scholarly journals Experience with Cinacalcet for Secondary Hyperparathyroidism in Patients with Chronic Kidney Disease Stage III and IV

2009 ◽  
Vol 1 ◽  
pp. CMT.S2983 ◽  
Author(s):  
Terje Forslund ◽  
Arvo Koistinen ◽  
Marja Miettinen
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Secondary Hyperparathyroidism ◽  
Chronic Kidney Disease Stage ◽  
Stage Iii ◽  
Disease Stage ◽  
Phosphate Binders ◽  
Increased Risk ◽  
Ckd Stage ◽  
Patient Reported

Dysequilibrium in calcium and phosphate metabolism with development of secondary hyperparathyroidism (SHPT) is common in patients with chronic kidney disease (CKD) stage III and IV. Dietary phosphate restrictions and calcium based oral phosphate binders have not been effective in all subjects with SHPT, and soft tissue and vascular calcifications with an increased risk of cardiovascular death related are known consequences. Treatment with the calcimimetic Cinacalcet (Cc) has contributed to a better calcium and phosphate control in patients given hemodialysis treatment. In this retrospective study we present our experience with Cc given to ten (one year) or five (two years) patients with CKD stage III and IV and SHPT not suitable for surgery. With conventional therapy target levels of intact parathyroid hormon (iPTH) are seldomly reached the reason why an iPTH value < 300 ng/l was considered acceptable. Levels of iPTH decreased significantly after 3 months of Cc treatment and remained at the lower level. Plasma ionized-Ca (Ca) concentrations decreased initially but remained above 1.00 mmol/l in all but one patient. Phophate (P) levels increased to 1.41 ± 0.09 mmol/l (mean ± SE) leaving the Ca × P product unchanged. While patients with high iPTH needed high Cc doses up to 90 mg/day, some of the patients required very low doses 4.5-20 mg/day in order to achieve a decrease in iPTH levels. Only one patient reported gastric pain needing dose reduction and other adverse effects were not found. No changes in QT-time were observed. We experienced that Cc treatment was promising to control SHPT and stabilized the Ca-P balance in patients with CKD stage III and IV. Dosing may be challenging and laboratory values should be controlled often (monthly) as these patients may have variable response to Cc treatment. Due to the minimal knowledge about its effect on morbidity and mortality in the predialytic population further controlled studies are needed to confirm its efficacy and safety.

scholarly journals Efficacy and Safety of Cinacalcet in Chronic Kidney Disease Stage III and IV

2009 ◽  
Vol 1 ◽  
pp. CMT.S3189
Author(s):  
Aiji Yajima ◽  
Andreas Pasch ◽  
Kosaku Nitta
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Secondary Hyperparathyroidism ◽  
Chronic Kidney Disease Stage ◽  
Stage Iii ◽  
Disease Stage ◽  
Control Serum ◽  
Ckd Stage ◽  
Cinacalcet Hydrochloride

Treatment of secondary hyperparathyroidism in patients with chronic kidney disease (CKD) stage III and IV with vitamin D sterols is useful to maintain optimal parathyroid hormone (PTH) levels and thereby, reduces the severity of bone abnormalities caused by high PTH levels. However, it should be borne in mind that serum calcium (Ca) levels may easily increase as bone turnover is easily suppressed due to diffuse or early nodular parathyroid tissue in these patients. Furthermore, an elevated risk of cardiovascular disease due to advanced atherosclerosis associated with both secondary hyperparathyroidism and the administration of vitamin D sterols has been reported in patients with moderate to severe CKD, resulting in a high mortality in these patients. In order to control serum Ca levels, therefore, additional use of cinacalcet hydrochloride may be useful. However, acute reduction of serum Ca levels and chronic hyperphosphatemia should be avoided; therefore, the doses of phosphorus (P) binders should be increased or the initiation of low doses of vitamin D sterols may be favorable in patients with stage III and IV CKD receiving cinacalcet hydrochloride. The phosphaturic effect of FGF-23 after treatment with cinacalcet is estimated to be small as compared with that of vitamin D in moderate to severe CKD patients, therefore, evaluation of osteocytes should be performed in patients with secondary hyperparathyroidism treated with cinacalcet hydrochloride.

Phosphate binders in patients with chronic kidney disease: Between the new and the old.

2019 ◽  
pp. 2-3
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Estimated Glomerular Filtration Rate ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Phosphate Binders ◽  
Advanced Chronic Kidney Disease ◽  
Phosphate Retention ◽  
Stage 4 ◽  
Dietary Phosphate

Impaired phosphate excretion by the kidney leads to Hyperphosphatemia. It is an independent predictor of cardiovascular disease and mortality in patients with advanced chronic kidney disease (stage 4 and 5) particularly in case of dialysis. Phosphate retention develops early in chronic kidney disease (CKD) due to the reduction in the filtered phosphate load. Overt hyperphosphatemia develops when the estimated glomerular filtration rate (eGFR) falls below 25 to 40 mL/min/1.73 m2. Hyperphosphatemia is typically managed with oral phosphate binders in conjunction with dietary phosphate restriction. These drugs aim to decrease serum phosphate by binding ingested phosphorus in the gastrointestinal tract and its transformation to non-absorbable complexes [1].

scholarly journals Analysof Reticulocyte Hemoglobin Equivalent Levels in Patients with Chronic Kidney Disease Stage IV and V

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Agri Febria Sari ◽  
Rikarni Rikarni ◽  
Deswita Sari
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Iron Status ◽  
Chronic Kidney Disease Stage ◽  
Stage Iv ◽  
Disease Stage ◽  
Cross Sectional ◽  
Iron Storage ◽  
Laboratory Installation ◽  
Ckd Stage

Reticulocyte hemoglobin equivalent (RET-He) represents hemoglobin content in reticulocyte. Reticulocyte hemoglobin equivalent test can be used to asses iron status of chronic kidney disease (CKD). Iron deficiency happens in 40% CKD and could lead to anemia manifestation. Level of RET-He gives real-time assesment of iron availability for hemoglobin production and the level will getting lower when iron storage for erythropoiesis decreasing. Reticulocyte hemoglobin equivalent is more stabil than feritin and transferin saturation in assessing iron status. Aim of this study is to determine RET-He level in patients with CKD stage IV and V. This study is  a cross sectional descripstive study. Subjects were 96 CKD stage IV and V patients that met inclusion and exclusion criterias. Subjects conducted blood tests at Central Laboratory Installation Dr. M. Djamil Hospital Padang from July to September 2020. Examination of RET-He level was analyzed by Sysmex XN-1000 flowcytometry fluorescense method. Data was presented in frequency distribution table. The RET-He level below cutoff (<29,2 pg) indicates the need for iron suplementation therapy for CKD stage IV and V patients. Samples with RET-He level below cutoff were 48 (50%) and 48 (50%) were above cutoff.

Factors Associated with Functional Capacity in CKD Patients

2020 ◽  
pp. 105477382095854
Author(s):  
Emanuele Poliana Lawall Gravina ◽  
Bruno Valle Pinheiro ◽  
Luciana Angélica da Silva Jesus ◽  
Fabrício Sciammarella Barros ◽  
Leda Marília Fonseca Lucinda ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Functional Capacity ◽  
Family Income ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Life Questionnaire ◽  
Factors Associated ◽  
Ckd Stage ◽  
Related Quality

To evaluate the factors associated with functional capacity in patients with chronic kidney disease (CKD). All patients were submitted to six-minute walk test (6MWT), 10-repetition sit-to-stand test (STS-10) and SF-36 health-related quality of life questionnaire (HRQoL). Patients with functional capacity ≥80% exhibited higher education level, family income, body mass index, estimated glomerular filtration rate, and lower age and STS-10 time. Multiple linear regression showed that gender, age, family income, chronic kidney disease stage, STS-10 time, and physical component summary of HRQoL were significantly associated with the 6MWT distance. Functional capacity was significantly associated with gender, age, family income, CKD stage, STS-10 time, and physical component of HRQoL. The progression of CKD has an impact on the decrease in functional capacity in these patients.

scholarly journals Increased Prevalence and Severity of Coronary Artery Calcification in Patients with Chronic Kidney Disease Stage III and IV

Nephron Extra ◽  
2012 ◽  
Vol 2 (1) ◽  
pp. 192-204 ◽  
Author(s):  
Maria Koukoulaki ◽  
Evangelos Papachristou ◽  
Christina Kalogeropoulou ◽  
Maria Papathanasiou ◽  
Petros Zampakis ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Coronary Artery ◽  
Kidney Disease ◽  
Coronary Artery Calcification ◽  
Chronic Kidney Disease Stage ◽  
Stage Iii ◽  
Disease Stage

scholarly journals Intermittent hemodialysis in dogs with chronic kidney disease stage III

2017 ◽  
Vol 47 (10) ◽  
Author(s):  
Alessandra Melchert ◽  
Silvano Salgueiro Geraldes ◽  
André Nanny Le Sueur Vieira ◽  
Regina Kiomi Takahira ◽  
Paulo Roberto Rodrigues Ramos ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Chronic Kidney Disease Stage ◽  
Kidney Injury ◽  
Electrolyte Imbalance ◽  
Stage Iii ◽  
Disease Stage ◽  
Control Group ◽  
Intermittent Hemodialysis ◽  
Before And After

ABSTRACT: Intermittent hemodialysis (IHD) is a form of renal replacement that is used in veterinary medicine for cases involving drug removal, electrolyte imbalance, acute kidney injury, and chronic kidney disease (CKD). The aim of the present study was to verify the efficacy of IHD in dogs with CKD staged at grade III and to evaluate the effect of IHD on quality of life. Twelve dogs with CKD at stage III met the inclusion criteria and were divided equally into two groups. The control group (n=6) received only clinical treatment and intravenous fluid therapy, and the hemodialysis group (n=6) received clinical and IHD treatments. Blood samples were collected before and after treatments in both groups. We evaluated complications and clinical parameters of IHD every 30 minutes. Hemodialysis decreased serum urea, creatinine, and phosphorus. Despite the evident removal of nitrogen compounds, dialysis treatment did not increase survival time in these patients. The results of this study do not support the early use of dialysis in dogs with chronic kidney disease stage III.

scholarly journals Hypertension, Chronic Kidney Disease, and Renal Pathology in a Child with Hermansky-Pudlak Syndrome

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Roberto Gordillo ◽  
Marcela Del Rio ◽  
David B. Thomas ◽  
Joseph T. Flynn ◽  
Robert P. Woroniecki
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Chronic Kidney Disease Stage ◽  
Stage Ii ◽  
Renal Pathology ◽  
Disease Stage ◽  
Not Otherwise Specified ◽  
Ckd Stage ◽  
History Of ◽  
Hermansky Pudlak Syndrome

We report a child with Hermansky-Pudlak Syndrome (HPS) and chronic kidney disease (stage II) with histological diagnosis of focal segmental glomerulosclerosis (FSGS). A 15-year-old male of Puerto Rico ancestry with history of HPS, hypertension (HTN), asthma, obesity, and chronic kidney disease (CKD) stage II presented with new-onset proteinuria without edema. His blood pressure had been controlled, serum creatinine had been 0.9–1.4 mg/dL, and first morning urine protein/creatinine ratio (UPC) ranged from 0.2 to 0.38. Due to persistent nonorthostatic proteinuria with CKD, renal biopsy was performed and FSGS (not otherwise specified) with chronic diffuse tubulopathy (tubular cytoplasmic droplets) and acute tubular injury was reported. Ceroid-like material is known to infiltrate tissues (i.e., lungs, colon, and kidney) in HPS, but the reason for the renal insufficiency is unknown. Nonspecific kidney disease and in one adult case IgA nephropathy with ANCA-positive glomerulonephritis have previously been reported in patients with Hermansky-Pudlak syndrome. To our knowledge, we report the first pediatric renal pathology case of HPS associated with CKD. This paper discusses presentation and management of renal disease in HPS.

scholarly journals Gambaran kadar serum magnesium pada pasien penyakit ginjal kronik stadium 5 non dialisis di Manado

2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Medhyka S.A. Kawilarang ◽  
Arthur E. Mongan ◽  
Maya Memah
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Home Care ◽  
Hospital Care ◽  
Serum Magnesium ◽  
Chronic Kidney Disease Stage ◽  
Muscular Contraction ◽  
Care Patient ◽  
Disease Stage ◽  
Ckd Stage

Abstract: Magnesium is a metal, one of the eight most abundant element in universe. Magnesium also is a mineral that responsible for bone metabolism control, neural transmission, cardiac excitability, neuromuscular conduction, muscular contraction, vasomotor, and blood pressure. In chronic kidney disease stage 4-5, compensation mechanism become inadequate that caused a hypermagnesemia. Objectives: This study aimed to know the picture of magnesium serum in non dialysis CKD stage 5 in Manado. Material Methods: This is a descriptive study, conducted by selecting 35 blood samples in Nephrology-Hypertension Polyclinic and IRINA of Interna of Prof. Dr. R.D Kandou Hospital and Teling Adventist Hospital. Result: There are 16 samples (45.7%) experience hypomagnesemia consisted of 8 home-care patient (22.9%) and 8 hospital-care patient (22.9%), 10 samples (28.6%) are in normal range consisted of 3 home-care patient (8.6%) and 7 hospital-care patient (20.0%), and 9 samples (25.7%) are experience hypermagnesemia consisted of 6 home-care patient (17.1%) and 3 hospital-care patient (8.6%) from total non dialysis CKD stage 5 samples result from laboratory examination. Conclusion: Patient with hypomagnesemia most frekuent than patient with hypermagnesemia.Keywords: magnesium, chronic kidney disease, non dialysisAbstrak: Magnesium merupakan logam yang masuk dalam delapan elemen paling melimpah di alam semesta. Magnesium juga merupakan mineral yang bertanggung jawab dalam pengaturan metabolisme tulang, transmisi saraf, eksitabilitas jantung, konduksi neuromuskular, kontraksi muscular, vasomotor, dan tekanan darah. Pada penyakit ginjal kronik stadium 4-5 mekanisme kompensasi ginjal menjadi inadekuat sehingga dapat menghasilkan hipermagnesemia. Tujuan: Penelitian ini bertujuan untuk mengetahui gambaran kadar serum magnesium pada pasien PGK non dialisis stadium 5 di Manado. Metode Penelitian: Penelitian ini adalah penelitian yang bersifat deskriptif yang dilaksanakan dengan cara mengambil sampel darah di Poliklinik Nefrologi-Hipertensi dan IRINA bagian Penyakit Dalam RSUP Prof. DR. R. D. Kandou Manado dan RS Advent Teling sebanyak 35 sampel. Hasil: Tercatat 16 orang yang mengalami hipomagnesemia (45,7%) diantaranya 8 orang pasien rawat jalan (22,9%) dan 8 orang pasien rawat inap (22,9%), 10 orang dalam batas nilai normal (28,6%) diantaranya 3 orang pasien rawat jalan (8,6%) dan 7 orang pasien rawat inap (20,0%), serta 9 orang mengalami hipermagnesemia (25,7%) diantaranya 6 orang pasien rawat jalan (17,1%) dan 3 orang pasien rawat inap (8,6%) dari total jumlah pasien terdiagnosis dokter PGK stadium 5 non dialisis yang didapatkan dari hasil pemeriksaan laboratorium. Simpulan: Frekuensi pasien yang mengalami hipomagnesemia lebih banyak dibandingkan pasien hipermagnesemiaKata kunci: magnesium, penyakit ginjal kronik, non dialisis

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