Abstract:
:As kidney function declines, chronic kidney disease (CKD) becomes an increasingly systemic disorder. Most patients with CKD eventually develop subclinical or clinical abnormalities in bone and mineral metabolism. Recent observational and basic scientific studies have led to a new emphasis on the changes in phosphorus and calcium metabolism, parathyroid hormone, and vitamin D that lead to this complex systemic bone/mineral disorder (CKD/BMD). At the center of the disorder are relationships among all 4 factors that conspire to create a perfect storm, leading to secondary hyperparathyroidism (SHPT). Some key current issues that are reviewed here are as follows: (1) factors promoting SHPT, (2) the role of fibroblast growth factor-23 in CKD/BMD, (3) molecular mechanisms of SHPT, (4) mechanisms of vascular calcification, and (5) medical management of the disorder, including calcimimetics. Current therapies directed at correcting the primary abnormalities (ie, improve conditions to an imperfect storm) and minimizing the consequences of CKD/BMD are discussed.
journal_name
Semin Nephroljournal_title
Seminars in nephrologyauthors
Williams MEdoi
10.1016/j.semnephrol.2009.01.002subject
Has Abstractpub_date
2009-03-01 00:00:00pages
97-104issue
2eissn
0270-9295issn
1558-4488pii
S0270-9295(09)00003-5journal_volume
29pub_type
杂志文章,评审abstract::Stephen Hales was the first to measure blood pressure directly in the horse (1733), and the definitive studies on human nephrins by Richard Bright followed much later (1836). The relation between high blood pressure and renal disease was established by Mahomed (1872). The discovery of renin and its possible link with ...
journal_title:Seminars in nephrology
pub_type: 历史文章,杂志文章
doi:
更新日期:2000-09-01 00:00:00
abstract::Recent new insights into the determinants of the plasma water sodium concentration ([Na(+)](pw)) have played an important role in advancing our understanding of the pathogenesis and treatment of the dysnatremias. Central to these recent advances is the recognition of the full significance of the Edelman equation disco...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2009.03.006
更新日期:2009-05-01 00:00:00
abstract::Autophagy is a ubiquitous intracellular catabolic process that contributes to homeostatic maintenance and regulates the balance between health and disease. Emerging evidence from both the immunology and renal literature suggests that important relationships exist between the immune system and renal autophagy that may ...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2013.11.008
更新日期:2014-01-01 00:00:00
abstract::Studies performed over the last 10 years have evaluated the role of nitric oxide (NO) in the control of renal hemodynamics. This article reviews the effects of administration of nitric oxide synthase (NOS) blockers on renal function in experimental animals and human volunteers. These studies show that NOS blockade inc...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:
更新日期:1999-05-01 00:00:00
abstract::From the beginning of the first described hemodialysis in 1889, history has shown an exponential evolvement of systems that have resulted in greater safety, efficiency, and broader utilization. It took 60 years, 1947, for the technology to be used in a clinical setting in North America, treating acute renal failure. C...
journal_title:Seminars in nephrology
pub_type: 历史文章,杂志文章
doi:
更新日期:1997-05-01 00:00:00
abstract::Kidney function declines with age in association with the development of age-associated glomerulosclerosis. The well-established structural and functional changes with age are reviewed briefly. The modification of aging pathology by calorie restriction is discussed. The role of the podocyte as a critical cell in the a...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2009.07.012
更新日期:2009-11-01 00:00:00
abstract::The association between increased uric acid (UA) levels and cardiovascular disease (CVD) has been observed and studied for many decades. The value of UA as an independent factor within the metabolic risk profile for prediction of CVD in the normal population remains an issue of ongoing discussion. In turn, increasing ...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2011.08.007
更新日期:2011-09-01 00:00:00
abstract::The antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by a combination of arterial and/or venous thrombosis, pregnancy morbidity, and the persistent presence of circulating antiphospholipid antibodies (aPL). APS has been described as primary APS when it occurs in the absence of any featur...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2015.08.009
更新日期:2015-09-01 00:00:00
abstract::This prospective multicenter study included 1,205 patients, who were referred for difficult-to-treat hypertension or analysis of possible secondary hypertension. After a standardized selection protocol based on sharply defined drug-resistant hypertension or renal function impairment during angiotensin-converting enzym...
journal_title:Seminars in nephrology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:
更新日期:2000-09-01 00:00:00
abstract::Premature menopause defined as secondary amenorrhea is common in women with kidney disease. Moreover, the aging population has resulted in increasing numbers of postmenopausal women with kidney disease. Though the pathophysiology is poorly understood, kidney transplantation and more frequent hemodialysis can restore m...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2017.05.013
更新日期:2017-07-01 00:00:00
abstract::A number of antineoplastic chemotherapeutic drugs may produce fluid and electrolyte disturbances or nephrotoxic reactions extending across the clinical spectrum, from subclinical renal dysfunction to progressive chronic renal insufficiency to severe acute failure. Although some of the drugs that are highly nephrotoxic...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:
更新日期:1997-01-01 00:00:00
abstract::Amiloride is a prototypic inhibitor of epithelial sodium channels. Rapid progress has been made in our understanding of the structure of the sodium channel and related cation-selective channels. This work, coupled with experiments examining how selected sodium channel mutations affect amiloride binding, provides criti...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:
更新日期:1999-11-01 00:00:00
abstract::Advances in information technology have changed human interactions. These changes have had considerable implications for nonmedical and medical educational practices. The use of semi-private applications such as WhatsApp (Mountain View, CA), Slack (Canada), Viber (Israel), and Google Hangouts (Mountain View, CA) has n...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2020.04.010
更新日期:2020-05-01 00:00:00
abstract::Cigarette smoking (CS) has been associated with augmented progression of nephropathies responsible for the 4 major causes of end-stage renal disease (ESRD) in the United States. CS has well-described ways by which it causes tissue injury in other organ systems and the mechanisms by which it adversely affects nephropat...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/s0270-9295(03)00037-8
更新日期:2003-05-01 00:00:00
abstract::Angiotensin II maintains extracellular volume homeostasis, in part, by regulating proximal tubule transport. Physiological doses of angiotensin II stimulate volume and solute transport in the proximal tubule independent of changes in the glomerular filtration rate. Stimulation of bicarbonate transport primarily occurs...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:
更新日期:1997-09-01 00:00:00
abstract::Recombinant human erythropoietin (rHuEPO) has revolutionized the treatment of anemia of chronic renal failure. RHuEPO has been shown to increase survival, decrease hospitalizations, improve brain and cognitive function, and improve quality of life for renal patients. Much has been learned about the normal and patholog...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1053/snep.2001.20939
更新日期:2001-03-01 00:00:00
abstract::In chronic kidney disease the excessive production of parathyroid hormone increases the bone resorption rate and leads to histologic bone signs of secondary hyperparathyroidism. However, in other situations, the initial increase in parathyroid hormone and bone remodeling may be slowed down excessively by a multitude o...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2014.09.004
更新日期:2014-11-01 00:00:00
abstract::Goodpasture (GP) syndrome is a form of anti-glomerular basement membrane (GBM) disease, in which autoantibodies bind to alpha3(IV) collagen in GBM causing rapidly progressive glomerulonephritis and pulmonary hemorrhage. The conformational GP epitopes have been mapped to 2 regions within the noncollagenous (NC1) domain...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1053/s0270-9295(03)00131-1
更新日期:2003-11-01 00:00:00
abstract::Cyclooxygenase inhibitors have long been used in experimental studies as well as in clinical practice to reduce urinary protein excretion in proteinuric renal diseases. However, the mechanisms by which this treatment limits glomerular filtration of proteins are not fully elucidated. We will review the cellular and mol...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:
更新日期:1995-05-01 00:00:00
abstract::Mechanisms regulating the establishment of the glomerular endothelium and mesangium during glomerulogenesis are not understood. In this article, we discuss two different blood vessel growth processes: vasculogenesis and angiogenesis, with particular attention on how these processes might operate in the developing kidn...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:
更新日期:1995-07-01 00:00:00
abstract::The mortality of end-stage renal disease (ESRD) patients, including those receiving long-term peritoneal dialysis (PD), has remained unacceptably high owing to the prevalence of cardiovascular disease. It is well recognized that both traditional Framingham risk factors and kidney disease-related risk factors may contr...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2011.01.005
更新日期:2011-03-01 00:00:00
abstract::Diabetes mellitus (DM) is becoming more common in the United States affecting an estimated 18.2 million Americans. Not only is the number of American's with DM staggering, but so are the medical and economic costs of DM. DM accounts for nearly 15% of all health care costs in the United States. The chronic hyperglycemi...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2005.09.009
更新日期:2006-03-01 00:00:00
abstract::Patients with cirrhosis have significant abnormalities in their fluid and electrolyte balance, this is manifested mainly by the development of ascites and edema. Ascites is the most common complication of patients with cirrhosis and its development constitutes the first and most important manifestation of the disease....
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1053/snep.2001.21666
更新日期:2001-05-01 00:00:00
abstract::Human immunodeficiency virus (HIV)-associated nephropathy (HIVAN), the single most common cause of end-stage renal failure in seropositive patients, has increased in incidence by 30% each year since 1991. Occurring almost exclusively in blacks, HIVAN became the third leading cause of ESRD in blacks, ages 20 to 64, in ...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:
更新日期:1998-07-01 00:00:00
abstract::Care of patients with type 1 diabetes (T1D) has changed during the past 30 years. Tools to control hyperglycemia have improved and it was shown that improvement in glycemic control diminished the risk of late diabetic complications, including nephropathy. Moreover, in patients with impaired renal function, aggressive ...
journal_title:Seminars in nephrology
pub_type: 杂志文章
doi:10.1016/j.semnephrol.2012.07.002
更新日期:2012-09-01 00:00:00
abstract::Chronic kidney disease mineral and bone disorder (MBD) encompasses changes in mineral ion and vitamin D metabolism that are widespread in the setting of chronic kidney disease and end-stage renal disease. MBD components associate with cardiovascular disease in many epidemiologic studies. Through impacts on hypertensio...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2018.08.001
更新日期:2018-11-01 00:00:00
abstract::Blood pressure increases with age in all US population groups that have been studies, but does so faster in African Americans. Evidence from extensive microscopic renal vascular studies at autopsy supports the view that blood pressure increases with age because of progressive fibroplasia of renal interlobular arteries...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:
更新日期:1996-03-01 00:00:00
abstract::The kidney plays a critical role in regulating water homeostasis through specific proteins highly expressed in the kidney, called aquaporins, allowing water permeation at a high rate. This brief review focuses on some nephropathies associated with impaired urinary concentrating ability and in particular analyzes the r...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2008.03.007
更新日期:2008-05-01 00:00:00
abstract::IgA nephropathy is one of the most common causes of glomerulonephritis in the world and is characterized histologically by the deposition of polymeric forms of IgA within the mesangium and in some cases along the glomerular capillary wall.(1) Proliferative and crescenteric forms of IgA are associated with nephrotic ra...
journal_title:Seminars in nephrology
pub_type: 杂志文章
doi:10.1016/j.semnephrol.2004.01.006
更新日期:2004-05-01 00:00:00
abstract::Cerebrovascular disease and stroke are very common at all stages of chronic kidney disease (CKD), likely representing both shared risk factors as well as synergy among risk factors. More subtle ischemic brain lesions may be particularly common in the CKD population, with subtle manifestations including cognitive impai...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2015.06.003
更新日期:2015-07-01 00:00:00