Abstract:
:Patients with chronic kidney disease (CKD) experience co-morbid illnesses, including cardiovascular disease and retinopathy. Sevelamer hydrochloride (Renagel®); a non-calcium phosphate binder reduces coronary artery and aortic calcification as compared to calcium containing phosphate binders and additionally effects inflammatory biomarkers such as C-reactive protein (CRP), and lowers LDL cholesterol in patients with CKD. Since retinopathy is proven to be associated with increased coronary calcification, shared pathophysiological processes may contribute to both microvascular and macrovascular disease. We here suggest three different mechanisms of possible sevelamer's influence on the retinopathy: (1) by direct effect on the microvasculature through lowering CRP and LDL, involved in endothelial dysfunction and atherogenesis, (2) indirectly by attenuation of vascular calcification of aorta and carotid internal artery, it reduces ischaemia and improves circulation in the opthalmic artery and hence postponing retinopathy, (3) through hypertension by reducing atherosclerosis and calcification of carotid arteries, sevelamer decreases stiffness and intima-media wall thickness, therefore lowering blood pressure, which is well known to increase progression of diabetic retinopathy. So far no studies have yet been published on the direct influence of sevelamer on the retinopathy which we believe has good theoretical background. With its combined macrovascular and microvascular effect, sevelamer could potentially postpone and/or decrease retinopathy in diabetic patients with hypertension, and that are on hemodialysis or even predialysis patients.
journal_name
Med Hypothesesjournal_title
Medical hypothesesauthors
Draca N,Lazic R,Simic P,Dumic-Cule I,Luetic AT,Gabric Ndoi
10.1016/j.mehy.2012.12.035subject
Has Abstractpub_date
2013-04-01 00:00:00pages
431-5issue
4eissn
0306-9877issn
1532-2777pii
S0306-9877(13)00024-8journal_volume
80pub_type
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pub_type: 杂志文章
doi:10.1016/j.mehy.2014.02.012
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journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/s0306-9877(03)00263-9
更新日期:2004-01-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2018-07-01 00:00:00
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journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/j.mehy.2005.02.017
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journal_title:Medical hypotheses
pub_type: 杂志文章
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更新日期:2020-11-01 00:00:00
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journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/j.mehy.2007.07.032
更新日期:2008-01-01 00:00:00
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journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/s0306-9877(02)00266-9
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pub_type: 杂志文章
doi:10.1016/j.mehy.2005.09.004
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journal_title:Medical hypotheses
pub_type: 杂志文章
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journal_title:Medical hypotheses
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journal_title:Medical hypotheses
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journal_title:Medical hypotheses
pub_type: 历史文章,杂志文章
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journal_title:Medical hypotheses
pub_type: 杂志文章
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更新日期:2020-09-01 00:00:00
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journal_title:Medical hypotheses
pub_type: 杂志文章,评审
doi:10.1016/j.mehy.2006.04.010
更新日期:2006-01-01 00:00:00
abstract::Extracts of the unripe fruit of Momordica charantia--bitter melon, which flourishes throughout the tropics--appear to have utility in the management of type 2 diabetes. Rodent studies suggest that the thus-far-uncharacterized active components of such extracts enhance the efficiency of postprandial glucose storage in ...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/j.mehy.2004.01.041
更新日期:2004-01-01 00:00:00
abstract::The etiology of Autism Spectrum Disorders (ASDs) continues to be elusive. While ASDs have been shown to be heritable, several environmental co-factors, such as, e.g. pre- or perinatal adverse events, could play a role in the pathogenesis of the disorder as well. Prevalence of ASDs appears to have increased in the last...
journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/j.mehy.2014.03.011
更新日期:2014-06-01 00:00:00
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journal_title:Medical hypotheses
pub_type: 杂志文章
doi:10.1016/j.mehy.2019.109479
更新日期:2020-03-01 00:00:00