cinacalcet (n = 16). Read More

    [GENETIC DISORDERS OF RENAL PHOSPHATE HANDLING].
    Harefuah 2017 Oct;156(10):654-658
    Pediatric Nephrology Institute, Rambam Health Care Campus, Technion Faculty of Medicine, Haifa, Israel.
    Introduction: Hereditary disorders of renal phosphate handling comprise a diverse group of genetic diseases, usually characterized by excessive urinary phosphate wasting and a negative phosphate balance. In the minority of cases, perturbations of renal phosphate handling are associated with excessive urinary phosphate reabsorption, leading to pathological hyperphosphatemia. Inorganic phosphate is an essential mineral in the human body, playing a crucial role in cellular metabolism and skeletal mineralization. Read More

    A service review to assess if innovative intensive phosphate dietary education can help reduce phosphate levels to the recommended range in a hemodialysis population.
    Hemodial Int 2017 Oct;21 Suppl 2:S22-S26
    Renal Dietetics Department, Queen Alexandra Hospital, Portsmouth, England.
    Introduction: Studies suggest that hemodialysis (HD) patients are less likely to adhere to phosphate dietary restriction than to potassium, sodium, or fluid restriction. It is particularly important that dietary education is provided appropriately, consistently, and reinforced regularly to encourage compliance with diet and phosphate-binder regimens. Patient awareness of the consequences of a chronically raised phosphate and its treatment is associated with lower serum phosphate levels. Read More

    The Leaky Gut and Altered Microbiome in Chronic Kidney Disease.
    J Ren Nutr 2017 Nov;27(6):458-461
    Division of Nephrology and Hypertension, Department of Medicine, University of California Irvine, Orange, California. Electronic address:
    Chronic kidney disease results in disruption of the intestinal epithelial barrier as well as profound changes in the gut microbial flora. These events are largely mediated by (1) heavy influx of circulating urea to the gut lumen and (2) dietary restrictions of foods containing high fiber (such as fruits and vegetable) and symbiotic organisms (such as yogurt and cheese) imposed to mitigate hyperkalemia and hyperphosphatemia. Collectively, these factors promote systemic inflammation and cardiovascular morbidity by mediating microbial dysbiosis, disruption of the intestinal epithelial barrier, and translocation of endotoxin, bacterial fragments, and uremic toxins across the "leaky gut" into the bloodstream. Read More

    The use of cinacalcet hinders the diagnosis of parathyroid carcinoma in a chronic dialysis patient: a case report.
    BMC Nephrol 2017 Oct 18;18(1):315. Epub 2017 Oct 18.
    Department of Nephrology, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo, Kyoto, Japan.
    Background: Secondary hyperparathyroidism (SHPT) is a common complication in patients receiving chronic dialysis therapy. Although cinacalcet can control parathyroid function and bone turnover, preventing ectopic calcification remains challenging. Cinacalcet can also suppress PTH secretion due to parathyroid carcinoma in the same way as it does for parathyroid hyperplasia in the uremic condition. Read More

    Coronary Artery Bypass Surgery in End-Stage Renal Disease Patients.
    Ann Vasc Dis 2017 Jun;10(2):79-87
    Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Saitama, Japan.
    The number of patients requiring hemodialysis is continuously increasing around the world. Hemodialysis affects patient quality of life and it is also associated with a higher risk for cardiovascular events. In addition to traditional risk factors for cardiovascular events such as hypertension, hyperlipidemia, and diabetes, hemodialysis is associated with hyperphosphatemia, chronic inflammation, vascular calcification, and anemia which accelerate atherosclerosis, vascular stiffness, and cardiac ischemia. Read More

    Sodium Phosphate Enemas do not Worsen Renal Function amongst Hospitalized Patients with Mild to Moderate Renal Failure. A Matched, Case-control study.
    QJM 2017 Aug 16. Epub 2017 Aug 16.
    Department of Internal Medicine T#, Chaim Sheba Medical Center; Ramat Gan, Israel.
    Background: Sodium Phosphate enemas (SPEs) are widely used amongst hospitalized patients despite their potential to worsen renal failure. The extent to which this side effect is clinically relevant is questionable.

    Methods: We conducted a matched case-control, retrospective study in a cohort of hospitalized patients. Read More

    Admission hyperphosphatemia increases the risk of acute kidney injury in hospitalized patients.
    J Nephrol 2017 Oct 3. Epub 2017 Oct 3.
    Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA.
    Background: Evidence on the association between elevated admission serum phosphate and risk of in-hospital acute kidney injury (AKI) is limited. The aim of this study was to assess the risk of AKI in hospitalized patients stratified by admission serum phosphate level.

    Methods: This is a single-center retrospective study conducted at a tertiary referral hospital. Read More

    Effect of restricted protein diet supplemented with keto analogues in end-stage renal disease: a systematic review and meta-analysis.
    Int Urol Nephrol 2017 Oct 3. Epub 2017 Oct 3.
    Division of Nephrology, Department of Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
    Aim: To evaluate the efficacy and safety of the restricted protein diet supplemented with keto analogues when applied in end-stage renal disease (ESRD).

    Methods: The Cochrane Library, PubMed, Embase, CBM and CENTRAL databases were searched and reviewed up to January 2017. Clinical trials were analyzed using RevMan 5. Read More

    A Pilot Study of OkKidney, a Phosphate Counting Application in Patients on Peritoneal Dialysis.
    Perit Dial Int 2017 Nov-Dec;37(6):613-618. Epub 2017 Sep 28.
    University of Ottawa, Ottawa, ON, Canada
    Background: Hyperphosphatemia is associated with adverse outcomes in patients treated with peritoneal dialysis (PD). We have shown that a fixed meal phosphate binder dosing schedule is not appropriate. The purpose of this study was to evaluate the beta version of OkKidney, a phosphate counting app that matches meal phosphate content with binder dose. Read More

    Safety, pharmacokinetic, and pharmacodynamics of erdafitinib, a pan-fibroblast growth factor receptor (FGFR) tyrosine kinase inhibitor, in patients with advanced or refractory solid tumors.
    Invest New Drugs 2017 Sep 30. Epub 2017 Sep 30.
    National Cancer Center Hospital East, Kashiwa, Japan.
    Introduction This phase 1, open-label, multicenter, single-arm, dose-escalation study aimed to evaluate safety, pharmacokinetics (PK), and pharmacodynamics of erdafitinib (JNJ-42756493), an oral selective pan-fibroblast growth factor receptor (FGFR) tyrosine kinase inhibitor, and to determine the recommended phase 2 dose in Japanese patients with advanced or refractory solid tumors. Methods Three to 6 patients were enrolled into sequentially escalating dose cohorts (erdafitinib 2, 4, or 6 mg) with a daily dosing schedule of 21-day cycles or a 7 days-on/7 days-off intermittent schedule (erdafitinib 10 mg or 12 mg) of 28-day cycles. Results Nineteen patients received escalating doses of erdafitinib with a daily or intermittent schedule. Read More

    Hematological, biochemical, and histopathological impacts of barium chloride and barium carbonate accumulation in soft tissues of male Sprague-Dawley rats.
    Environ Sci Pollut Res Int 2017 Sep 27. Epub 2017 Sep 27.
    Department of Clinical Pathology, Faculty of Veterinary medicine, Zagazig University, Zagazig, 44511, Egypt.
    The present study was designed to investigate the hematotoxicity, sero-biochemical and histological changes due to the accumulation of BaCl2 and BaCO3, the most important barium salts in our daily lives, in different soft tissues including the liver, kidney, heart, and spleen of adult rats after an oral exposure for 30 consecutive days, and to explain the different mechanisms by which this metal can exert these impacts. For this purpose, adult male rats were divided into three main groups of 15 animals each: group I, serving as controls, group II, receiving BaCl2 orally in a dose of 179 mg barium/kg b.wt, and group III, receiving BaCO3 orally in a dose of 418 mg barium/kg b. Read More

    Calcium and Bone Metabolism Indices.
    Adv Clin Chem 2017 7;82:1-46. Epub 2017 Aug 7.
    David Geffen School of Medicine, University of California, Los Angeles, CA, United States. Electronic address:
    Calcium and inorganic phosphate are of critical importance for many body functions, thus the regulations of their plasma concentrations are tightly controlled by the concerted actions of reabsorption/excretion in the kidney, absorption in the intestines, and exchange from bone, the major reservoir for calcium and phosphate in the body. Parathyroid hormone (PTH) and 1,25-dihydroxyvitamin D (1,25(OH)2D) control calcium homeostasis, whereas PTH, 1,25(OH)2D, and bone-derived fibroblast growth factor 23 (FGF 23) control phosphate homeostasis. Hypoparathyroidism can cause hypocalcemia and hyperphosphatemia, whereas deficient vitamin D actions can cause osteomalacia in adults and rickets in children. Read More

    Inorganic phosphate-induced impairment of osteoclast cell-cell fusion by the inhibition of AP-1-mediated DC-STAMP expression.
    Biochem Biophys Res Commun 2017 Nov 20;493(1):9-13. Epub 2017 Sep 20.
    Department of Clinical Pharmacology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
    Chronic kidney disease (CKD) causes hyperphosphatemia and secondary hyperparathyroidism, leading to several disorders of bone metabolism. Although high concentrations of extracellular inorganic phosphate (Pi) inhibit osteoclastogenesis, the molecular mechanism of this effect has not been fully understood. In the present study, therefore, we examined the effect of Pi on the differentiation of the osteoclast precursor RAW-D cells. Read More

    Efficacy and safety of sevelamer carbonate in hyperphosphatemic pediatric patients with chronic kidney disease.
    Pediatr Nephrol 2017 Sep 12. Epub 2017 Sep 12.
    Children's Mercy Kansas City, 2401 Gilham Road, Kansas City, MO, 64108, USA.
    Background: Treatment for hyperphosphatemia in chronic kidney disease (CKD) involves dietary control of phosphorus intake, dialysis, and treatment with oral phosphate binders, none of which were approved by the Federal Food and Drug Administration in pediatric patients at the time of this study.

    Methods: This was a phase 2, multicenter study (NCT01574326) with a 2-week, randomized, placebo-controlled, fixed-dose period (FDP) followed by a 6-month, single-arm, open-label, dose-titration period (DTP), with the aim to evaluate the safety and efficacy of sevelamer carbonate (SC) in hyperphosphatemic pediatric patients with CKD. Following a 2-4 week screening phase, pediatric patients with a serum phosphorus level higher than age-appropriate levels were randomized to receive either SC or placebo as powder/tablets in 0. Read More

    The Role of Secondary Calciprotein Particles in the Mineralisation Paradox of Chronic Kidney Disease.
    Calcif Tissue Int 2017 Dec 31;101(6):570-580. Epub 2017 Aug 31.
    Department of Nephrology, Royal Melbourne Hospital, Parkville, VIC, Australia.
    Mineralisation paradox is prevalent in chronic kidney disease and ageing where increased vascular calcification is accompanied by reduced bone mineralisation and osteopenia. Secondary calciprotein particles (CPP2), colloidal nanoparticles containing hydroxyapatite crystal stabilised by a protein shell, have been implicated in vascular calcification in chronic kidney disease. Here, we describe the effect of CPP2 on osteoblasts and vascular smooth muscle cells (VSMC) mineralisation in an in vitro model system. Read More

    Hyperphosphatemia induces senescence in human endothelial cells by increasing endothelin-1 production.
    Aging Cell 2017 Dec 31;16(6):1300-1312. Epub 2017 Aug 31.
    Instituto Reina Sofía de Investigación Nefrológica, IRSIN, Madrid, Spain.
    Hyperphosphatemia is related to some pathologies, affecting vascular cell behavior. This work analyzes whether high concentration of extracellular phosphate induces endothelial senescence through up-regulation of endothelin-1 (ET-1), exploring the mechanisms involved. The phosphate donor β-glycerophosphate (BGP) in human endothelial cells increased ET-1 production, endothelin-converting enzyme-1 (ECE-1) protein, and mRNA expression, which depend on the AP-1 activation through ROS production. Read More

    The activin receptor is stimulated in the skeleton, vasculature, heart, and kidney during chronic kidney disease.
    Kidney Int 2017 Aug 23. Epub 2017 Aug 23.
    Renal Division, Department of Pediatrics, Washington University School of Medicine, Saint Louis, Missouri, USA; Departments of Medicine and Cell Biology, Washington University School of Medicine, Saint Louis, Missouri, USA. Electronic address:
    We examined activin receptor type IIA (ActRIIA) activation in chronic kidney disease (CKD) by signal analysis and inhibition in mice with Alport syndrome using the ActRIIA ligand trap RAP-011 initiated in 75-day-old Alport mice. At 200 days of age, there was severe CKD and associated Mineral and Bone Disorder (CKD-MBD), consisting of osteodystrophy, vascular calcification, cardiac hypertrophy, hyperphosphatemia, hyperparathyroidism, elevated FGF23, and reduced klotho. The CKD-induced bone resorption and osteoblast dysfunction was reversed, and bone formation was increased by RAP-011. Read More

    [Management of bone and mineral metabolism disorders before the dialysis stage remains still perfectible. Data from the French Phosphorus and Calcium Survey Photo-Graphe].
    Nephrol Ther 2017 Nov 23;13(6):470-478. Epub 2017 Aug 23.
    Département de néphrologie, université de Lyon, CENS, hôpital Lyon-Sud, 69495 Lyon, France.
    Only limited data is available on the management of the chronic kidney disease-associated bone and mineral metabolism disorder (CKD-MBD) in the pre-dialysis stages of CKD in France. A better knowledge of current management habits could lead to an improvement in the implementation of international recommendations (KDIGO). The 3rd version of the French Phosphorus and Calcium Survey Photo-Graphe (Sanofi) included a cohort of CKD stages 4 and 5 patients, whose aim was to examine the prevalence of CKD-MBD and the quality of its management in patients under the care of 62 nephrologists from over 20 geographical regions in France. Read More

    Comparative efficacy and safety of paricalcitol versus vitamin D receptor activators for dialysis patients with secondary hyperparathyroidism: a meta-analysis of randomized controlled trials.
    BMC Nephrol 2017 Aug 25;18(1):272. Epub 2017 Aug 25.
    Department of Nephrology, The Third Affiliated Hospital of Guangxi University of Chinese medicine, No.32, Jie-Fang-Bei Road, Cheng-Zhong District, Liuzhou, Guangxi, 545001, People's Republic of China.
    Background: Secondary hyperparathyroidism (SHPT) is a severe complication for dialysis patients. Vitamin D receptor activators (VDRAs) are used to treat SHPT, but the comparative efficacy and safety between paricalcitol and other vitamin D receptor activators for management of SHPT in dialysis patients has been unproven.

    Methods: We searched PubMed, Embase, and the Cochrane Library for the time period through June 2017 to identify randomized controlled trials that evaluated paricalcitol compared with other VDRAs for treatment of SHPT. Read More

    Surface-Engineered Blood Adsorption Device for Hyperphosphatemia Treatment.
    ASAIO J 2017 Aug 8. Epub 2017 Aug 8.
    From the *Fiber and Polymer Science Program, Department of Textile Engineering, Chemistry and Science, North Carolina State University, Raleigh, NC; †Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC; ‡University of North Carolina, Chapel Hill, NC; and §Skaggs School of Pharmacy and Pharmaceutical Sciences, Department of Pharmaceutical Sciences, and School of Medicine, Nephrology and Hypertension, University of Colorado, Aurora, CO.
    Correspondence: Melanie S. Joy, PharmD, PhD, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Department of Pharmaceutical Sciences, Mail Stop C238, Room V20-4108, 12850 East Montview Blvd, Aurora, CO 80045. Email: Melanie. Read More

    Correlation of lanthanum dosage with lanthanum deposition in the gastroduodenal mucosa of dialysis patients.
    Pathol Int 2017 Sep 11;67(9):447-452. Epub 2017 Aug 11.
    Department of Pathology, Osaka Medical College, 2-7 Daigaku-cho, Takatsuki, Osaka, Japan.
    Lanthanum (La) deposition has been observed in gastrointestinal mucosa of dialysis patients treated with La carbonate to treat hyperphosphatemia in the 6 years since its authorization in Japan. We investigated gastrointestinal biopsies from 112 dialysis patients, and found 15 cases of histiocytic aggregation with crystalloids and one case of duodenitis with histiocyte aggregation without crystalloids in the 30 patients treated with La carbonate. No histiocytic lesions were observed in the 82 patients without La carbonate administration. Read More

    The FGF23-Klotho axis and cardiac tissue Doppler imaging in pediatric chronic kidney disease-a prospective cohort study.
    Pediatr Nephrol 2017 Aug 9. Epub 2017 Aug 9.
    Division of Renal Medicine, CLINTEC, Karolinska Institutet, Stockholm, Sweden.
    Background: Chronic kidney disease-associated mineral bone disorder (CKD-MBD) is common in pediatric kidney disease patients and a risk factor for future cardiovascular disease (CVD). Fibroblast growth factor-23 (FGF23) and Klotho are novel key players in CKD-MBD, and has been suggested to be involved in the development of CVD.

    Methods: This prospective cohort study included 74 pediatric patients; 31 with CKD (age range 0. Read More

    Calciphylaxis with extensive arterial calcification.
    Clin Case Rep 2017 Aug 3;5(8):1418-1419. Epub 2017 Jul 3.
    Division of Nephrology, Hypertension and Renal TransplantationUniversity of FloridaGainesvilleFlorida.
    Calciphylaxis is a clinical syndrome of arteriolar calcification with resultant tissue necrosis, most commonly seen in patients with end-stage renal disease (ESRD) on dialysis. This condition carries a high mortality rate mainly due to infection. Helpful interventions include adequate dialytic therapy, medical management of hyperparathyroidism, hyperphosphatemia, and intravenous sodium thiosulfate therapy. Read More

    Clinical Characteristics of Seven Patients with Lanthanum Phosphate Deposition in the Stomach.
    Intern Med 2017 Aug 1;56(16):2089-2095. Epub 2017 Aug 1.
    Department of Internal Medicine, Okayama Saiseikai General Hospital, Japan.
    Objective To analyze the clinical characteristics and endoscopic features of patients with lanthanum deposition in the stomach. Patients We retrospectively reviewed seven patients with lanthanum deposition in the stomach who were diagnosed at Okayama Saiseikai General Hospital. We investigated the patient sex, age at diagnosis, medical and medication histories, gastrointestinal symptoms, complications, presence or absence of gastric atrophy, and outcome. Read More

    Efficacy of intralesional sodium thiosulfate injections for disabling tumoral calcinosis: Two cases.
    Semin Arthritis Rheum 2017 Dec 17;47(3):451-455. Epub 2017 Jun 17.
    Service de pédiatrie, Hopital de la Mère et de l'Enfant, Limoges, France. Electronic address:
    Introduction: Tumoral calcinosis (TC) is a difficult-to-treat complication that can occur during several diseases such as dermatomyositis or genetic hyperphosphatemia. It is a painful and disabling condition that can lead to local complications including joint mobility reduction, cutaneous ulceration and superinfection. For the largest lesions, the treatment relies essentially on surgery. Read More

    Biology of Fibroblast Growth Factor 23: From Physiology to Pathology.
    Cold Spring Harb Perspect Med 2017 Aug 4. Epub 2017 Aug 4.
    Division of Bone and Mineral Research OMII, Harvard School of Dental Medicine, Boston, Massachusetts 02115.
    Fibroblast growth factor (FGF)23 is a phosphaturic hormone produced by osteocytes and osteoblasts that binds to FGF receptors in the presence of the transmembrane protein αKlotho. FGF23 mainly targets the renal proximal tubule to inhibit calcitriol production and the expression of the sodium/phosphate cotransporters NaPi2a and NaPi2c, thus inhibiting renal phosphate reabsorption. FGF23 also acts on the parathyroid glands to inhibit parathyroid hormone synthesis and secretion. Read More

    Comparative Efficacy and Safety of Phosphate Binders in Hyperphosphatemia Patients With Chronic Kidney Disease.
    JPEN J Parenter Enteral Nutr 2017 Aug 1:148607117715440. Epub 2017 Aug 1.
    1 Department of Nephrology, Linyi People's Hospital, Linyi, Shandong, China.
    Background: In this study, we coordinated a network meta-analysis to establish the efficacy and safety of different agents used in the treatment of hyperphosphatemia patients with chronic kidney disease.

    Methods: PubMed, CNKI, and Embase were systematically searched to retrieve relevant studies. Outcomes were presented by mean differences, odds ratios, and corresponding 95% credible intervals for continuous outcomes and binary outcomes, respectively. Read More

    Characterization and assessment of potential microRNAs involved in phosphate-induced aortic calcification.
    J Cell Physiol 2017 Aug 4. Epub 2017 Aug 4.
    Laboratory of Cancer Biology and Molecular Immunology, Faculty of Sciences I, Lebanese University, Hadath, Beirut, Lebanon.
    Medial artery calcification, a hallmark of type 2 diabetes mellitus and chronic kidney disease (CKD), is known as an independent risk factor for cardiovascular mortality and morbidity. Hyperphosphatemia associated with CKD is a strong stimulator of vascular calcification but the molecular mechanisms regulating this process remain not fully understood. We showed that calcification was induced after exposing Sprague-Dawley rat aortic explants to high inorganic phosphate level (Pi , 6 mM) as examined by Alizarin red and Von Kossa staining. Read More

    Reversible central neural hyperexcitability: an electroencephalographic clue to hypocalcaemia.
    BMJ Case Rep 2017 Aug 1;2017. Epub 2017 Aug 1.
    Neurology, T.N.M.C and B.Y.L Nair Ch. Hospital, Mumbai, maharasthra, India.
    A 23-year-old male patient presented with cognitive decline and seizures. Examination revealed Chvostek's and Trousseau's signs. Investigations revealed hypocalcaemia, hyperphosphatemia and normal intact parathyroid hormone levels. Read More

    Evaluation of a New Fully Automated Assay for Plasma Intact FGF23.
    Calcif Tissue Int 2017 Nov 31;101(5):510-518. Epub 2017 Jul 31.
    Department of Clinical Chemistry, University of Liège, CHU de Liège, 4000, Liège, Belgium.
    Several FGF23 immunoassays are available. However, they are reserved for research purposes as none have been approved for clinical use. We evaluated the performances of a new automated assay for intact FGF23 on the DiaSorin Liaison platform which is approved for clinical use. Read More

    Study of chronic kidney disease-mineral bone disorders in newly detected advanced renal failure patients: A Hospital-based cross-sectional study.
    Saudi J Kidney Dis Transpl 2017 Jul-Aug;28(4):874-885
    Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
    We aim to evaluate the disturbances in mineral metabolism, abnormalities in bone mineral density (BMD), and extraskeletal calcification in newly detected, untreated predialysis stage 4 and 5 chronic kidney disease (CKD) patients at a tertiary care hospital in North India. This is cross-sectional observational study. A total of 95 (68 males, 27 females) newly detected patients underwent clinical evaluation, biochemical assessment [serum calcium, phosphorus, alkaline phosphatase (ALP), albumin, creatinine, intact parathyroid hormone (iPTH), 25- hydroxyvitamin D (25(OH)D)], BMD measurement (at spine, hip, and forearm) by dual-energy X-ray absorptiometry (DXA), lateral abdominal radiograph [for abdominal aortic calcification (AAC)], skeletal survey (to look for any abnormality including fractures), and echocardiography [for any cardiac valvular calcification (CVC)]. Read More

    Vitamin D levels and other biochemical parameters of mineral bone disorders and their association with diastolic dysfunction and left ventricular mass in young nondiabetic adult patients with chronic kidney disease.
    Saudi J Kidney Dis Transpl 2017 Jul-Aug;28(4):758-763
    Division of Clinical and Experimental Medicine, CSIR-Central Drug Research Institute, Lucknow, Uttar Pradesh, India.
    Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in patients with end-stage renal disease. Chronic kidney disease (CKD)-associated cardiovascular mortality is more prevalent in those with diastolic heart failure and is an early predictor, while increased left ventricular mass (LVM) is a strong independent risk factor. Hypovitaminosis D is extensively being studied as a nontraditional risk factor for CVD. Read More

    [Effects of keto/amino acids and a low-protein diet on the nutritional status of patients with Stages 3B-4 chronic kidney disease].
    Ter Arkh 2017;89(6):30-33
    I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia.
    Aim: To evaluate the efficacy of keto/amino acids in maintaining protein balance and preventing mineral metabolic disturbances and the development of uremic hyperparathyroidism in the long-term use of a low-protein diet (LPD) in patients with Stages 3B-4 chronic kidney disease (CKD).

    Subjects And Methods: Ninety patients with CKD caused by chronic latent glomerulonephritis in 65 patients and chronic tubulointerstitial nephritis of various etiologies (gout, drug-induced, and infection) in 25 were examined. The investigators conducted clinical, laboratory, and instrumental examinations, including bioelectrical impedance analysis (body mass index (BMI), the percentages of lean and fat mass), echocardiography and radiography of the abdominal aorta in the lateral projection (the presence of cardiac valvular and aortic calcification), and pulse wave velocity measurements using a Sphygmocor apparatus (vessel stiffness estimation). Read More

    [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, 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 level of 25 hydroxyvitamin 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 Sep 19;12(9):1489-1497. 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 Dec 17;30(6):755-765. 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

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