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

Calcif Tissue Int 2017 Aug 31. 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

Aging Cell 2017 Aug 31. 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

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

Nephrol Ther 2017 Aug 23. 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

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

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

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

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

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

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

Semin Arthritis Rheum 2017 Jun 17. 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

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

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

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

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

Calcif Tissue Int 2017 Jul 31. 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

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

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

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

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

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

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

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

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

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

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

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

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

Toxicon 2017 Oct 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

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

Pathol Int 2017 Aug 28;67(8):389-397. 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

J Med Econ 2017 Oct 13;20(10):1024-1038. 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

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

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

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

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

Intern Med 2017 15;56(12):1605-1606. Epub 2017 Jun 15.

Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Japan.

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

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

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

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

Am J Emerg Med 2017 Sep 26;35(9):1384.e1-1384.e2. 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

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

Drugs 2017 07;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

Am J Kidney Dis 2017 Sep 2;70(3):377-385. 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

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

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