New developments in hyperphosphatemia management.

@article{Slatopolsky2003NewDI,
  title={New developments in hyperphosphatemia management.},
  author={Eduardo A Slatopolsky},
  journal={Journal of the American Society of Nephrology : JASN},
  year={2003},
  volume={14 9 Suppl 4},
  pages={
          S297-9
        }
}
  • E. Slatopolsky
  • Published 2003
  • Medicine
  • Journal of the American Society of Nephrology : JASN
Patients with chronic renal failure have many associated medical problems, including a high propensity for cardiovascular disease (CVD). CVD and stroke are the leading causes of mortality in patients with ESRD (chronic kidney disease stage 5), with a 10- to 20-fold greater risk than in the general population (1,2). These data have generated greater awareness of cardiovascular risk in the chronic renal failure patient, and the most recent National Kidney Foundation guidelines for chronic kidney… Expand
Chronic kidney disease and secondary hyperparathyroidism in children
TLDR
Although most guidelines recommend prescription of vitamin D analogs in pre-dialysis CKD patients, there is no consensus on dose, time of prescription, type of analog (D2 or D3) and duration of prescription of Vitamin D. Expand
Phosphorus as an early marker of morbidity and mortality in type 2 chronic kidney disease diabetic patients.
TLDR
Phosphorus levels might have a significant clinical use, possibly translated as an early marker of mortality and hospitalizations in this population of type-2 diabetic patients in phase 3/4 of CKD. Expand
Sevelamer and the bone-vascular axis in chronic kidney disease: bone turnover, inflammation, and calcification regulation.
TLDR
The evidence for these pleiotropic effects of sevelamer may help in some way to improve the substantial disease burden in the CKD-MBD population is reviewed, and the potential benefit of reducing calcium load is suggested. Expand
Pharmacological control of secondary hyperparathyroidism in chronic hemodialysis patients: cinacalcet is coming to Japan
  • K. Iseki
  • Medicine
  • Expert opinion on pharmacotherapy
  • 2008
TLDR
Cinacalcet, a newly developed calcimimetic, is reported to decrease parathyroidism, as well as serum levels of phosphorus (P) and calcium (Ca) and therefore Ca × P product, which will be a welcome therapeutic option for end-stage renal disease and probably also for pre-end- stage renal disease patients. Expand
Drug Insight: vitamin D analogs in the treatment of secondary hyperparathyroidism in patients with chronic kidney disease
TLDR
Vitamin D analogs that inhibit PTH gene transcription and parathyroid hyperplasia (and have reduced calcemic activity) are a safer treatment for secondary hyperparathyroidism than calcitriol; these agents enhance the survival of patients with CKD. Expand
Hyperphosphatemia in children receiving peritoneal dialysis—an educational program
TLDR
The results of this study suggest that an aggressive 3-month patient education program targeting dietary phosphorus knowledge, phosphate binder name and dosing, and knowledge of medical consequences associated with non-compliance had no effect on the serum phosphorus, calcium, PTH or phosphate binders need. Expand
Management of Bone Disease in Candidates for Organ Transplant
TLDR
This chapter discusses the preventive measures that can reduce the risk of bone disease in candidates of organ transplant, which is easier to prevent bone loss than to restore bone, and optimization of factors that relate to bone health should be done as soon as possible. Expand
Paricalcitol Treatment and Arterial Tone in Experimental Renal Insufficiency
TLDR
Paricalcitol treatment showed both benefits and harmful effects in uremic rats: in the large artery vasoconstriction was reduced but calcification increased, while in the small artery vasorelaxation via potassium channels was moderately improved but hypertrophic remodeling was aggravated. Expand
Antibodies to Periodontal Organisms Are Associated with Decreased Kidney Function
TLDR
Elevated IgG to periodontal pathogens is significantly associated with impaired kidney function, independent of traditional risk factors. Expand
Phosphorus and phosphate metabolism in veterinary patients
TLDR
Phosphorus and phosphate are important in many biological functions and their role in normal metabolism and the clinical importance of phosphate imbalances for emergency and critical care patients is reviewed. Expand
...
1
2
3
...

References

SHOWING 1-10 OF 24 REFERENCES
Re-evaluation of risks associated with hyperphosphatemia and hyperparathyroidism in dialysis patients: recommendations for a change in management.
  • G. Block, F. Port
  • Medicine
  • American journal of kidney diseases : the official journal of the National Kidney Foundation
  • 2000
TLDR
It is shown that the current treatment paradigm for serum phosphorus and secondary hyperparathyroidism is ineffective for a large segment of dialysis patients, and it is believed that prevention of uremic calcification, cardiac death, and vascular disease should assume primary importance when evaluating the risks associated with elevated levels of phosphorus, CaxP, and PTH. Expand
K/DOQI clinical practice guidelines for chronic kidney disease
TLDR
This guideline contains brief reference to diagnosis and clinical interventions and can serve as a "road map" linking other clinical practice guidelines and pointing out where other guidelines need to be developed. Expand
Atherosclerotic cardiovascular disease risks in chronic hemodialysis patients.
TLDR
It is suggested that traditional risk factors are inadequate predictors of coronary heart disease in hemodialysis patients, while other factors did not correlate with atherosclerotic cardiovascular diseases in this cross-sectional study. Expand
Hyperphosphatemia: pharmacologic intervention yesterday, today and tomorrow.
TLDR
Control of serum phosphorus continues to be of utmost importance in renal replacement therapy, due to the high prevalence of hyperphosphatemia in the dialysis population and the use of nonabsorbed phosphate binders that are aluminum- and calcium-free and the development of vitamin D analogs that control parathyroid hormone activity with less calcemic effects. Expand
Sevelamer attenuates the progression of coronary and aortic calcification in hemodialysis patients.
TLDR
Compared with calcium-based phosphate binders, sevelamer is less likely to cause hypercalcemia, low levels of PTH, and progressive coronary and aortic calcification in hemodialysis patients. Expand
Association of elevated serum PO(4), Ca x PO(4) product, and parathyroid hormone with cardiac mortality risk in chronic hemodialysis patients.
TLDR
This study identifies strong relationships between elevated serum PO(4), Ca xPO(4) product, and parathyroid hormone and cardiac causes of death in HD patients, especially deaths resulting from CAD and sudden death. Expand
Control of Hyperphosphatemia in Renal Failure: Role of Aluminum
TLDR
This review will evaluate the available therapies for the control of hyperphosphatemia in renal failure and re-examine the role of aluminum as a phosphate binder. Expand
Hyperphosphatemia: its consequences and treatment in patients with chronic renal disease.
  • J. Delmez, E. Slatopolsky
  • Medicine
  • American journal of kidney diseases : the official journal of the National Kidney Foundation
  • 1992
TLDR
Phosphorus balance in chronic renal insufficiency is determined primarily by the net amount absorbed by the bowel and the quantity removed during dialytic therapy, and large doses are often necessary to attain satisfactory control of phosphorus. Expand
Ischemic heart disease in patients with uremia undergoing maintenance hemodialysis.
TLDR
The rate of IHD in dialysis women was greater than it was in nondialysis subjects, and coronary artery disease only affected long-term survival of patients with preexisting disease; and autopsy data did not suggest accelerated atherosclerosis. Expand
Association of serum phosphorus and calcium x phosphate product with mortality risk in chronic hemodialysis patients: a national study.
TLDR
This study concludes that a large percentage of hemodialysis patients who have a serum phosphorus level above 6.5 mg/dL and that this places them at increased risk of death, and supports the need for vigorous control of hyperphosphatemia to improve patient survival. Expand
...
1
2
3
...