Effectiveness of Native Vitamin D Therapy in Patients with Chronic Kidney Disease Stage 3 and Hypovitaminosis D in Colombia, South America.
Conclusion: Cholecalciferol with adjustment in its dose, and obtaining normal serum levels is an excellent therapeutic alternative for the treatment of patients with CKD stage 3, and hypovitaminosis D. In the group of patients with GFR close to 30 mL/min, or lower values (stage 4), and with the presence of secondary hyperparathyroidism, the use of active form of vitamin D (calcitriol, paricalcitol) is recommended as the first therapeutic alternative. PMID: 31827333 [PubMed]
Conclusion18F-FCH PET/CT was more sensitive and accurate for uHPT than99mTc-sestaMIBI SPECT/CT and US, and had better preoperative diagnostic efficacy, particularly for lesions diagnosed as a thyroid nodule by US.
Abstract Bone mineral abnormalities (defined as Chronic Kidney Disease Mineral Bone Disorder; CKD-MBD) are prevalent and associated with a substantial risk burden and poor prognosis in CKD population. Several lines of evidence support the notion that a large proportion of patients receiving maintenance dialysis experience a suboptimal biochemical control of CKD-MBD. Although no study has ever demonstrated conclusively that CKD-MBD control is associated with improved survival, an expanding therapeutic armamentarium is available to correct bone mineral abnormalities. In this position paper of Lombardy Nephrologists,...
A 28-year-old woman sought care due to an increase in mandible volume lasting approximately 1 year. The patient had chronic kidney disease caused by Berger disease in childhood, and underwent hemodialysis 3 times a week. An intraoral clinical examination revealed an expansive lesion on the left side of the mandible, causing mobility of the adjacent teeth. The radiographic examination showed a lesion of imprecise borders in the region of the right mandible of approximately 2 cm in size. An incisional biopsy and histologic examination revealed a giant cell lesion.
The brown tumor of hyperparathyroidism is a rare condition associated with excessive production of parathyroid hormone in response to decreased serum calcium levels associated with chronic kidney disease (CKD). A 28-year-old female patient with CKD undergoing hemodialysis presented an asymptomatic swelling in the buccal region of teeth 34 to 44 and mobility of them. Similar swellings were observed on the palate and alveolar ridge distal to tooth 17. On the panoramic radiograph, a radiolucent area not defined by radiopaque halo was observed in the anterior region of the mandible of approximately 2.5 cm in length and radiolu...
We report a case of a 30-year-old female patient referred to our clinic with a chief complaint of a painful swelling of the left mandible and difficulty chewing. Her medical history included systemic lupus erythematosus, hypertension, and chronic kidney disease (was on hemodialysis for the past 9 years).
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: CKD-MBD is common among patients on hemodialysis in our center. Screening for CKD-MBD and appropriate use of phosphate binder and Vitamin D when indicated are highly recommended.
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]
Abstract INTRODUCTION: Severe uncontrolled secondary hyperparathyroidism and kidney transplantation history are both risk factors for fractures in hemodialyzed patients. Moreover, patients who return to dialysis after transplant failure have more severe infections/anemia and higher mortality risk than transplant-naive patients starting dialysis with native kidneys. In this context, our aim was to test the hypothesis that transplant failure patients have more secondary hyperparathyroidism than transplant-naive patients. METHODS: We retrospectively compared 29 transplant failure patients to 58 transpl...
A 46-year-old woman with a history of sickle cell disease and associated predialysis stage V chronic kidney disease (CKD) with secondary hyperparathyroidism presented with fever, severe extremity pain, and perioral numbness. On examination, she had a prominent Chvostek ’s sign, carpopedal spasm, hyperactive tendon reflexes, and a nontender mass in the left lobe of her thyroid gland. She was not on bisphosphonates or calcimimetics and had not been taking her prescribed calcitriol for 2 weeks.