The kidney and bone metabolism: Nephrologists' point of view

Fukagawa, Masafumi; Hamada, Y.; Nakanishi, Shohei; Tanaka, Motoko

doi:10.1007/s00774-006-0719-7

Cited by 42 publications

(27 citation statements)

References 70 publications

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“…The kidneys are vital organs regulating calcium and phosphorous homeostasis (8). SHPT is an adaptive pathophysiological process in response to deteriorating renal insufficiency (6).…”

Section: Introductionmentioning

confidence: 99%

“…SHPT is an adaptive pathophysiological process in response to deteriorating renal insufficiency (6). The fundamental mechanism of PTH in kidneys is to suppress the reabsorption of phosphate in the proximal tubule, and to stimulate calcium reabsorption in the ascending loop of Henle, distal tubule and collecting tubule (8). Upon the stimulation of PTH, renal calcium reabsorption and phosphate excretion are increased (9 (12).…”

Section: Introductionmentioning

confidence: 99%

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Risk factors associated with secondary hyperparathyroidism in patients with chronic kidney disease

Wei

Lin

Yang

et al. 2016

Experimental and Therapeutic Medicine

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Abstract. Secondary hyperparathyroidism (SHPT) is common in patients with chronic kidney disease (CKD), and its development and progression are affected by various factors. The aim of the present study was to identify the risk factors for SHPT in patients with CKD. A retrospective study was performed in 498 patients (305 males and 193 females) with CKD, observed in the The First Hospital of Jilin University between January 2008 and December 2012. The demographic, clinical and laboratory data were collected. Patients were divided into the SHPT group (n=424) with elevated serum parathyroid hormone (PTH) expression levels and the control group (n=74) with normal serum PTH expression levels. Univariate and multivariate regression analyses were employed to explore the risk factors for SHPT. Serum PTH expression levels in women with CKD were significantly higher than in men (P= 0.047). Serum PTH expression levels were positively correlated with the expression levels of serum creatinine (P<0.01), phosphorus (P<0.01), C-reactive protein (P<0.05), triglyceride (P<0.05), cholesterol (P<0.05) and low-density lipoprotein cholesterol (P<0.05), but were negatively correlated with the expression levels of hemoglobin (P<0.05), calcium (P<0.01) and CO 2 combining power (P<0.01) in patients with CKD. Multivariate analysis showed that the serum expression levels of creatinine [µmol/l; odds radio (OR), 1.003; 95% confidence interval (CI), 1.002-1.004; P=0.001] and phosphorus (mmol/l; OR, 2.19; 95% CI, 1.254-3.826; P=0.006) in patients with CKD significantly influenced serum PTH expression levels. The SHPT risk factors include female gender, low calcium, high phosphorus, acidosis, anemia, hypertension, hyperlipidemia and micro-inflammation, with blood phosphorus and creatinine being independent risk factors. IntroductionThe incidence of chronic kidney disease (CKD) is rapidly increasing, posing a serious health problem worldwide. More than 16 million adults are affected by end stage CKD in the USA (1,2). Abnormal serum calcium, phosphorus and parathyroid hormone (PTH) expression levels are common challenges in the management of CKD (3,4). These biochemical abnormalities, together with the dysregulation of vitamin D metabolism and bone turnover, constitute a systemic syndrome termed CKD mineral and bone disorder (CKD-MBD) (5).Secondary hyperparathyroidism (SHPT) is a common complication of patients with CKD, which is characterized by increased blood PTH levels, and abnormal mineral and bone metabolism (6). It is associated with increased morbidity and mortality, and adversely influences the quality of life of patients with CKD (3,6). The incidence of SHPT is reported to increase with the stage of CKD: 40% in stage 3, 70% in stage 4 and >80% in stage 5 (4,7).The kidneys are vital organs regulating calcium and phosphorous homeostasis (8). SHPT is an adaptive pathophysiological process in response to deteriorating renal insufficiency (6). The fundamental mechanism of PTH in kidneys is to suppress the reabsorption of phosphate in the pro...

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“…The kidneys are vital organs regulating calcium and phosphorous homeostasis (8). SHPT is an adaptive pathophysiological process in response to deteriorating renal insufficiency (6).…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk factors associated with secondary hyperparathyroidism in patients with chronic kidney disease

Wei

Lin

Yang

et al. 2016

Experimental and Therapeutic Medicine

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“…Phosphate toxicity due to excessive retention of PO 4 in the body can cause a variety of cellular and tissue damage. An example is seen with the higher occurrence of vascular calcification, encountered in patients with chronic kidney disease, is related to the increased retention of phosphate in the body [26,27]. The normal range of PO 4 should be in the order of 2.4-4.1 mg/dL, so this is of importance as when scaffold is placed in the system, the levels in the local region may be slightly higher than normal, but should not increase the overall levels to prevent any complications such as cell death, which in turn would lead to killing new bone cells.…”

Section: Discussionmentioning

confidence: 99%

Controlling calcium and phosphate ion release of 3D printed bioactive ceramic scaffolds: An in vitro study

2017

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This paper characterizes in an in vitro setting the release of calcium (Ca) and phosphate (PO 4 ) of 3D printed bioactive ceramic scaffold prepared from extrudable paste containing hydroxyapatite and β-tricalcium phosphate (β-TCP). Hydroxyapatite and β-TCP were calcined at 800 ℃ for 11 h, fabricated into four experimental groups (100% HA, 100% β-TCP, 15%/85% HA/β-TCP, and 15%/85% HA/β-TCP (design)), sintered to 1100 ℃ for 4 h. Calcium and phosphorus concentrations were evaluated using ICP spectroscopy, and the release of Ca and PO 4 ions during dissolution of the CaP-based scaffolds was measured by submerging in 0.05 mol/L Tris(hydroxymethyl)aminomethane-HCl and maintaining a temperature of 37 ℃. The Ca and PO 4 concentrations of the solutions were measured with the utilization of a calcium assay kit and a phosphate assay kit and read in a UV-visible spectrophotometer. The 100% HA scaffold group showed the greatest concentration of Ca ions (~1.9 mg/dL), but ultimately released at a lower amount as time increased; the 100% HA scaffold also showed the lowest total amount of calcium ions released over the course of evaluation. The results for the 100% β-TCP were on the opposite of the HA with the highest amount of calcium ion release over the study. While the PO 4 ion release showed a similar trend as those observed with Ca ions with an apparent difference in the 100% HA scaffold group. There was nearly 0 mg/dL of the phosphate ions released in the first 24 h, in comparison to the amount of Ca ions released during the same time frame. Since various formulations can lead to different properties of these bioactive ceramic scaffolds, it is important to understand how the tailoring of this important biphasic material can impact the long-term outcome of an ever-important in vivo clinical trial in the future.

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“…It is not only the target organ of mineral regulating hormones, but also the main organ that activates vitamin D [1]. Accordingly, in CKD patients, various abnormalities develop in this system, such as secondary hyperparathyroidism [2,3].…”

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confidence: 99%