KDOQI US Commentary on the 2009 KDIGO Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of CKD–Mineral and Bone Disorder (CKD-MBD)

Uhlig, Katrin; Berns, Jeffrey S.; Kestenbaum, Bryan; Kumar, Rajiv; Leonard, Mary B.; Martin, Kévin; Sprague, Stuart M.; Goldfarb, Stanley

doi:10.1053/j.ajkd.2010.02.340

Cited by 245 publications

(183 citation statements)

References 83 publications

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“…In this study, although the levels of calcium and phosphate tended to deteriorate with the progression of renal failure, they were in the normal range suggested by clinical guidelines,45, 46 even in patients with advanced CKD (Table S1), and we failed to identify the association between mineral parameters and the presence of CAC (data not shown). Despite some studies showing that phosphate level increases in CAC within the normal range,47 the Kidney Disease: Improving Global Outcomes and Kidney Disease Outcomes Quality Initiative guidelines do not recommend phosphate lowering in patients with CAC in the normal range 45, 46. Further research is needed to establish strong evidence.…”

Section: Discussioncontrasting

confidence: 51%

Extracellular Fluid Excess Is Significantly Associated With Coronary Artery Calcification in Patients With Chronic Kidney Disease

Park

Jhee

Yun

et al. 2018

JAHA

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BackgroundExtracellular fluid (ECF) excess is an independent predictor of cardiovascular morbidity in patients undergoing dialysis. This study aimed to investigate the relationship between ECF status, which is affected by renal function, and coronary artery calcification (CAC), which is a marker of cardiovascular disease, in patients with chronic kidney disease (CKD).Methods and ResultsA total of 1741 patients at all stages of pre‐dialysis CKD from the prospective observational cohort of CMERC‐HI (Cardiovascular and Metabolic Disease Etiology Research Center‐High Risk) were analyzed for the association between ECF status and CAC. ECF status was defined as extracellular water‐to‐total body water ratio (ECW/TBW) measured using bioelectrical impedance analysis. ECF excess was defined as ECW/TBW ≥0.390 or ≥0.400 depending on its severity. To define CAC, Agatston coronary artery calcium scores were measured. A total coronary artery calcium score of ≥400 was defined as CAC. The CKD stages were defined according to estimated glomerular filtration rate calculated using the CKD Epidemiology Collaboration equation. ECW/TBW and the proportion of ECF excess increased with progressing CKD stages. Multivariable logistic regression analyses showed that ECW/TBW was independently associated with CAC (per 0.01 increase of ECW/TBW, odds ratio 1.168, 95% confidence interval, 1.079–1.264, P<0.001). The adjusted R 2 for predicting higher coronary artery calcium scores and CAC significantly improved after ECW/TBW was added to conventional factors. This association was further confirmed by net reclassification and integrated discriminant improvements, sensitivity analysis, and subgroup analysis.Conclusions ECF status is independently associated with a high risk of CAC in patients with CKD.Study Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT02003781.

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Section: Discussioncontrasting

confidence: 51%

Extracellular Fluid Excess Is Significantly Associated With Coronary Artery Calcification in Patients With Chronic Kidney Disease

Park

Jhee

Yun

et al. 2018

JAHA

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“…Serum phosphate is not effectively reduced by conventional dialysis (7,8). Calcium-based phosphate binders effectively are used for treatment of hyperphosphatemia in CKD (9).…”

Section: Discussionmentioning

confidence: 99%

Hypoparathyroidism versus hyperparathyroidism in pediatric dialysis patients; a single center study

Naseri¹

2017

J Nephropathol

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Background: Abnormalities in calcium, phosphorous and parathyroid hormone (PTH) metabolisms are common in dialysis patients. Reaching target levels for these serologic factors and calcium × phosphorous products is recommended to minimize cardiovascular events. Objectives: The aim of this study was to examine calcium, phosphorous and intact PTH (iPTH) abnormalities in a group of dialysis patients. Patients and Methods: Bone minerals status and iPTH levels were assessed in 46 dialysis patients aged 19-300 (165.2 ± 75.73) months. Low and high Ca dialysate solutions routinely were used for hemodialysis (63%) and peritoneal dialysis (30.4%) patients respectively. Comparisons between groups were performed with considering age (≤5, 6-10, and > 10 years), gender and modality of dialysis. Results: Serum calcium and corrected calcium levels were significantly higher in peritoneal dialysis (PD) patients. Hypoparathyroidism was the most frequent iPTH abnormality (58.7%). It was more prevalent in males. Hyperparathyroidism was more frequent in females. Conclusions: We found that hypoparathyroidism is the most prevalent PTH abnormality. We also noted that patients on peritoneal dialysis are more prone to develop this form of PTH abnormality. We found that phosphate control is better in peritoneal dialysis vs. hemodialysis cases.

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“…6 Kidney disease is an improving worldwide outcome (KDIGO) guidelines have acknowledged that assessment of ionized calcium is the best method for estimating calcium levels in CKD subjects. 7 Depending on the above rules and regulationssome studies reported that there is a fair accruement among these parameters in CKD subjects. Although some other studies were reported that non-corrected and albumin corrected that total calcium levels weak predictors of calcium levels in CKD subjects.…”

Section: Introductionmentioning

confidence: 99%

A study of comparison between ionized calcium and albumin corrected calcium in patients with chronic kidney disease

2020

IJCBR

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Chronic kidney disease (CKD) is a global health issue rising in alarming rate. Diseases of mineral and bone metabolism are more common in chronic kidney disease. This study was aimed to evaluate comparison between ionized calcium and albumin corrected calcium in Subjects with CKD with dialysis treatment, to assess their calcium levels. Subjects with CKD on dialysis treatment, who presented to the Department of Medicine, PESIMSR, Kuppam were included into the study. Sample (n=40) was collected from all patients from AV fistula. This was used to analyze total calcium, serum albumin, pH and also ionized calcium values. Albumin corrected calcium is calculated using equation. The preliminary data analyses reporting a significant variation among ionized calcium and total calcium besides albumin corrected calcium in patients with CKD (p< 0.001). The factors that influence the ionized calcium levels are being currently determined.There is a significant variation among ionized calcium and total as well as albumin corrected calcium in subjects with CKD (P < 0.001). These results need further analyses to identify factors that influence ionized calcium levels. This will help us to know the importance of ionized calcium in estimating calcium levels in CKD subjects.

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KDOQI US Commentary on the 2009 KDIGO Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of CKD–Mineral and Bone Disorder (CKD-MBD)

Cited by 245 publications

References 83 publications

Extracellular Fluid Excess Is Significantly Associated With Coronary Artery Calcification in Patients With Chronic Kidney Disease

Extracellular Fluid Excess Is Significantly Associated With Coronary Artery Calcification in Patients With Chronic Kidney Disease

Hypoparathyroidism versus hyperparathyroidism in pediatric dialysis patients; a single center study

A study of comparison between ionized calcium and albumin corrected calcium in patients with chronic kidney disease

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