Cinacalcet Shows Little Benefit in End-Stage Kidney DiseaseCinacalcet Shows Little Benefit in End-Stage Kidney Disease
Cinacalcet reduces the need for parathyroidectomy in a few patients with chronic kidney disease but appears to have no effect on all-cause or cardiovascular mortality and comes with adverse effects. Medscape Medical News
ConclusionImplementation of an ALP-based prophylactic calcium replacement protocol with daily serum calcium monitoring can ameliorate severe hypocalcaemia post-parathyroidectomy
CONCLUSION: Hospitalization or death was not influenced by the type of RO, Al accumulation, or TMV classification. An elevated prevalence of osteoporosis and Al accumulation was detected. PMID: 31967202 [PubMed - as supplied by publisher]
ConclusionsLong hemodialysis periods and elevated PTH levels were the probable factors for the development of facial deformities in this group of patients. The main complications associated to the surgical management of facial deformities in ROD patients are directly related to end-stage renal disease, with increased risks for hemorrhage and systemic drug accumulation.
CONCLUSION: Recurrence of sHPTH after PTX remains a problem, occurring in every fifth patient. In our experience, the introduction of intraoperative PTH measurement has helped to lower the rates of persistence and recurrence. Further reductions in the recurrence rate might be achieved with novel, more accurate pre- and intraoperative imaging techniques. PMID: 31800966 [PubMed - in process]
Secondary hyperparathyroidism is a common complication in patients with chronic kidney disease that requires vigilant treatment due to its high mortality rate. Pharmacologic therapy is recommended as an initia...
ConclusionThe parathyroid oxyphil cell proportion was associated with preoperative PTH and total weight of removed parathyroid glands in the patients with CKD. Patients with more parathyroid oxyphil proportion had lower preoperative PTH level and smaller total weight of the removed parathyroid glands.
CONCLUSIONS: Bisphosphonate therapy may reduce fracture and bone pain after kidney transplantation, however low certainty in the evidence indicates it is possible that treatment may make little or no difference. It is uncertain whether bisphosphonate therapy or other bone treatments prevent other skeletal complications after kidney transplantation, including spinal deformity or avascular bone necrosis. The effects of bone treatment for children and adolescents after kidney transplantation are very uncertain. PMID: 31637698 [PubMed - as supplied by publisher]
This article aims to compile existing research, provide an overview of current practice with regard to PTX and post-PTX chronic management. It highlights gaps and controversies and aims to re-orient the focus to clinically relevant contemporary priorities in CKD-MBD management after PTX. PMID: 31313380 [PubMed - as supplied by publisher]
Abstract Mineral and bone disorders are frequently observed in chronic kidney disease. Prevening these metabolic, bone and cardiovascular consequences requires a treatment strategy based on physiopathology and international recommendations. The precise diagnosis of these mineral and bone disorders is based on serum parathyroid hormone and alkaline phosphatases values allowing to identify secondary hyperparathyroidism and adynamic bone disease, that are both associated with cardiovascular complication together with calcium and phosphate imbalance. Chronic kidney disease-mineral and bone disorders are associated wit...
AbstractSecondary and tertiary hyperparathyroidism is an important problem of chronic kidney disease. Brown tumor is a benign, unusual, reactive lesion as a result of disturbed bone remodeling, from long-standing increase in parathyroid hormone level. Brown tumors may cause morbidity due to pressure symptoms on neural structures and spontaneous bone fractures. Herein, we presented a peritoneal dialysis patient with tertiary hyperparathyroidism under calcand calcitriol treatment for 4 years due to refusing of the parathyroidectomy operation. She admitted to hospital for sudden onset back pain with difficulty in gait a...