Archive for the ‘Bone Mineral Metabolism’ Category

March 23, 2016

Sevelamer Versus Calcium-Based Binders for Treatment of Hyperphosphatemia in CKD: A Meta-Analysis of Randomized Controlled Trials

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This meta-analysis included 25 studies with a total of 4770 participants, of which 88% were on hemodialysis.  The results show that for patients with CKD stages 3-5 using sevelamer have lower all-cause mortality compared with those using calcium based binders. However, due to the lack of placebo-controlled studies, the benefit of phosphate binders for patients with CKD stages 3-5 and not on […]

No Comments Posted in Bone Mineral Metabolism, Clinical Trial Results, Vascular Disease/Calcification
May 8, 2015

Bone histomorphometry before and after long-term treatment with cinacalcet in dialysis patients with secondary hyperparathyroidism

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This long-term follow-up study of dialysis patient treated with cinacalcet for 6-12 months showed improved PTH, biochemical markers as well as bone histology.  Of the 77 patients that underwent a second bone biopsy at 12 months, 20 had normal had a normal bone biopsy.  

No Comments Posted in Bone Mineral Metabolism, Chronic Kidney Disease, Clinical Nephrology
December 21, 2013

Use of phosphate-binding agents is associated with a lower risk of mortality

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In this mulitcenter, observational, prospective study of stage 5 CKD patients on dialysis, the use of phosphate-binding agents was shown to lower all-cause and cardiovascular mortality by 29% and 22% respectively. All agents proved to be beneficial except aluminum salts. There interesting findings need to be confirmed in randomized clinical trials.

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December 21, 2013

No independent association of serum phosphorus with risk for death or progression to end-stage renal disease in a large screen for chronic kidney disease

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Contrary to the generally held belief, this study showed that when adjusted for potential confounders, serum phosphorus was not independently found to be associated with a risk of death or progression to ESRD in the group of over 10 000 patients with eGFRs < 60 ml/min.

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July 25, 2013

The demise of calcium-based phosphate binders

This editorial provides commentary on the paper Effect of calcium-based versus non-calcium-based phosphate binders on mortality in patients with chronic kidney disease: an updated systematic review and meta-analysis.

Comments Off on The demise of calcium-based phosphate binders Posted in Bone Mineral Metabolism, Chronic Kidney Disease, Vascular Disease/Calcification
July 25, 2013

Effect of calcium-based versus non-calcium-based phosphate binders on mortality in patients with chronic kidney disease: an updated systematic review and meta-analysis.

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This meta-analysis looks at the effect of calcium-based versus non-calcium-based phosphate binders on mortality in patients with chronic kidney disease.  It has been updated from a 2009 meta-analysis (read it here) looking at the same question but with the benefit of additional clinical trial data.  Analysis of the trials that reported mortality showed a 22% […]

Comments Off on Effect of calcium-based versus non-calcium-based phosphate binders on mortality in patients with chronic kidney disease: an updated systematic review and meta-analysis. Posted in Bone Mineral Metabolism, Chronic Kidney Disease, Vascular Disease/Calcification
November 4, 2012

Effect of Cinacalcet on Cardiovascular Disease in Patients Undergoing Dialysis

In this randomized, placebo controlled trial, patients on hemodialysis with moderate-to-severe secondary hyperparathyroidism were randomized to receive either cinacalcet or placebo.   No difference was seen in the primary composite end point (time until death, myocardial infarction, hospitalization for unstable angina, heart failure, or a peripheral vascular event) between cinacalcet (48.2%) versus placebo (49.2%) HR 0.93; 95% CI, 0.85 to […]

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December 22, 2011

CKD–Mineral and Bone Disorder: Core Curriculum 2011

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This AJKD Core Curriculum article nicely covers the challenging topic of bone mineral metabolism in chronic kidney disease.

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November 12, 2011

Late Breaking Clinical Trials at ASN 2011 – FISH study and more

The late breaking clinical trials session from the 2011 American Society of Nephrology meeting was held on November 12, 2011.  The following are summaries of some of the clinical trial results.  Access to the full details of these studies awaits publication in peer reviewed journals. Charmaine E. Lok et al.  The Fish Oil Inhibition of Stenosis […]

Comments Off on Late Breaking Clinical Trials at ASN 2011 – FISH study and more Posted in Bone Mineral Metabolism, Clinical Trial Results, General Nephrology, Glomerulonephritis, Pediatric Nephrology, Renal Transplantation, Vascular Access
February 8, 2011

Raloxifene, a selective estrogen receptor modulator, is renoprotective: a post-hoc analysis

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This study is a post-hoc analysis of the Multiple Outcomes of Raloxifene Evaluation Trial, a double-masked, placebo-controlled randomized clinical trial of post-menopausal women with osteoporosis who were randomized to raloxifene or placebo. Compared with those in the placebo group, participants on raloxifene had a significantly slower yearly rate of decrease in eGFR.

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December 26, 2010

Intestinal radiopacities in chronic renal failure

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This CT abdomen image shows an incidental finding of deposition of lanthanum carbonate in the small and large intestine.

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November 1, 2010

Cinacalcet hydrochloride treatment significantly improves all-cause and cardiovascular survival in a large cohort of hemodialysis patients

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This observational study utilizing USRDS data showed a survival benefit associated with the use of cinacalcet in those patients receiving intravenous vitamin D.  The authors indicate that “definitive proof, however, of a survival advantage awaits the performance of randomized clinical trials.”

2 Comments Posted in Bone Mineral Metabolism
May 1, 2010

Interventions for bone disease in children with chronic kidney disease.

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This systematic review of interventions for bone disease in children with CKD concludes that all examined vitamin D formulations reduce PTH levels and that sevelamer as compared to calcium-based binders reduced serum calcium and hypercalcemic events. However, no reduction in hard clinical endpoints was identified.

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