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Korean J Intern Med 2021 Jun 22. Epub 2021 Jun 22.

Harold Simmons Center for Kidney Disease Research and Epidemiology, University of California Irvine, School of Medicine, Orange, CA, USA.

High dietary protein intake may lead to increased intraglomerular pressure and glomerular hyperfiltration, which in the long-term can lead to de novo or aggravating preexisting chronic kidney disease (CKD). Hence, a low protein diet (LPD, 0.6 to 0. Read More

J Surg Case Rep 2021 Jun 16;2021(6):rjab228. Epub 2021 Jun 16.

Surgical Clinic Associates, Mississippi Baptist Hospital, Jackson, MS, USA.

Sevelamer is a common phosphate binder used to manage hyperphosphatemia in end-stage renal disease. The medication has a well-documented gastrointestinal side-effect profile including nausea, vomiting and abdominal pain. There are few case reports of Sevelamer crystal deposition causing gastrointestinal mucosal injury, pseudotumor or obstruction. Read More

J Ren Nutr 2021 May 5. Epub 2021 May 5.

Nutrition Department, Nephrocare, Lisbon, Portugal.

Objective: The purpose of this study was to assess the effect of a telehealth-delivered nutritional intervention via telephone in maintenance hemodialysis (HD) patients during the coronavirus outbreak.

Methods: This was a multicenter, observational, prospective, and longitudinal study of 156 patients undergoing maintenance HD from 15 dialysis units conducted during the COVID-19 pandemic. We assigned patients to receive dietary counseling through a phone call, according to their biochemical and nutritional parameters. Read More

Mini Rev Med Chem 2021 Jun 16. Epub 2021 Jun 16.

Department of Chemistry, Faculty of Food Technology, University of Agriculture, Kraków, Poland.

It is estimated that by 2040 Chronic Kidney Disease (CKD) will be the 5th main cause of global deaths. It has been suggested that hyperphosphatemia is among the main factors leading to the increased risk of death. This review focuses on potential and currently used phosphate binders (PB). Read More

Cardiorenal Med 2021 Jun 11:1-10. Epub 2021 Jun 11.

Baylor University Medical Center, Dallas, Texas, USA.

Background: Cardiovascular disease (CVD) is a major cause of death in patients with chronic kidney disease (CKD) on dialysis. Mortality rates are still unacceptably high even though they have fallen in the past 2 decades. Hyperphosphatemia (elevated serum phosphate levels) is seen in almost all patients with advanced CKD and is by far the largest remaining modifiable contributor to CKD mortality. Read More

Adv Nutr 2021 Jun 10. Epub 2021 Jun 10.

Department of Agricultural, Food and Nutritional Sciences, 4-002G Li Ka Shing Centre for Health Innovation, University of Alberta, Edmonton, Alberta, Canada.

Lower phosphorus intake to prevent hyperphosphatemia for those with chronic kidney disease (CKD) is often recommended. Plant proteins are frequently restricted for their high phosphorus content despite having lower bioavailability. To summarize the evidence on protein type and dietary phosphorus intake, serum phosphate concentrations, and nutritional adequacy in adults with CKD, a search in MEDLINE via Ovid was conducted. Read More

Am J Nephrol 2021 Jun 7:1-11. Epub 2021 Jun 7.

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

Introduction: Phosphate binders are used to treat hyperphosphatemia. Some patients have inappropriately controlled serum phosphorus levels, which may occur for many reasons, including a high pill burden and adverse events (AEs). Tenapanor selectively inhibits the passive paracellular transfer of phosphate in the gastrointestinal tract, thereby reducing serum phosphorus levels. Read More

Am J Case Rep 2021 Jun 7;22:e930026. Epub 2021 Jun 7.

Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin, Poland.

BACKGROUND Calciphylaxis is a rare and lifethreatening syndrome characterized by small vascular calcifications, which lead to the occlusion of blood vessels and painful skin lesions with tissue necrosis. Although the disease can develop in a population without kidney failure, it is typically detected in patients receiving dialysis, with an increasing frequency ranging from 1% to 4%. Therefore, the disease is also known as calcific uremic arteriolopathy. Read More

Front Vet Sci 2021 19;8:679970. Epub 2021 May 19.

Department of Ecology and Diseases of Zoo Animals, Game, Fish and Bees, Faculty of Veterinary Hygiene and Ecology, University of Veterinary Sciences Brno, Brno, Czechia.

Significant mortalities associated with emerging viral diseases are challenging the economy of common carp aquaculture. As such, there is an increased need to disentangle how infected fish cope with progressive disease pathology and lose the ability for homeostatic maintenance of key physiological parameters. A natural carp edema virus (CEV) infection outbreak at a carp fish farm provided an opportunity to examine diseased and healthy carp in the same storage pond, thereby contributing to our better understanding of CEV disease pathophysiology. Read More

Clin J Gastroenterol 2021 Jun 1. Epub 2021 Jun 1.

Department of Internal Medicine, Local Incorporated Administrative Agency, Tokushima Prefecture Naruto Hospital, 32 Kurosaki Aza Kotani Muya-cho, Naruto, Tokushima, 772‑8503, Japan.

Lanthanum carbonate is used to prevent hyperphosphatemia in dialysis patients with chronic renal failure and generally recognized as poorly absorbed by the gastrointestinal tract. However, some clinical cases of lanthanum deposition in the stomach have been shown. In addition, few endoscopic images of lanthanum deposition have been reported, particularly with respect to early-stage gastric cancer. Read More

Nutrients 2021 May 14;13(5). Epub 2021 May 14.

Department of Nephrology, Tokyo Women's Medical University, Tokyo 162-8666, Japan.

A series of problems including osteopathy, abnormal serum data, and vascular calcification associated with chronic kidney disease (CKD) are now collectively called CKD-mineral bone disease (CKD-MBD). The pathophysiology of CKD-MBD is becoming clear with the emerging of αKlotho, originally identified as a progeria-causing protein, and bone-derived phosphaturic fibroblast growth factor 23 (FGF23) as associated factors. Meanwhile, compared with calcium and parathyroid hormone, which have long been linked with CKD-MBD, phosphate is now attracting more attention because of its association with complications and outcomes. Read More

Antioxidants (Basel) 2021 May 21;10(6). Epub 2021 May 21.

Department of Biochemistry, Faculty of Veterinary Medicine, Zagazig University, Zagazig 44519, Egypt.

This study examined the effect of sodium salicylates (SS), alone and in combination with curcumin (CUR), on kidney function and architecture in rats. Five rat groups were given 1 mL physiological saline/rat orally, 1 mL olive oil/rat orally, 50 mg CUR/kg bwt orally, 300 mg SS/kg bwt intraperitoneally, or CUR+SS for 15 days. The hematological indices, serum protein profile, serum electrolytes balance, oxidative stress, and lipid peroxidation of kidney tissues were assessed. Read More

J Nephrol 2021 Jun 1. Epub 2021 Jun 1.

Division of Nephrology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, 1873 RAMA IV, Bangkok, 10330, Thailand.

Background: Besides reducing hyperphosphatemia in chronic kidney disease (CKD) patients, phosphate lowering agents might provide beneficial effects on clinical and laboratory parameters. This meta-analysis was conducted to comprehensively examine the impact of all phosphate lowering agents on various aspects of clinical and laboratory outcomes in CKD patients.

Method: A systematic literature search was performed in MEDLINE, Scopus, and the Cochrane Register of Controlled Trials until July 2020 to identify randomized controlled trials (RCTs) which compared the effects of each phosphate lowering agent with controls, comprising placebo and all other phosphate lowering agents. Read More

Vet Pathol 2021 Jun 1:3009858211020669. Epub 2021 Jun 1.

3447Colorado State University, Fort Collins, CO, USA.

In a collection of 6 young binturongs (), 3 presented with anorexia, lethargy, and footpad swelling diagnosed by surgical biopsy as calcinosis circumscripta. Despite supportive care over the next 4 years, affected binturongs had progressive weight loss, hyperphosphatemia, and hyperkalemia and developed large radiodense deposits in tissues adjacent to appendicular joints, thoracolumbar vertebrae, and the sternum. Two binturongs died and necropsies showed severe periarticular mineral deposition with fibrosis and granulomatous inflammation. Read More

BMC Pharmacol Toxicol 2021 May 28;22(1):30. Epub 2021 May 28.

King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.

Objective: The aim of this study is to examine the association of hypophosphatemia and hyperphosphatemia on the first day of ICU admission with mortality in septic critically ill patients.

Methods: In this retrospective cohort study, all adult patients who were admitted to the medical-surgical ICUs between 2014 and 2017 with sepsis or septic shock were categorized as having hypophosphatemia, normophosphatemia and hyperphosphatemia based on day 1 serum phosphate values. We compared the clinical characteristics and outcomes between the three groups. Read More

J Mater Chem B 2021 Jun;9(22):4555-4566

Key Laboratory of Marine Materials and Related Technologies, Zhejiang Key Laboratory of Marine Materials and Protective Technologies, Ningbo Institute of Materials Technology & Engineering, Chinese Academy of Sciences, No. 1219 Zhongguan West Rd, Ningbo 315201, China. and University of Chinese Academy of Sciences, 19 A Yuquan Rd, Shijingshan District, Beijing 100049, China.

Hyperphosphatemia, a common complication of chronic renal failure patients, is described as an excess amount of serum phosphate >4.5 mg dL-1. Current therapy for hyperphosphatemia is limited by low removal efficiency, secondary hyperparathyroidism, uremic bone disease, and the promotion of vascular and visceral calcifications. Read More

Front Pediatr 2021 11;9:550158. Epub 2021 May 11.

Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Japan.

Secondary hyperparathyroidism (HPT) is a common complication of end-stage renal disease (ESRD) and may be an important precipitating factor for the development of myelofibrosis. However, there have been only a few reports on myelofibrosis caused by secondary HPT in children. We describe a case of a 15-year-old boy with myelofibrosis due to secondary HPT who was successfully treated with hemodialysis, erythropoietin, phosphate binders, and activated vitamin D agents. Read More

Ther Adv Med Oncol 2021 18;13:17588359211015499. Epub 2021 May 18.

Latin American Cooperative Oncology Group - LACOG, Genito-Urinary Tumors Section, Porto Alegre, RS, Brazil.

Background: Erdafitinib is the first targeted therapy approved for the treatment of patients with metastatic urothelial carcinoma (mUC). Approval was based on a phase II single-arm trial that demonstrated significant activity of erdafitinib in patients with tumors harboring FGFR2/3 alterations. In Brazil, an Expanded Access Program (EAP) provided patients with early access to erdafitinib prior to market authorization. Read More

Case Rep Med 2021 10;2021:9962624. Epub 2021 May 10.

Ronald Reagan UCLA Medical Center, David Geffen School of Medicine, Kidney Transplant Program, Los Angeles, CA, USA.

Hyperphosphatemia may arise from various conditions including exogenous ingestion, extracellular shifts due to cell death or alterations in acid-base status, increased bone resorption, hormonal dysregulations leading to reduced renal excretion, reduced kidney function, or faulty measurement techniques. We herein present a case of a young pregnant woman who presented with mild acute kidney injury (AKI), invasive mucormycosis receiving liposomal amphotericin, and hyperphosphatemia out of proportion to the degree of kidney injury. While the patient was given routine phosphate-binding agent by her primary care team for presumed AKI-associated hyperphosphatemia, a full investigation by the renal consulting team for contributing factors other than kidney injury revealed that she actually had pseudohyperphosphatemia associated with the use of liposomal amphotericin. Read More

Indian J Nucl Med 2021 Jan-Mar;36(1):76-77. Epub 2021 Mar 4.

Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Tumoral calcinosis is a rare entity presenting with periarticular calcium deposits, leading to multiple swellings and biochemical hyperphosphatemia and normocalcemia. Skeletal scintigraphy in these cases is helpful by providing a whole-body survey and delineating the common multifocality of this entity. We present the case of a 16-year-old boy with multiple swellings around the knee and elbow joints, having developed over 4 years and diagnosed as tumor calcinosis. Read More

Front Vet Sci 2021 5;8:621084. Epub 2021 May 5.

Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma del Estado de Mexico, Toluca, Mexico.

This research was performed to describe the characteristics of the progression of naturally occurring chronic kidney disease (CKD) in dogs, together with the management of identified risk factors, following the International Renal Interest Society recommendations. Dogs diagnosed and staged with CKD, and with a longitudinal follow-up from the moment of diagnosis of up to a maximum of 730 days, were included. A total of 545 dogs that presented risk factors for the development of CKD were analyzed, out of which 36 met the inclusion criteria. Read More

Kidney Int 2021 Jun;99(6):1264-1267

Department of Nephrology, Ambroise Paré University Hospital, Assistance publique Hôpitaux de Paris, Boulogne-Billancourt, France; Institut national de la santé et de la recherche médicale U1018-Team 5, Centre de recherche en Epidémiologie et Santé des Populations, Université de Versailles Saint-Quentin-en-Yvelines, University Paris Saclay, Villejuif, France; University Versailles-Saint Quentin, University Paris-Saclay, Villejuif, France. Electronic address:

Cardiovascular disease is highly prevalent in patients with chronic kidney disease. Hyperphosphatemia is associated with subclinical atheromatosis in chronic kidney disease. Phosphate-induced endothelial dysfunction and vascular calcification are thought to be key inducers of atherosclerosis in this condition. Read More

Nephrol Dial Transplant 2021 May 21. Epub 2021 May 21.

Vascular and Renal Translational Research Group, Biomedical Research Institute, IRBLLEIDA, and RedinRen RETIC, ISCIII.

Background: Secondary hyperparathyroidism (SHPT) is a complication of chronic kidney disease (CKD), and it is associated with changes in calcium and phosphate. These related changes have been associated with increased cardiovascular mortality and CKD progression. It is not clear whether negative outcomes linked to SHPT are confounded by such factors. Read More

Aging (Albany NY) 2021 05 20;13(10):14355-14371. Epub 2021 May 20.

Department of Physiology and Pathophysiology, National Key Discipline of Cell Biology, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China.

In the present study, the effects and mechanism of action of U50,488H (a selective κ-opioid receptor agonist) on calcification of rat vascular smooth muscle cells (VSMCs) induced by β-glycerophosphate (β-GP) were investigated. VSMCs were isolated and cultured in traditional FBS-based media. A calcification model was established in VSMCs under hyperphosphatemia and intracellular calcium contents. Read More

JAMA 2021 05;325(19):1946-1954

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

Importance: Among patients with hyperphosphatemia undergoing dialysis, it is unclear whether non-calcium-based phosphate binders are more effective than calcium-based binders for reducing cardiovascular events.

Objective: To determine whether lanthanum carbonate reduces cardiovascular events compared with calcium carbonate in patients with hyperphosphatemia at risk of vascular calcification undergoing hemodialysis.

Design, Setting, And Participants: Open-label, randomized, parallel-group clinical trial with blinded end point adjudication performed in 2374 patients with chronic kidney disease from 273 hemodialysis facilities in Japan. Read More

Indian J Nephrol 2021 Jan-Feb;31(1):27-32. Epub 2020 Nov 7.

Department of Nephrology, Laboratory Sciences and Molecular Medicine, Army Hospital (Research and Referral), New Delhi, India.

Background: The benefits of twice-weekly dialysis at initiation are significant with respect to access longevity, preservation of residual renal function, economic factors, and patient quality of life. It is widely practiced in developing countries due to resource and financial constraints. We present a 3-year follow-up of patients on twice-weekly dialysis and their outcomes. Read More

Iran J Kidney Dis 2021 May;15(3):199-205

Department of Nephrology, Dayanand Medical College and Hospital, Ludhiana, India.

Introduction: Mineral bone disease is an important complication of chronic kidney disease ends up in increased cardiovascular morbidity and mortality in these patients. The aim of present study was to determine the pattern, prevalence and the clinical, biochemical and radiological profile of mineral bone disease in predialysis and dialysis (stage 5D) patients of chronic kidney disease.

Methods: Patients of stage 3, 4, 5 and 5D of chronic kidney disease admitted to the department of nephrology were enrolled in this study. Read More

J Vet Intern Med 2021 May 15;35(3):1265-1273. Epub 2021 May 15.

Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Ozzano Emilia, Italy.

Background: Hypercortisolism affects calcium and phosphate metabolism in dogs; however, the exact mechanisms are not completely understood.

Objectives: To evaluate circulating concentrations of whole parathormone (wPTH), 25-hydroxyvitamin D (25-(OH)D), calcitriol, and fibroblast growth factor-23 (FGF-23) in dogs with naturally occurring hypercortisolism (NOHC) and healthy dogs, and their association with calcium and phosphate homeostasis.

Animals: Twenty-three client-owned dogs with NOHC, and 12 client or staff-owned healthy dogs. Read More

JBMR Plus 2021 May 22;5(5):e10470. Epub 2021 Mar 22.

National Institute of Dental and Craniofacial Research, National Institutes of Health Bethesda MD USA.

Hyperphosphatemic familial tumoral calcinosis (HFTC) is a rare autosomal recessive disorder caused by mutations in , , , or FGF23 autoantibodies. Prominent features include high blood phosphate and calcific masses, usually adjacent to large joints. Dental defects have been reported, but not systematically described. Read More

Cureus 2021 Apr 7;13(4):e14338. Epub 2021 Apr 7.

Pediatric Nephrology, University of Louisville School of Medicine, Louisville, USA.

Seizures secondary to hypocalcemia have been well documented and studied. There are various causes of hypocalcemia described in the literature, but a prolonged seizure episode leading to cell lysis, severe hyperphosphatemia, and hypocalcemia is rarely reported. We present the case of a 3-year-old male with severe hyperphosphatemia and hypocalcemia secondary to the likely presence of cell lysis from prolonged seizure activity. Read More