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Curr Med Chem 2022 Jun 27. Epub 2022 Jun 27.

Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China.

Fibroblast growth factor 23 (FGF23) is a new endocrine product discovered in the past decade. In addition to being related to bone diseases, it has also been found to be related to kidney metabolism and parathyroid metabolism, especially as a biomarker and a key factor to be used in the kidney field. FGF23 is upregulated as early as the second and third stages of chronic kidney disease (CKD) in response to relative phosphorus overload. Read More

J Med Case Rep 2022 Jun 28;16(1):252. Epub 2022 Jun 28.

Department of Oncology, Keck School of Medicine of USC, Los Angeles, CA, USA.

Background: Tumor lysis syndrome is an oncologic emergency that involves multiple metabolic abnormalities and clinical symptoms such as acute renal failure, cardiac arrhythmias, seizures, and multiorgan failure, and may be fatal if not promptly recognized. Tumor lysis syndrome occurs most often in patients with hematologic malignancies, and relatively few cases have been described in patients with sarcoma.

Case Presentation: A 64-year-old male of Asian heritage presented to his primary care physician with a right lower-extremity mass and was ultimately diagnosed with widely metastatic osteosarcoma. Read More

BMC Nephrol 2022 Jun 27;23(1):229. Epub 2022 Jun 27.

Karolinska Institutet, Stockholm, Sweden.

Background: Controversy surrounds which factors are important for predicting early mortality after dialysis initiation (DI). We investigated associations of predialysis course and circumstances affecting planning and execution of DI with mortality following DI.

Methods: Among 1580 patients participating in the Peridialysis study, a study of causes and timing of DI, we registered features of predialysis course, clinical and biochemical data at DI, incidence of unplanned suboptimal DI, contraindications to peritoneal dialysis (PD) or hemodialysis (HD), and modality preference, actual choice, and cause of modality choice. Read More

J Pers Med 2022 Jun 12;12(6). Epub 2022 Jun 12.

School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya 47500, Malaysia.

This study aims to determine the effectiveness of a phosphate mobile app (PMA), MyKidneyDiet-Phosphate Tracker ©2019, on hemodialysis (HD) patients with hyperphosphatemia. A multicenter, open-label, randomized controlled trial design allowed randomization of patients with hyperphosphatemia to either the usual care group (UG; receiving a single dietitian-led session with an education booklet) or the PMA group (PG). Thirty-three patients in each intervention group completed the 12-week study. Read More

Int J Mol Sci 2022 Jun 8;23(12). Epub 2022 Jun 8.

Center for Pediatric and Adolescent Medicine, Division of Pediatric Nephrology, University of Heidelberg, 69120 Heidelberg, Germany.

Chronic kidney disease (CKD) frequently leads to hyperphosphatemia and hyperparathyroidism, mineral bone disorder (CKD-MBD), ectopic calcifications and cardiovascular mortality. PTH activates the osteoanabolic Gα/PKA and the Gα/PKC pathways in osteoblasts, the specific impact of the latter in CKD-MBD is unknown. We generated osteoblast specific Gα knockout (KO) mice and established CKD-MBD by subtotal nephrectomy and dietary phosphate load. Read More

J Taibah Univ Med Sci 2022 Jun 9;17(3):376-383. Epub 2021 Nov 9.

College of Agriculture and Biotechnology, Provincial Resources, Zhejiang University, Hangzhou, China.

Objective: Chronic kidney disease and/or disturbance in renal excretory function may lead to nitrogenous waste collection beyond the term as well as derangements of several serum biochemicals. There is no previous study from Pakistan that reveals serum electrolyte derangements in confirmed chronic kidney disease (CKD) patients and other biochemicals associated with CKD. This study aims to examine the derangements of serum biochemicals and the association of several risk factors with CKD. Read More

JBMR Plus 2022 Jun 14;6(6):e10604. Epub 2022 Apr 14.

Endocrine Unit Massachusetts General Hospital, and Harvard Medical School Boston MA USA.

Consistent with a vital role of parathyroid hormone (PTH) receptor type 1 (PTH1R) in skeletal development, homozygous loss-of-function PTH1R mutations in humans results in neonatal lethality (Blomstrand chondrodysplasia), whereas such heterozygous mutations cause a primary failure of tooth eruption (PFE). Despite a key role of PTH1R in calcium and phosphate homeostasis, blood mineral ion levels are not altered in such cases of PFE. Recently, two nonlethal homozygous PTH1R mutations were identified in two unrelated families in which affected members exhibit either dental and skeletal abnormalities (PTH1R-V204E) or hypocalcemia and hyperphosphatemia (PTH1R-R186H). Read More

FASEB J 2022 Jul;36(7):e22407

Department of Pediatric Kidney, Liver and Metabolic Diseases, Pediatric Research Center, Hannover Medical School, Hannover, Germany.

Dietary phosphate intake in the Western population greatly exceeds the recommended dietary allowance and is linked to enhanced cardiovascular and all-cause mortality. It is unclear whether a chronic high phosphate diet (HPD) causes kidney injury in healthy individuals. Here, we show that feeding a 2% HPD in C57BL/6N mice for one up to six months resulted in hyperphosphatemia, hyperphosphaturia, increased plasma levels of fibroblast growth factor (FGF) 23, and parathyroid hormone (PTH) compared to mice on a 0. Read More

Hemodial Int 2022 Jun 16. Epub 2022 Jun 16.

Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.

Introduction: Nutritional interventions have been envisaged to improve hyperphosphatemia and malnutrition, two important risk factors associated with mortality in dialysis patients. We evaluated the effects of egg white consumption on serum phosphate and malnutrition in dialysis patients.

Methods: In an open-label, per protocol clinical trial, conducted in Kerman dialysis centers, 150 hemodialysis patients aged ≥18 years with serum phosphorus ≥5. Read More

Curr Opin Nephrol Hypertens 2022 Jul 10;31(4):326-331. Epub 2022 Jun 10.

Laboratorio de Fisiopatologia Renal LIM16, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo.

Purpose Of Review: In patients with chronic kidney disease (CKD), hyperphosphatemia is associated with several adverse outcomes, including bone fragility and progression of kidney and cardiovascular disease. However, there is a knowledge gap regarding phosphate balance in CKD. This review explores its current state, depending on the stage of CKD, dialysis modalities, and the influence of kidney transplantation. Read More

Sci Rep 2022 Jun 10;12(1):9614. Epub 2022 Jun 10.

Division of Oral Microbiology and Immunology, Department of Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule (RWTH) University Hospital of Aachen, Pauwelsstr. 30, 52057, Aachen, Germany.

Hyperphosphatemia is a consequence of chronic kidney disease associated with mineral/bone impairment, increased cardiovascular events and mortality. Therapeutically, most dialysis patients have to take phosphate binders. Here, we investigated effects of the Fe(3+)-based phosphate binder sucroferric oxyhydroxide (SFOH) on the oral and gastrointestinal microbiome of 11 hemodialysis patients. Read More

Drug Chem Toxicol 2022 Jun 7:1-9. Epub 2022 Jun 7.

Department of Biology, Faculty of Science and Letters, Çukurova University, Adana, Turkey.

Sevelamer hydrochloride (SH) and calcium carbonate (CaCO) are two agents included in the phosphate-binding group which are frequently prescribed in the treatment of patients with hyperphosphatemia. However, there are no satisfactory studies on the genotoxic effects of SH in vitro. This study was conducted to reveal the genotoxic and/or cytotoxic potential of these two drugs in cultured human peripheral lymphocytes. Read More

Acta Biomed 2022 06 6;93(S3):e2022194. Epub 2022 Jun 6.

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Background And Aim: Pseudohypoparathyroidism (PHP) is a rare disease, which can occur in the youth, characterized by hypocalcemia and hyperphosphatemia due to resistance to parathyroid hormone (PTH) in target organs. This condition encompasses different conditions which differ between one another by different clinical, biochemically, and genetic features.

Methods: Herein we report the clinical history of a boy with PHP1B with an interesting clinical presentation. Read More

Front Med (Lausanne) 2022 17;9:870637. Epub 2022 May 17.

Department of Critical Care Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.

Introduction: Serum phosphate level is often deranged during critical illness. Hyperphosphatemia, as a marker of disease severity, attracts more and more attention. This study aimed to evaluate the impact of hyperphosphatemia on clinical outcomes in critically ill patients. Read More

Int J Gynaecol Obstet 2022 Jun 3. Epub 2022 Jun 3.

Alborz University of Medical Sciences, Karaj, Iran.

Objective: To evaluate possible interactions of magnesium sulfate-the drug of choice in the management of pre-eclampsia/eclampsia-in response to a few case reports that revealed maternal electrolyte disturbances, especially symptomatic changes, following magnesium sulfate administration in pre-eclampsia.

Methods: Prospectively, women with pre-eclampsia were given 4 g of intravenous magnesium sulfate followed by a 2 g/h infusion up to 24 h after delivery. Sequential blood samples were drawn from each patient and used to measure the serum levels of sodium, potassium, calcium, phosphorus, magnesium, and parathyroid hormone. Read More

Crit Care Nurse 2022 Jun;42(3):19-25

Elizabeth Mary Durfee is a pediatric acute care nurse practitioner at UCSF Benioff Children's Hospital, Oakland, California.

Background: Tumor lysis syndrome is a life-threatening oncologic emergency in adult and pediatric patients with hematologic cancer. It occurs most often in malignancies with rapid cell turnover and large tumor burden, but its incidence has risen in solid tumors. The subsequent release of tumor cell contents into the bloodstream results in dangerous electrolyte and metabolic disturbances. Read More

Children (Basel) 2022 May 15;9(5). Epub 2022 May 15.

Department of Pediatrics, Yeungnam University School of Medicine, Yeungnam University Hospital, Daegu 42415, Korea.

Pseudohypoparathyroidism (PHP) is a rare, heterogeneous disorder characterized by end-organ resistance to parathyroid hormone (PTH). PTH resistance causes elevated PTH levels, hypocalcemia, and hyperphosphatemia. Since hypocalcemia causes life-threatening events, early diagnosis is crucial. Read More

PLoS One 2022 27;17(5):e0268732. Epub 2022 May 27.

Faculty of Dentistry, Department of Physiology, Center of Excellence in Skeletal Disorders and Enzyme Reaction Mechanism, Chulalongkorn University, Bangkok, Thailand.

Although patients with either β-thalassemia or chronic kidney disease (CKD) clinically correlate with severe osteoporosis, the mechanism by which CKD exposed to high phosphate affects bone turnover has not been characterized in β-thalassemia. We aimed to determine the effects of renal insufficiency on high phosphate intake induced changes in bone metabolism after 5/6th nephrectomy in hemizygous β-globin knockout (BKO) mice. Male BKO mice manifested severe anemia and osteopenia. Read More

Pharmacol Res Perspect 2022 06;10(3):e00973

Research Division, Chugai Pharmaceutical Co., Ltd., Gotemba, Shizuoka, Japan.

Hyperphosphatemia associated with chronic kidney disease (CKD) not only dysregulates mineral metabolism and bone diseases, but also strongly contributes to the progression of kidney disease itself. We have identified a novel drug for hyperphosphatemia, EOS789, that interacts with several sodium-dependent phosphate transporters (NaPi-IIb, PiT-1, and PiT-2) known to contribute to intestinal phosphate absorption. In this study, we investigated whether EOS789 could ameliorate kidney disease progression in glomerulonephritis rats. Read More

Cureus 2022 Apr 18;14(4):e24245. Epub 2022 Apr 18.

Internal Medicine, Baptist Health - University of Arkansas for Medical Sciences, North Little Rock, USA.

A 56-year-old male patient with a medical history of essential hypertension was referred to the emergency room after he was found to have a serum creatinine level of 13 mg/dL at his primary care physician's office. The patient reported that he had developed a coronavirus disease 2019 (COVID-19)-like infection six months prior that was not confirmed. Two months later, he started to notice dyspnea on exertion and bilateral lower limb swelling and was started on furosemide. Read More

Clin Case Rep 2022 May 16;10(5):e05849. Epub 2022 May 16.

Department of Endocrinology Faculty of Medicine of Sousse Ibn Jazzar University Hospital Kairouan University of Medicine Kairouan Tunisia.

Pseudohypoparathyroidism (PHP) indicates a rare heterogeneous group of disorders characterized by hypocalcemia, hyperphosphatemia, increased serum concentration of parathyroid hormone (PTH), and insensitivity to the biologic activity of PTH. One of its most common types is PHP-1a. In this report, we present a familial PHP-1a and a novel mutation of the gene. Read More

BMC Nephrol 2022 May 21;23(1):192. Epub 2022 May 21.

The First Affiliated Hospital, Department of Nephrology, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China.

Background: Hyperphosphatemia (HP) is associated with vascular calcification (VC) in chronic kidney disease (CKD). However, relationship between HP-induced-endothelial extracellular vesicles (HP-EC-EVs) and VC is unclear, and miR expression in HP-EC-EVs has not been determined.

Methods: We isolated HP-EC-EVs from endothelial cells with HP and observed that HP-EC-EVs were up-taken by vascular smooth muscle cells (VSMCs). Read More

Bioorg Med Chem 2022 Jul 2;66:116783. Epub 2022 May 2.

Taisho Pharmaceutical Co., Ltd., 1-403 Yoshino-cho, Kita-ku, Saitama 331-9530, Japan.

Intestinal sodium-dependent phosphate transport protein 2b (SLC34A2, NaPi2b) inhibitors are expected to be potential new candidates for anti-hyperphosphatemia drugs. However, a risk of on-target side effects based on the inhibition of NaPi2b in the lung and testis has been reported.In this article, we report on our identification of novel indole derivatives as gut-selective NaPi2b inhibitors with good activity, low systemic exposure and moderate hydrophobicity. Read More

Nutrients 2022 Apr 22;14(9). Epub 2022 Apr 22.

Think Healthy Group, LLC, Washington, DC 20001, USA.

The Western diet is high in dietary phosphorus, partially due to added phosphorus, (i.e., phosphates) predominantly present in processed food products. Read More

Saudi J Kidney Dis Transpl 2021 Sep-Oct;32(5):1407-1417

Department of Nephrology, Charles Nicolle Hospital, Tunis, Tunisia.

Chronic kidney disease (CKD) treated by hemodialysis (HD) is a worldwide major public health problem. Its incidence is getting higher and higher, leading to an alarming social and economic impact. The survival of these patients is significantly low, especially during the first year of treatment. Read More

Pflugers Arch 2022 May 5. Epub 2022 May 5.

Synlab Suisse, 6002, Lucerne, Switzerland.

Phosphate is essential in living organisms and its blood levels are regulated by a complex network involving the kidneys, intestine, parathyroid glands, and the skeleton. The crosstalk between these organs is executed primarily by three hormones, calcitriol, parathyroid hormone, and fibroblast growth factor 23. Largely due to a higher intake of ultraprocessed foods, dietary phosphate intake has increased in the last decades. Read More

Kidney Int Rep 2022 Apr 1;7(4):688-698. Epub 2022 Feb 1.

Division of Nephrology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.

Cardiovascular (CV) disease (CVD) accounts for >50% of deaths with known causes in patients on dialysis. Elevated serum phosphorus levels are an important nontraditional risk factor for bone mineral disease and CVD in patients with chronic kidney disease (CKD). Given that phosphorus concentrations drive other disorders associated with increased CV risk (e. Read More

J Bone Miner Res 2022 Apr 29. Epub 2022 Apr 29.

Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.

Hypoparathyroidism is the only endocrine deficiency for which hormone replacement therapy is not the standard of care. Although conventional treatments may control hypocalcaemia, other complications such as hyperphosphatemia, kidney stones, peripheral calcifications, and bone disease remain unmet needs. This meta-analysis (PROSPERO registration number CRD42019126881) aims to evaluate and compare the efficacy and safety of PTH and PTH in restoring calcium metabolism in chronic hypoparathyroidism. Read More

BMC Vet Res 2022 Apr 28;18(1):157. Epub 2022 Apr 28.

Waltham Petcare Science Institute, Mars Petcare UK, Freeby Lane, Waltham-on-the-Wolds, Melton Mowbray, Leicestershire, LE14 4RT, UK.

Early responses in healthy adult dogs fed grain-free diets with high inclusion of split peas (20%) and lentils (40%) that may lead to canine diet-induced dilated cardiomyopathy (DCM) were investigated. To help understand the clinical relevance of the findings, a survey of electronic health records (EHR) was conducted of dogs with and without suspected DCM for comparison. Control and Test diets were fed to Labrador retriever dogs for 30 days (n = 5 and 6, respectively). Read More

BMC Nephrol 2022 04 28;23(1):162. Epub 2022 Apr 28.

Department of Extracorporeal Therapy Systems, Fraunhofer Institute for Cell Therapy and Immunology, Schillingallee 68, 18057, Rostock, Germany.

Background: The progression of chronic kidney disease (CKD) is associated with an increasing risk of cardiovascular morbidity and mortality due to elevated serum phosphate levels. Besides low phosphate diets and hemodialysis, oral phosphate binders are prescribed to treat hyperphosphatemia in CKD patients. This study reports on a processed clay mineral as a novel and efficient phosphate sorbent with comparable efficacy of a clinically approved phosphate binder. Read More