An Update on Phosphate Binders: A Dietitian's Perspective

Control of serum phosphorus (PO4) has been long recognized as a goal in the nutritional and medical management of the patients with chronic kidney disease. Phosphate-binding compounds were introduced in the 1970s for the treatment of hyperphosphatemia in patients on dialysis after it was observed that oral administration of aluminum hydroxide as an antacid also reduced serum PO4 levels. Forty years later, aluminum is very seldom used as a phosphate binder as many other safer compounds are now available.
Source: Journal of Renal Nutrition - Category: Urology & Nephrology Authors: Tags: Review Article Source Type: research

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Conclusions: Cell cycle arrest biomarkers, TIMP-2 and IGFBP7, improve risk stratification for severe outcomes in patients with stage 1 acute kidney injury by urine output, serum creatinine or both, with risk increasing with each acute kidney injury indicator. Longer term outcomes demonstrate that the associated risks of a [TIMP-2]•[IGFBP7] greater than 2.0 is equivalent to acute kidney injury progression even where no progression from stage 1 acute kidney injury is observed.
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research
ConclusionsThe timing of recovery provides an added dimension to AKI phenotyping and prognostic information regarding the future occurrence of loss of kidney function. Studies to identify effective interventions on the timing of recovery from AKI are warranted.
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
AbstractBackgroundSecondary hyperparathyroidism (SHPT) is a common and serious complication of chronic kidney disease, particularly in end-stage renal disease. Currently, both cinacalcet and vitamin D are used to treat SHPT via two different mechanisms, but it is still unclear whether the combination use of these two drugs can be a safe and effective alternative to vitamin D alone. Therefore, the aim of this meta-analysis was to assess the efficacy and safety of cinacalcet plus vitamin D in the treatment of SHPT.MethodsFour electronic databases, including PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENT...
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
Authors: McGill RL, Lacson EK Abstract INTRODUCTION: Nephrologists have increased arteriovenous access placement in patients with chronic kidney disease. Not yet usable 'maturing' arteriovenous fistulas and grafts are nearly as common as mature arteriovenous fistulas or grafts. Little has been reported about patients initiating haemodialysis with unready arteriovenous fistulas or grafts. METHODS: The United States Renal Data System records for all adult patients initiating haemodialysis with central venous catheters between July 2010 and December 2011. Patients were categorized by whether a maturing arterioveno...
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research
We describe methods, trial activity, and lessons learned.The trial aimed to recruit 130 participants with severe diuretic-resistant HF (New York Heart Association [NYHA] 3/4) and chronic kidney disease (CKD) stage 3/4 on optimal medical treatment for ≥ 4 weeks from 6 UK centers. Participants were randomized to either continuation of conventional HF treatment or to additionally receiving PuF (1 overnight exchange using Icodextrin dialysate). Primary outcome was change in 6-minute walk test (6MWT) between baseline and 28 weeks (end of trial). Secondary outcomes were changes in patient reported quality of life as assessed ...
Source: Peritoneal Dialysis International - Category: Urology & Nephrology Tags: Perit Dial Int Source Type: research
Publication date: Available online 9 September 2019Source: American Journal of Kidney DiseasesAuthor(s): Lilia Cervantes, Romana Hasnain-Wynia, John F. Steiner, Michel Chonchol, Stacy FischerMembers of racial and ethnic minority groups make up nearly 50% of US patients with end-stage kidney disease and face a disproportionate burden of socioeconomic challenges (ie, low income, job insecurity, low educational attainment, housing instability, and communication challenges) compared with non-Hispanic whites. Patients with end-stage kidney disease who face social challenges often have poor patient-centered and clinical outcomes...
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
Abstract We hypothesized that high incidence rates of end-stage renal disease (ESRD) in certain counties of the U.S. are partly due to patients with a type of ESRD resembling chronic kidney disease of uncertain etiology (CKDu), which has been observed in Central America and other countries. Using data on 338,126 incident ESRD patients from the United States Renal Data System (USRDS) (2011 - 2013) and the Behavior Risk Factor Surveillance System (BRFSS) Supplement on county-level variables (2006), we describe both patient-level and county-level characteristics in counties with the highest quartile of ESRD...
Source: Clinical Nephrology - Category: Urology & Nephrology Authors: Tags: Clin Nephrol Source Type: research
This report has been originally notified from the Ministry of Health, Labor and Welfare in Japanese. This is the English version of it.
Source: Clinical and Experimental Nephrology - Category: Urology & Nephrology Source Type: research
ConclusionsAnti-EPOR antibodies were detected in patients on maintenance hemodialysis, and these autoantibodies were independent factors for hyporesponsiveness to ESAs in these patients.
Source: Clinical and Experimental Nephrology - Category: Urology & Nephrology Source Type: research
In this paper we present a case of a 65-year-old man, with chronic kidney insufficiency treated with hemodialysis, found dead by his wife, lying in his bed. Based on autopsy findings, toxicological analysis, the police report and circumstances of death, it...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Suicide and Self-Harm Source Type: news
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