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Osteoporos Int 2018 Jun 20. Epub 2018 Jun 20.

Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, Lebanon.

Hyperphosphatemic familial tumoral calcinosis (HFTC), secondary to fibroblast growth factor 23 (FGF23) gene mutation, is a rare genetic disorder characterized by recurrent calcified masses. We describe young Lebanese cousins presenting with HFTC, based on a retrospective chart review and a prospective case study. In addition, we present a comprehensive review on the topic, based on a literature search conducted in PubMed and Google Scholar, in 2014 and updated in December 2017. Read More

J Pharmacol Exp Ther 2018 Jun 14. Epub 2018 Jun 14.

Queen's University.

Patients with chronic kidney disease have a markedly increased risk for developing cardiovascular disease. Non-traditional risk factors, such as increased phosphate retention, and deficiencies in vitamins D and K metabolism, likely play key roles in the development of vascular calcification during CKD progression. Calcitriol (1,25-(OH)2-D3) is a key transcriptional regulator of Matrix Gla protein (MGP), a vitamin K dependent protein that inhibits vascular calcification. Read More

BMC Res Notes 2018 Jun 8;11(1):363. Epub 2018 Jun 8.

Department of Kidney Disease, Kawashima Hospital, 1-39 Kitasakoichiban-cho, Tokushima, 770-0011, Japan.

Objective: Sucroferric oxyhydroxide, a novel iron-based phosphate-binder, has been shown to have beneficial effects in lowering serum phosphorus levels and improving renal anemia in clinical studies. Although an effect of this agent on fibroblast growth factor 23 (FGF23) has been reported in an animal study, there is little clinical data supporting this finding. This study aimed to evaluate the effect on chronic kidney disease-mineral and bone disorder, FGF23, renal anemia, iron-related parameters, adverse events of sucroferric oxyhydroxide in hemodialysis patients. Read More

Lab Invest 2018 Jun 1. Epub 2018 Jun 1.

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

Cisplatin (CP)-induced nephrotoxicity is widely accepted as a model for acute kidney injury (AKI). Although cisplatin-induced chronic kidney disease (CKD) in rodent has been reported, the role of phosphate in the cisplatin-induced CKD progression is not described. In this study, we gave a single peritoneal injection of CP followed by high (2%) phosphate diet for 20 weeks. Read More

Platelets 2018 May 31:1-4. Epub 2018 May 31.

a Division of Nephrology, Department of Medicine , Tri-Service General Hospital, National Defense Medical Center , Taipei , Taiwan.

We describe the case of a 62-year-old woman with schizophrenia and intellectual disability, who presented with intermittent muscle cramping for 2 weeks. A dysmorphic face and a positive Trousseau's sign, but without ecchymosis or petechial lesion were noted. Laboratory data revealed impaired renal function (creatinine level = 1. Read More

Cancer Discov 2018 May 30. Epub 2018 May 30.

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

BGJ398, a potent and selective pan-FGFR antagonist, was prospectively evaluated in patients with metastatic urothelial carcinoma bearing a diverse array of alterations. Patients ( = 67) who were unable to receive platinum chemotherapy were enrolled. The majority (70. Read More

Hosp Pract (1995) 2018 Jun 18:1-7. Epub 2018 Jun 18.

a Division of Nephrology and Hypertension, Department of Medicine , Mayo Clinic , Rochester , MN , USA.

Background: The aim of this study was to assess the relationship between admission serum phosphate levels and in-hospital mortality in all hospitalized patients.

Methods: All adult hospitalized patients who had admission serum phosphate available between years 2009 and 2013 were enrolled. Admission serum phosphate was categorized based on its distribution into six groups (<2. Read More

J Clin Endocrinol Metab 2018 May 25. Epub 2018 May 25.

Metabolic Disorders and Complications, McGill University Health Centre Research Institute, Departments of Medicine, Physiology, and Human Genetics, McGill University Montréal, QC, Canada.

Context: Autosomal dominant hypocalcemia type 1 is caused by heterozygous activating mutations in the calcium-sensing receptor gene (CASR). Whether polymorphisms that are benign in the heterozygous state pathologically alter receptor function in the homozygous state is not known.

Objective: To identify the genetic defect in an adolescent female with a past history of surgery for bilateral cataracts and seizures. Read More

Gynecol Oncol Rep 2018 May 24;24:21-23. Epub 2018 Feb 24.

Department of Obstetrics and Gynecology, Yamagata University, Faculty of medicine, Iidanishi 2-2-2, Yamagata 990-9585, Japan.

Tumor lysis syndrome (TLS) is an oncological life-threatening complication characterized by hyperuricemia, hyperphosphatemia, and hyperkalemia, which can lead to acute renal failure, cardiac arrhythmias, cardiac arrest and seizures. Although TLS is a rare complication in patients with non-hematological malignancy, the mortality rate of TLS in solid tumors is higher than that in hematological malignancies. Acute renal injury is the most common cause of mortality associated with TLS in solid tumors. Read More

Pathol Res Pract 2018 Jul 23;214(7):934-939. Epub 2018 May 23.

Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.

Objective: Although lanthanum deposition in the stomach has been most frequently reported to occur as white lesions, no study has investigated whether the white lesions observed during esophagogastroduodenoscopy are truly lanthanum-related. Here, we retrospectively investigated the amount of lanthanum in endoscopic biopsy specimens.

Methods: We reviewed four patients showing gastric white spots or annular whitish mucosa in the gastric white lesions (Bw) and peripheral mucosa where the white substance was not endoscopically observed (Bp) during biopsy. Read More

Rev Med Chil 2018 Jan;146(1):116-121

Departamento de Endocrinología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

Pseudohypoparathyroidism (PHP) is a group of rare genetic disorders that share organ targeted resistance to the action of parathyroid hormone (PTH) as a common feature. Biochemically, they may present with hypocalcemia, hyperphosphatemia and elevated PTH. Some forms present with a specific phenotype: short stature, round facies, short neck, obesity, brachydactyly and subcutaneous calcifications, called Albrigth's Hereditary Osteodystrophy (AHO). Read More

J Bras Nefrol 2018 Jan-Mar;40(1):26-34. Epub 2018 May 7.

Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil.

Introduction: The diagnosis and treatment of mineral and bone disorder of chronic kidney disease (CKD-MBD) is a challenge for nephrologists and health managers. The aim of this study was to evaluate the prevalence, biochemical profile, and drugs associated with CKD-MBD.

Methods: Cross-sectional study between July and November 2013, with 1134 patients on dialysis. Read More

Can J Kidney Health Dis 2018 13;5:2054358118775097. Epub 2018 May 13.

Université du Québec à Trois-Rivières, Trois-Rivières, Canada.

Background: The implementation of advanced chronic kidney disease (CKD) multidisciplinary clinics has now demonstrated their effectiveness in delaying and even avoiding dialysis for patients with CKD. However, very little has been documented on the management and achievement of targets for a number of parameters in this context.

Objective: Our goal was to assess our multidisciplinary clinic therapy performance in relation to the targets for hypertension, anemia, and calcium phosphate assessment. Read More

Expert Opin Drug Saf 2018 Jun 21;17(6):597-607. Epub 2018 May 21.

a Department of Nephrology and Dialysis , A. Manzoni Hospital ASST Lecco , Lecco , Italy.

Introduction: Hyperphosphatemia is common in late stages of chronic kidney disease and is often associated with elevated parathormone levels, abnormal bone mineralization, extra-osseous calcification, and increased risk of cardiovascular events and death. Several classes of oral phosphate binders are available to help control plasma phosphorus levels. Although effective at lowering serum phosphorus, they all have safety, tolerability, and compliance issues that need to be considered when selecting which one to use. Read More

Kardiologiia 2018 SFeb(S2):42-62

Federal State Budgetary Educational Institution of Higher Education, "Pirogov Russian National Research Medical University" of the Ministry of Health of the Russian Federation.

In many patients, chronic heart failure (CHF) is associated with chronic kidney disease (CKD). Virtually all patients with terminal CKD and many patients with early CKD display various disorders of mineral and bone metabolism (MBM) related with all-cause mortality and high risk of cardiovascular complications. This review addressed disorders of mineral and bone metabolism in patients with CHF, including hypocalcemia, hyperphosphatemia, vitamin D insufficiency/deficiency, secondary hyperparathyroidism, changed levels of FGF23 and Klotho, osteoporosis, osteopenia, their clinical and prognostic significance, and possibilities of their correction. Read More

Front Endocrinol (Lausanne) 2018 4;9:207. Epub 2018 May 4.

Department of Internal Medicine and Cardiology, Charité-Universität Medizin Berlin, Berlin, Germany.

Medial vascular calcification, a major pathophysiological process associated with cardiovascular disease and mortality, involves osteo-/chondrogenic transdifferentiation of vascular smooth muscle cells (VSMCs). In chronic kidney disease (CKD), osteo-/chondrogenic transdifferentiation of VSMCs and, thus, vascular calcification is mainly driven by hyperphosphatemia, resulting from impaired elimination of phosphate by the diseased kidneys. Hyperphosphatemia with subsequent vascular calcification is a hallmark of klotho-hypomorphic mice, which are characterized by rapid development of multiple age-related disorders and early death. Read More

Eur J Epidemiol 2018 May 15. Epub 2018 May 15.

Department of Internal Medicine, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.

Hyperphosphatemia has been associated with increased mortality in chronic kidney disease but the nature of such a relation in the general population is unclear. To investigate the association between phosphate (P) levels and all-cause and cause-specific mortality, we assessed two cohorts from the Rotterdam Study, with follow-up of 14.5 (RS-I) and 10. Read More

Exp Biol Med (Maywood) 2018 May;243(9):796-802

1 Laboratory of Experimental Nephrology (LABNEX) and Interdisciplinary Nucleus of Laboratory Animal Studies (NIDEAL), Reproductive Biology Center (CBR), Federal University of Juiz de Fora (UFJF), Juiz de Fora 36036900, Brazil.

Cross-linked chitosan iron (III) is a chitin-derived polymer with a chelating effect on phosphorus, but it is untested in vascular calcification. We evaluated this compound's ability to reduce hyperphosphatemia and its effect on vascular calcification in uremic rats using an adenine-based, phosphorus-rich diet for seven weeks. We used a control group to characterize the uremia. Read More

J Bras Nefrol 2018 May 7. Epub 2018 May 7.

Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil.

Introduction: The diagnosis and treatment of mineral and bone disorder of chronic kidney disease (CKD-MBD) is a challenge for nephrologists and health managers. The aim of this study was to evaluate the prevalence, biochemical profile, and drugs associated with CKD-MBD.

Methods: Cross-sectional study between July and November 2013, with 1134 patients on dialysis. Read More

Kidney Int 2018 Jul 30;94(1):102-113. Epub 2018 Apr 30.

Laboratory of Pathophysiology, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium. Electronic address:

Chronic kidney disease (CKD) causes dysregulation of mineral metabolism, vascular calcification and renal osteodystrophy, an entity called 'CKD-Mineral and Bone Disorder' (CKD-MBD). Here we determine whether metformin, an anti-diabetic drug, exerts favorable effects on progressive, severe CKD and concomitant mineral metabolism disturbances. Rats with CKD-MBD, induced by a 0. Read More

Cell Physiol Biochem 2018 18;46(4):1305-1316. Epub 2018 Apr 18.

Department of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Background/aims: Fibulin-3, an extracellular matrix glycoprotein, inhibits vascular oxidative stress and remodeling in hypertension. Oxidative stress is prevalent in chronic kidney disease (CKD) patients and is an important mediator of osteo-/chondrogenic transdifferentiation and calcification of vascular smooth muscle cells (VSMCs) during hyperphosphatemia. Therefore, the present study explored the effects of Fibulin-3 on phosphate-induced vascular calcification. Read More

Stud Health Technol Inform 2018 ;247:810-814

Dept. of Health Science and Technology, Aalborg University, Aalborg, Denmark.

Hyperphosphatemia is known as one of the more challenging conditions in end-stage renal disease patients. This study set out to present and evaluate a healthcare-oriented decision support tool in the management of hyperphosphatemia within hemodialysis therapy. A prototype module was designed to fit into the interface of a modern dialysis machine (Fresenius 5008). Read More

Nephrol Dial Transplant 2018 Apr 16. Epub 2018 Apr 16.

Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, Isehara, Japan.

Background: Hyperphosphatemia and poor nutritional status are associated with increased mortality. Lanthanum carbonate is an effective, calcium-free phosphate binder, but little is known about the long-term impact on mineral metabolism, nutritional status and survival.

Methods: We extended the follow-up period of a historical cohort of 2292 maintenance hemodialysis patients that was formed in late 2008. Read More

Semin Dial 2018 Apr 19. Epub 2018 Apr 19.

NorthShore University HealthSystem and University of Chicago-Pritzker School of Medicine, Chicago, IL, USA.

Hyperphosphatemia is a common complication of CKD. Prior to development of overt hyperphosphatemia, there are several adaptive mechanisms that occur to maintain normal phosphorus equilibrium in patients with CKD. These include an early and progressive rise in fibroblast growth factor 23 (FGF 23), followed by an increase in parathyroid hormone (PTH) with a decrease in 1,25-dihydroxyvitamin D (1,25 Vit D). Read More

Am J Physiol Renal Physiol 2018 Apr 18. Epub 2018 Apr 18.

Medicine, University of Ottawa / Ottawa Hospital Research Institute, Canada.

Loss of ubiquitin C-terminal hydrolase L1 (UCHL1), a deubiquitinating enzyme required for neuronal function, led to hyperphosphatemia accompanied by phosphaturia in mice, while calcium homeostasis remained intact. We therefore investigated the mechanisms underlying the phosphate imbalance in Uchl1-/- mice. Interestingly, phosphaturia was not a result of lower renal brush border membrane sodium-phosphate cotransporter expression as sodium-phosphate cotransporter 2a and 2c expression levels were similar to wild type levels. Read More

Hemodial Int 2018 Apr 15. Epub 2018 Apr 15.

University of California, Los Angeles, California, USA.

Introduction: Sucroferric oxyhydroxide (SFOH) is a non-calcium, iron-based phosphate binder that demonstrated sustained serum phosphorus (sP) control, good tolerability, and lower pill burden, vs. sevelamer carbonate ("sevelamer"), in a Phase 3 study conducted in dialysis patients with hyperphosphatemia. This analysis evaluates the efficacy and safety of SFOH and sevelamer among African American (AA) patients participating in the trial. Read More

Am J Kidney Dis 2018 Apr 11. Epub 2018 Apr 11.

Perelman School of Medicine at the University of Pennsylvania, Hospital of the University of Pennsylvania, Philadelphia, PA.

J Am Soc Nephrol 2018 Jun 13;29(6):1636-1648. Epub 2018 Apr 13.

Department of Internal Medicine and Cardiology, Charité- Universitätsmedizin Berlin, Berlin, Germany.

The high cardiovascular morbidity and mortality of patients with CKD may result in large part from medial vascular calcification, a process promoted by hyperphosphatemia and involving osteo-/chondrogenic transdifferentiation of vascular smooth muscle cells (VSMCs). Reduced serum zinc levels have frequently been observed in patients with CKD, but the functional relevance of this remains unclear. We performed experiments in primary human aortic VSMCs; klotho-hypomorphic (), subtotal nephrectomy, and cholecalciferol-overload mouse calcification models; and serum samples from patients with CKD. Read More

J Endocrinol 2018 Jun 9;237(3):285-300. Epub 2018 Apr 9.

Department of Calcified Tissue BiologySchool of Dentistry, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan

The type I transmembrane protein αKlotho (Klotho) serves as a coreceptor for the phosphaturic hormone fibroblast growth factor 23 (FGF23) in kidney, while a truncated form of Klotho (soluble Klotho, sKL) is thought to exhibit multiple activities, including acting as a hormone, but whose mode(s) of action in different organ systems remains to be fully elucidated. FGF23 is expressed primarily in osteoblasts/osteocytes and aberrantly high levels in the circulation acting via signaling through an FGF receptor (FGFR)-Klotho coreceptor complex cause renal phosphate wasting and osteomalacia. We assessed the effects of exogenously added sKL on osteoblasts and bone using Klotho-deficient () mice and cell and organ cultures. Read More

Kidney Res Clin Pract 2018 Mar 31;37(1):69-76. Epub 2018 Mar 31.

Department of Nephrology, Ajou University School of Medicine, Suwon, Korea.

Background: For phosphate control, patient education is essential due to the limited clearance of phosphate by dialysis. However, well-designed randomized controlled trials about dietary and phosphate binder education have been scarce.

Methods: We enrolled maintenance hemodialysis patients and randomized them into an education group (n = 48) or a control group (n = 22). Read More

Kidney Res Clin Pract 2018 Mar 31;37(1):4-7. Epub 2018 Mar 31.

Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie (INSPECT-LB), Faculty of Public Health, The Lebanese University, Fanar, Lebanon.

J Vet Med Sci 2018 May 6;80(5):823-828. Epub 2018 Apr 6.

Department of Veterinary Medicine and Surgery, University of Missouri, College of Veterinary Medicine, 900 East Campus Drive, Columbia, MO 65211, U.S.A.

Five Japanese Black embryo transfer calves from a single embryo flush, 30 to 45-days-old, including 4 live animals for clinical examination and 1 dead for necropsy, were presented with a history of decreased milk intake and hypoproteinemia. Consistent clinicopathological abnormalities in the 4 calves presented for clinical evaluation included hyperkalemia, hyperphosphatemia, hypoproteinemia, hypoalbuminemia, hyperbilirubinemia, increased creatine phosphokinase activity, and proteinuria. Four calves ultimately were necropsied and all had histologic evidence of immune complex glomerulonephritis. Read More

Kidney Blood Press Res 2018 29;43(2):536-544. Epub 2018 Mar 29.

Department of Blood Purification, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

Background/aims: Hyperphosphatemia is common in patients on hemodialysis. The efficacy of lanthanum carbonate (LC) in the treatment of hyperphosphatemia in these patients remains controversial. The objective of this meta-analysis was to evaluate the effect of LC on all-cause mortality in patients on maintenance hemodialysis. Read More

Am J Case Rep 2018 Apr 6;19:406-409. Epub 2018 Apr 6.

Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA.

BACKGROUND Gastrointestinal tract mucosal calcinosis (MC) tends to affect the gastric mucosa, while esophageal involvement is rare. Gastric MC may be seen with solid organ transplantation, use of aluminum-containing antacids or sucralfate, malignancy, and chronic renal failure. While the incidence of gastric MC in renal transplant patients undergoing gastric biopsy is common (between 15-29%), to our knowledge esophageal MC has only been previously reported 3 times. Read More

J Clin Endocrinol Metab 2018 Jun;103(6):2319-2328

Université Paris Descartes, Faculté de Médecine, Paris, France.

Context: The bone-derived hormone fibroblast growth factor (FGF) 23 controls phosphate homeostasis and urinary phosphate excretion. FGF23 plasma levels increase in the early stage of renal insufficiency to prevent hyperphosphatemia. Recent evidence suggests that this increase has effects on cardiac and immune cells that compromise patients' health. Read More

Nephrol Dial Transplant 2018 Apr 3. Epub 2018 Apr 3.

Duke University School of Medicine and Duke Clinical Research Institute, Durham, NC, USA.

Background: Elevated serum fibroblast growth factor 23 (FGF23) is strongly associated with cardiovascular risk and mortality. Tenapanor, an inhibitor of gastrointestinal sodium/hydrogen exchanger isoform 3, decreased serum phosphate in a randomized, double-blind, placebo-controlled Phase 2 trial (ClinicalTrials.gov identifier NCT02081534) of patients receiving hemodialysis with hyperphosphatemia. Read More

BMC Nephrol 2018 Apr 3;19(1):80. Epub 2018 Apr 3.

Department of Nephrology, Fujita Health University, Toyoake, Aichi, Japan.

Background: Aortic stenosis (AS) is common in patients on dialysis as well as in the general population. AS leads to difficulty with dialysis therapy because of unstable conditions such as intradialytic hypotension due to low cardiac output. However, the precise morbidity rates and risk factors of AS in patients on dialysis are unknown. Read More

PLoS One 2018 3;13(4):e0195316. Epub 2018 Apr 3.

Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, Kanagawa, Japan.

Cinacalcet hydrochloride (cinacalcet), an oral calcimimetic agent has been widely used for the management of secondary hyperparathyroidism (SHPT) in chronic kidney disease (CKD). In sharp contrast to vitamin D receptor activators, cinacalcet suppresses SHPT without inducing hypercalcemia or hyperphosphatemia. Nevertheless, some patients remain refractory to SHPT with this agent, as the dose cannot be sufficiently increased due to gastrointestinal symptoms. Read More

Pediatr Nephrol 2018 Jul 28;33(7):1263-1267. Epub 2018 Mar 28.

Centre de Référence des Maladies Rénales Rares, Centre de Référence des Maladies Rares du Calcium et du Phosphate, Hospices Civils de Lyon, Hôpital Femme Mère Enfant, 59 boulevard Pinel, 69677, Bron cedex, France.

Background: Hyperphosphatemic familial tumoral calcinosis (HFTC) is a rare autosomal recessive disease caused by mutations in genes encoding FGF23 or its regulators, and leading to functional deficiency or resistance to fibroblast growth factor 23 (FGF23). Subsequent biochemical features include hyperphosphatemia due to increased renal phosphate reabsorption, and increased or inappropriately normal 1,25-dihydroxyvitamin D (1,25-D) levels.

Case-diagnosis/treatment: A 15-year-old girl was referred for a 1. Read More

G Ital Nefrol 2018 Mar;35(2)

Dipartimento di Scienze Cardiovascolari Respiratorie Nefrologiche Anestetiche e Geriatriche. Sapienza Università di Roma.

CKD-MBD is a systemic disorder of the mineral and bone metabolism as a result of CKD. The clinical relevance of this syndrome has led to the identification of the biochemical targets to be achieved in order to improve the outcome of the patient. However, in hemodialysis (HD) and peritoneal dialysis (DP) patients, these targets are not reached. Read More

Kidney Int 2018 May 23;93(5):1060-1072. Epub 2018 Mar 23.

Department of Nephrology, Amsterdam Cardiovascular Sciences, VU University Medical Center, Amsterdam, the Netherlands; Department of Epidemiology and Biostatistics, Amsterdam Public Health Institute, VU University Medical Center, Amsterdam, the Netherlands.

Hyperphosphatemia has consistently been shown to be associated with dismal outcome in a wide variety of populations, particularly in chronic kidney disease (CKD). Compelling evidence from basic and animal studies elucidated a range of mechanisms by which phosphate may exert its pathological effects and motivated interventions to treat hyperphosphatemia. These interventions consisted of dietary modifications and phosphate binders. Read More

Value Health 2018 03 18;21(3):318-325. Epub 2017 Oct 18.

Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.

Background: Phosphate binders are used to treat hyperphosphatemia among patients with chronic kidney disease (CKD).

Objectives: To conduct an economic evaluation comparing calcium-free binders sevelamer and lanthanum with calcium-based binders for patients with CKD.

Methods: Effectiveness data were obtained from a recent meta-analysis of randomized trials. Read More

Medicine (Baltimore) 2018 Mar;97(12):e0117

Hemodialysis Room, Liaocheng People's Hospital of Shandong Province, China.

Background: Studies indicate that nicotinic acid and related compounds may decrease phosphorus concentrations effectively by reducing the absorption in the gastrointestinal tract. However, the efficacy and safety of oral niacin treatments have only been investigated in a limited number of small-scale studies.

Methods: We performed this meta-analysis by pooling 12 qualified relevant preclinical and clinical trials to evaluate the association of nicotinic acid (and its related compounds) treatment and hyperphosphatemia among dialysis patients. Read More

Am J Kidney Dis 2018 Mar 14. Epub 2018 Mar 14.

Nephrology Division, University of São Paulo School of Medicine, São Paulo-SP, Brazil; Universidade Nove de Julho, São Paulo-SP, Brazil. Electronic address:

Primary tumoral calcinosis is a rare autosomal recessive disorder characterized by ectopic calcified tumoral masses. Mutations in 3 genes (GALNT3, FGF23, and KL) have been linked to this human disorder. We describe a case of a 28-year-old man with a history of painful firm masses over his right and left gluteal region, right clavicle region, knees, and left elbow. Read More

FASEB J 2018 Mar 16:fj201700653R. Epub 2018 Mar 16.

Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB)-Arrixaca, Murcia, Spain.

Vascular smooth muscle cells (VSMCs) transdifferentiate into osteoblast-like cells during vascular calcification, inducing active remodeling and calcification of the extracellular matrix (ECM). Intracellular and extracellular enzymes, such as lysyl hydroxylase 1 (PLOD1) and lysyl oxidase (LOX), contribute to ECM maturation and stabilization. We assessed the contribution of these enzymes to hyperphosphatemia (HPM)-induced calcification. Read More

Pediatr Emerg Care 2018 Mar 12. Epub 2018 Mar 12.

Background: Mistaken ingestion of all manner of toxic matter is common in childhood, but poisoning with fireworks and matchsticks is rare. Fireworks usually contain 10% yellow phosphorus and 50% potassium chlorate. Potassium chlorate is an extremely reactive and toxic agent that is used in fireworks and matchstick heads. Read More

Clin Exp Nephrol 2018 Mar 13. Epub 2018 Mar 13.

Department of Comprehensive Kidney Disease Research, Osaka University Graduate School of Medicine, Suita, Japan.

Background: In dialysis patients, mortality risk due to cardiovascular diseases is remarkably high and prognosis is poor; coronary artery calcification is considered one of the major contributing factors. It is known that hyperphosphatemia is associated with coronary artery calcification. Therefore, controlling serum phosphate level and thereby mitigating vascular calcification could improve the poor prognosis of dialysis patients. Read More

J Am Coll Nutr 2018 Mar 13:1-6. Epub 2018 Mar 13.

a Department of Nutrition , Chung Shan Medical University Hospital , Taichung , Taiwan.

Objective Vegetarian diets have been shown to increase the risk of certain nutritional deficiencies, such as iron. As a number of patients with chronic kidney disease (CKD) in Taiwan are lacto-ovo vegetarians, the aim of this study was to investigate the effects of different proportions and sources of protein in lacto-ovo vegetarian and omnivorous diets, as well as the influence of adequate dietary protein intake, on renal function and nutritional status of Taiwanese patients with stage 3 to stage 5 CKD. Methods This is a cross-sectional study. Read More

Clin J Am Soc Nephrol 2018 Jun 9;13(6):952-961. Epub 2018 Mar 9.

Harold Simmons Center for Kidney Disease Research and Epidemiology, University of California, Irvine, California

Secondary hyperparathyroidism develops in CKD due to a combination of vitamin D deficiency, hypocalcemia, and hyperphosphatemia, and it exists in nearly all patients at the time of dialysis initiation. There is insufficient data on whether to prefer vitamin D analogs compared with calcimimetics, but the available evidence suggests advantages with combination therapy. Calcium derangements, patient adherence, side effects, and cost limit the use of these agents. Read More

J Am Coll Cardiol 2018 Mar;71(10):1117-1126

Department of Vascular Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands. Electronic address:

Background: In pseudoxanthoma elasticum (PXE), low pyrophosphate levels may cause ectopic mineralization, leading to skin changes, visual impairment, and peripheral arterial disease.

Objectives: The authors hypothesized that etidronate, a pyrophosphate analog, might reduce ectopic mineralization in PXE.

Methods: In the Treatment of Ectopic Mineralization in Pseudoxanthoma Elasticum trial, adults with PXE and leg arterial calcifications (n = 74) were randomly assigned to etidronate or placebo (cyclical 20 mg/kg for 2 weeks every 12 weeks). Read More