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Management of Hyperphosphatemia in Patients with ESRD: A New Direction for Treatment in 2008
(Medical Education Resources, Cancun, Mexico, January, 2008)
Qunibi: How do sevelamer and acetate compare in terms of phosphate control? In terms of grams of binder needed to achieve equivalent phosphate control? The explanation for reduced progression rate of vascular calcification in the RIND and DCOR studies has been lack of calcium-loading with sevelamer. To what extent is an alternative hypothesis, that of lowering of LDL- cholesterol, consistent with the data? What are data in animal models regarding vascular calcification in CKD and the effect of calcium-based phosphate binders? In the CARE-2 study (now available on-line at the AJKD website) progression of calcification was compared between calcium acetate plus atorvastatin and sevelamer plus atorvastatin (as needed to achieve equivalent LDL levels). What were the principal findings of CARE-2? Nolan: What did Treat-to-Goal, DCOR, RIND, DCOR Revisited, and CARE-2 show with respect to both calcification and mortality? How were the mortality results different from the calcification results? What are the DOPPS data with regard to phosphate binder use and mortality? What percentage of patients do the KDOQI guidelines recommend for non-calcium containing phosphate binders? What are the relative costs of sevelamer, calcium acetate, and calcium carbonate?
(more...)
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Medical Crossfire: Managing Phosphorus in CKD -- The Challenge Remains
(ASN Renal Week Official Symposium, 2007)
Panel Discussion: What are the factors that promote vascular calcification in early CKD and in ESRD? How does vascular calcification affect prognosis? Should we screen for vascular calcification? If so, how? If yes, then how do we use this information? What should the target serum phosphate levels be as CKD progresses from stage 3 through 5? How good is the data suggesting lower phosphate targets? What are the various phosphate binder options available? Are they equally effective? Equally potent? Are there patient factors affecting choice of binder? To what extent should we control serum phosphate in predialysis patient? How should this be done? What are the key take-home points?
(more...)
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Phosphate Binders in CKD: An Update on Treatment Outcomes and Future Directions
(ASN Renal Week Official Symposium, 2007)
Langman: What is the pathogenesis of mineral bone disorder in CKD? As GFR falls, at what point does serum Pi increase? What is the comparative efficacy of currently used Pi binders? What's the association between serum Pi levels and cardiovascular risk in ESRD, stage 2-4 CKD, and stage 2 CKD? What percent have coronary calcification at onset of dialysis? What were the conclusions of the DCOR and RIND studies in terms of coronary calcification and survival in patients using sevelamer vs. calcium-containing binders? What are the new data concerning sevelamer carbonate? Ketteler: What is fibroblast growth factor 23, and what is its role in phosphate excretion as GFR falls? How does extracellular phosphate affect vascular smooth muscle biology? What are the pathways for activating vascular smooth muscle transformation into osteoblast phenotypes? What does fetuin-A do? How does sevelamer affect fetuin-A levels? What is the role of matrix Gla protein and pyrophosphate in preventing calcification?
(more...)
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Contemporary Diagnosis and Treatment of Vitamin D-Related Disorders ASBMR 2006
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Clinical implications of bone biopsy ASN Renal Week 2006 (audio only)
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Magnesium Balance: Hypomagnesemia and Hypermagnesemia (Coyne) ASN Board Review 2006
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Low Bone Turnover Disease: Consequences, Prevalence, Detection and Treatment (Thomas L. Cantor, BA; Hassan Fehmi, MD; Gerard M. London, MD; Simon Waller, MD, MBBS, BSc) ADC 2006 (audio only)
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Update on Vascular Calcification in Chronic Kidney Disease (CKD) Patients (Isaac Teitelbaum, MD; Robert Toto, MD; Dennis Andress, MD; Gerard M. London, MD) ADC 2006 (audio only)
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Newer Approaches to Renal Osteodystrophy in Chronic Kidney Disease Patients
(London, Sprague, Coyne, Goodman, Wolf)
ADC 2006 (audio only)
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Managing Renal Osteodystrophy: Discussion of Interesting Cases
(Sprague, Moe)
ASN Renal Week 2005 (audio only)
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Active Vitamin D Therapeutic Options: Links to Cardiovascular Outcomes in the Management of CKD
(Wolf, Llach)
ASN Renal Week 2005 (audio only)
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Atherosclerosis and Vascular Calcification in CKD
(Hruska, Vanholder, Himmelfarb)
ASN Renal Week 2005 (audio only)
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Strategies for Reducing Parathyroid Hyperplasia, Fractures and the Need for Parathyroidectomy in Renal Disease
(Fukagawa, Cunningham)
ASN Renal Week 2005 (audio only)
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Advances in the Treatment of Renal Osteodystrophy
(Goodman, Sprague)
ASN Renal Week 2005 (audio only)
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Controversies in Managing Hyperphosphatemia in CKD and ESRD
(Young, Rosas, Goldfarb)
ASN Renal Week 2005 (audio only)
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Stones and Bones
(Coe, Kramer, Thakker)
ASN Renal Week 2005 (audio only)
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Recent Advances in Regulation of Calcium, Magnesium and Phosphate Homeostasis and Metabolism
(Murer, Konrad, Huang, Weinman)
ASN Renal Week 2005 (audio only)
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An Expert Panel Debates Key Clinical Issues in Mineral Metabolism and Mortality in CKD (Medical Crossfire)
(Coyne, Moe, Martin)
ASN Renal Week 2005
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Case Discussions: Disorders of Calcium Metabolism
(Bushinsky, Andress)
ASN Board Review 2005
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The Role of Vitamin D in CKD
(Slatopolsky, Sprague, Thadhani)
ADC 2005 (audio only)
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Calciphylaxis
(Bleyer)
ASN Renal Week 2004
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Bones, Moans, and Groans: Skeletal Disorders in Chronic Kidney Disease Part 1
of 2.
(Alleman)
ANNA
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Bones, Moans, and Groans: Skeletal Disorders in Chronic Kidney Disease Part 2
of 2.
(Alleman)
ANNA
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Mineral and Bone Treatment Options for the Stage 3 and 4 CKD Patient
(Lindberg)
ASN 2004
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The Essential Role of Vitamin D in the Pathophysiology of CKD
(Jones)
ASN 2004
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Mineral and Metal Accumulation Without Changes in the "Usual Laboratory
Suspects": How to Detect and Manage such Patients
(Moe)
ASN 2004
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Tissue and Vascular Calcification: Clinical Overview and Detection
(Raggi)
ASN 2004
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Coronary Artery Calcification: Scanning Methods and Clinical Results in the
General Population
(Rumberger)
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Spurious Hyperphosphatemia in Patients on Hemodialysis With Catheters (Schiller et al) Am J Kidney Dis (Sep 2008)
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Calcimimetics in chronic kidney disease: evidence, opportunities and challenges (Evenepoel P) Kidney Int - Aug - 08
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Oral estrogen therapy in postmenopausal women is associated with loss of kidney function Kidney Int - Aug - 08
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Development and progression of secondary hyperparathyroidism in chronic kidney disease: lessons from molecular genetics (Goodman WG et al) Kidney Int - Aug -08
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When is it appropriate to order an ionized calcium? (Calvi and Bushinsky) JASN (Jul 2008)
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Oxalate in renal stone disease: the terminal metabolite that just won't go away NCPN (Jul 2008)
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Urinalysis: core curriculum 2008 Am J Kidney Dis (Jun 2008)
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Adynamic bone in patients with chronic kidney disease Kidney Int (Jun 2008)
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Factors associated with osteonecrosis of the jaw among bisphosphonate users Am J Med (Jun 2008)
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A dietary alternative to phosphorus control J Ren Nutr (Mar 2008)
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WNK kinases and renal sodium transport in health and disease: an integrated view Hypertens (Mar 2008)
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24-h uric acid excretion and the risk of kidney stones Kidney Int (Feb 2008)
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Metabolic acidosis inhibits soft tissue calcification in uremic rats Kidney Int (Feb 2008)
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Mechanisms of vascular calcification in chronic kidney disease J Am Soc Nephrol (Feb 2008)
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Poor correlation between coronary artery calcification and obstructive coronary artery disease in an end-stage renal disease patient Hemodial Int (Jan 2008)
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Battleground: chronic kidney disorders mineral and bone disease - calcium obsession, vitamin F, and binder confusion Clin J Am Soc Nephrol (Jan 2008)
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Towards the incidence of acute phosphate nephropathy (Markowitz et al) J Am Soc Nephrol (Dec 2007)
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Effects of sevelamer and calcium-based phosphate binders on mortality in hemodialysis patients (Suki et al) Kidney Int (Nov 2007)
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Genetics of hypercalciuric stone forming diseases (Devuyst et al) Kidney Int (Nov 2007)
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Incidence and clinical spectrum of thiazide-associated hypercalcemia (Wemers et al) Am J Med (Oct 2007)
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The role of magnesium binders in chronic kidney disease (Spiegel) Semin Dial (Aug 2007)
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Expanding role for vitamin D in chronic kidney disease: importance of blood 25-OH-D levels and extra-renal 1alpha-hydroxylase in the classical and nonclassical actions of 1alpha,25-(OH)2-D3 (Jones) Semin Dial (Aug 2007)
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Can calcimimetics inhibit parathyroid hyperplasia? Evidence from preclinical studies (Drueke et al) Nephrol Dial Transplant (Jul 2007)
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Hypophosphatemia: clinical consequences and management (Brunelli et al) J Am Soc Nephrol (Jul 2007)
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Hidden Phosphorus: Where Do We Go From Here? (Murphy-Gutekunst L) J Ren Nutr (Jul 07)
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Hidden phosphorus: where do we go from here? (Lisa Murphy- Gutekunst) J Ren Nutr (Jul 2007)
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Pulse wave velocity is inversely related to vertebral bone density in hemodialysis patients (Raggi et al) Hypertens (Jun 2007)
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How fibroblast growth factor 23 works (Liu et al) J Am Soc Nephrol (Jun 2007)
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Bisphosphonates in the renal patient (Cunningham) Nephrol Dial Transplant (Jun 2007)
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Calcific uremic arteriolopathy: advances in pathogenesis and treatment (Rogers et al.) Semin Dial (Apr 2008)
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Metabolic bone disease in chronic kidney disease JASN 03-07
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Metabolic bone disease in chronic kidney disease (Martin, Gonzalez) JASN (03-2007)
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Hypomagnesemia in patients with type 2 diabetes CJASN 03-07
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ACCF/AHA 2007 Clinical Expert Consensus Document on coronary artery calcium scoring by computed tomography in global cardiovascular risk assessment and in evaluation of patients with chest pain. Circulation (02-07)
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Prevalence of abnormal serum vitamin D, PTH, calcium, and phosphorus in patients with chronic kidney disease: Results of the study to evaluate early kidney disease. (A. Levin et al) Kidney Int 01-07
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Pathogenesis and prevention of bone loss in patients who have kidney disease and receive long-term immunosuppression JASN (01-2007)
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Calcific uremic arteriolopathy: advances in pathogenesis and treatment Semin Dial 04-07
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Pathogenesis and prevention of bone loss in patients who have kidney disease and receive long-term immunosuppression. JASN (01-07)
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Bone Disease Links
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HDCN
Topic Pages (KEY)
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