Abstract:
BACKGROUND:This multicenter, open-label, dose-titration study assessed the safety and efficacy of RenaGel(R), a nonabsorbed calcium- and aluminum-free phosphate binder, in lowering serum phosphorus. Secondary outcomes were its effects on serum intact parathyroid hormone (iPTH) and serum lipids. METHODS:Phosphate binders were discontinued during a two-week washout period. Patients whose serum phosphorus was more than 6.0 mg/dl during washout were eligible for treatment. RenaGel(R), at starting doses of two, three, or four 440 mg capsules three times per day with meals, was administered to 172 hemodialysis patients for eight weeks. RenaGel(R) could be increased by one capsule per meal every two weeks as necessary to achieve serum phosphorus control. A second two-week washout period followed. RESULTS:Mean serum phosphorus rose from 6.8 +/- 2.0 mg/dl at prewashout to 9.1 +/- 2.4 mg/dl at the end of the washout period. It then declined to 6.6 +/- 1.9 mg/dl by the end of the eight-week RenaGel(R) treatment period (P < 0. 0001). Serum phosphorus increased to 8.0 +/- 2.2 mg/dl at the end of the second washout period. The mean dose at the end of RenaGel(R) treatment was 5.4 g per day. Eighty-four percent of the patients previously used calcium-based phosphate binders. As expected, calcium declined during the initial washout period when calcium-based phosphate binders were discontinued. Mean serum calcium declined from 9.6 +/- 1.0 mg/dl at prewashout to 9.1 +/- 0.8 mg/dl after washout. It then increased to 9.4 +/- 0.9 mg/dl by the end of RenaGel(R) treatment. Median serum iPTH increased during the two-week washout from 208 pg/ml to 316 pg/ml and then declined to 224 pg/ml at the end of the eight-week treatment period (P < 0.0001 vs. end of initial washout). After eight weeks of treatment, RenaGel(R) reduced mean serum total cholesterol from 171.0 +/- 43.1 mg/dl to 145.0 +/- 38.7 mg/dl (P < 0.0001) and mean serum low-density lipoprotein cholesterol from 102.0 +/- 34.9 mg/dl to 75. 6 +/- 29.4 mg/dl (P < 0.0001). High-density lipoprotein cholesterol, triglycerides, and serum albumin did not change. CONCLUSIONS:RenaGel(R), a novel and calcium- plus aluminum-free effective phosphate binder, can control serum phosphorus and reduce the levels of PTH and cholesterol without inducing hypercalcemia or other side effects. Thus, this new phosphate binder may be effective in the treatment of renal osteodystrophy in uremic patients.
journal_name
Kidney Intjournal_title
Kidney internationalauthors
Slatopolsky EA,Burke SK,Dillon MAdoi
10.1046/j.1523-1755.1999.00240.xsubject
Has Abstractpub_date
1999-01-01 00:00:00pages
299-307issue
1eissn
0085-2538issn
1523-1755pii
S0085-2538(15)30986-8journal_volume
55pub_type
临床试验,杂志文章,多中心研究abstract:BACKGROUND:Microarray technology is a powerful tool that can probe the molecular pathogenesis of renal injury. In this present study microarray analysis was used to monitor serial changes in the renal transcriptome of a rat model of mesangial proliferative glomerulonephritis. Administration of anti-Thy1 antibody result...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1111/j.1523-1755.2005.00661.x
更新日期:2005-12-01 00:00:00
abstract::In landmark clinical trials, pharmacological inhibition of the renin-angiotensin system (RAS) with angiotensin-converting enzyme inhibitors (ACEIs) attenuated the decline in renal function associated with chronic renal disease (CRD). Hemodynamic and nonhemodynamic effects of angiotensin II (Ang II) attest to its centr...
journal_title:Kidney international
pub_type: 杂志文章,评审
doi:10.1046/j.1523-1755.2000.00031.x
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND:Cardiovascular disease is the most frequent cause of mortality in chronic renal failure (CRF). Therefore, it is important to identify appropriate treatment measures. The antioxidant N-acetylcysteine (NAC) has been shown to reduce cardiovascular events in hemodialysis patients. Here we examine a possible dire...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1111/j.1523-1755.2005.00332.x
更新日期:2005-06-01 00:00:00
abstract::The incidence of malnutrition disorders in chronic kidney disease (CKD) appears unchanged over time, whereas patient-care and dialysis techniques continue to progress. Despite some evidence for cost-effective treatments, there are numerous caveats to applying these research findings on a daily care basis. There is a s...
journal_title:Kidney international
pub_type: 杂志文章,评审
doi:10.1038/ki.2011.118
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Tumor necrosis factor (TNF) receptor family members, such as Fas and TNF receptor 1 (TNFR1), are thought to induce apoptosis in a variety of cells and organs. Although a number of potential scenarios have been postulated for the involvement of these receptors in the pathogenesis of acute renal failure (ARF),...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.2003.00709.x
更新日期:2003-01-01 00:00:00
abstract::Hemodialysis adequacy can be quantified using ultraviolet absorbance of the spent dialysate, or by analysis of dialysate conductivity at the dialyzer inlet and outlet in response to changes in dialysate electrolyte concentration. These measurements can be made at every dialysis, including initial and acute treatments ...
journal_title:Kidney international
pub_type: 评论,杂志文章
doi:10.1038/ki.2010.218
更新日期:2010-11-01 00:00:00
abstract::Direct-acting antivirals have revolutionized the treatment of hepatitis C virus (HCV) infection in patients with chronic kidney disease, with implications for the timing of antiviral treatment among kidney transplant candidates and for the use of HCV viremic donors. A recent consensus conference reviewed the available...
journal_title:Kidney international
pub_type: 评论,杂志文章
doi:10.1016/j.kint.2017.09.002
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Glucose degradation products (GDPs) are cytotoxic in vitro and potentially toxic in vivo during peritoneal dialysis (PD). We are presenting the results of a two-year randomized clinical trial of a new PD fluid, produced in a two-compartment bag and designed to minimize heat-induced glucose degradation while ...
journal_title:Kidney international
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1523-1755.2001.00497.x
更新日期:2001-01-01 00:00:00
abstract::Management of idiopathic glomerular disease associated with nephrotic syndrome (INS) remains controversial and one of the most complex areas relates to utilization of the drug cyclosporin. This is despite its demonstrated effectiveness in several histologic types of the INS in randomized controlled trials. Cyclosporin...
journal_title:Kidney international
pub_type: 共识发展会议,杂志文章
doi:10.1038/sj.ki.5002553
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:Non-(1-84) parathyroid hormone (PTH) fragments are large circulating carboxyl-terminal (C) fragments with a partially preserved amino-terminal (N) structure. hPTH (7-84), a synthetic surrogate, has been demonstrated to exert biologic effects in vivo and in vitro which are opposite to those of hPTH (1-34) on ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1111/j.1523-1755.2005.00493.x
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Arteriovenous (AV) fistulas used for hemodialysis access may affect cardiac load by increasing the preload while decreasing the afterload. In dogs, AV fistulas have also been shown to affect coronary perfusion negatively. We investigated the net effect of AV fistulas on cardiac oxygen supply and demand. MET...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.1999.00433.x
更新日期:1999-05-01 00:00:00
abstract::Colony stimulating factor-1 (CSF-1) is a chemoattractant and growth factor for macrophages. In autoimmune MRL-lpr mice, CSF-1 is detected in the circulation and there is an increase in CSF-1 transcripts and macrophages in the kidney. The purpose of this study was to establish whether the MRL-lpr kidney is responsible ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1996.9
更新日期:1996-01-01 00:00:00
abstract::Chronic inflammation is a complication of conventional hemodialysis that induces progressive cardiovascular damage. An apparently straightforward manipulation to treat this-removal of a large amount of uremic toxins by convection-has proven that the relationships between inflammation and convective techniques such as ...
journal_title:Kidney international
pub_type: 评论,杂志文章
doi:10.1038/ki.2014.81
更新日期:2014-08-01 00:00:00
abstract::In organ donation, the donor, recipient, and transplant team must all accept potential health risks to the donor and any uncertainties. To gauge these risks, we surveyed general altruism and risk-taking behaviors in 112 potential donors, 111 potential recipients, and 51 transplant professionals. Next, participants ind...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.2008.65
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:Knowledge of the long-term renal prognosis of diarrhea associated hemolytic uremic syndrome (HUS) is important for patient counseling and follow-up. However, estimates of long-term risk are highly variable, with previous studies not using a healthy control group. METHODS:A municipal water system in the smal...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1111/j.1523-1755.2005.00225.x
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:Tumor necrosis factor (TNF)-alpha rapidly primes neutrophils (PMN) for an anti-neutrophil cytoplasmic antibody (ANCA)-induced respiratory burst and is thus proinflammatory. TNF-alpha also progressively accelerates apoptosis. We investigated the effect of TNF-alpha-mediated apoptosis on ANCA antigen expressio...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.2002.00161.x
更新日期:2002-02-01 00:00:00
abstract::The early identification of renal transplant recipients at enhanced risk of developing acute and subclinical rejection would allow individualized adjustment of immunosuppression before functional graft injury occurs and would exclude these patients from drug-weaning studies. Protein and reverse transcriptase-polymeras...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/sj.ki.5000343
更新日期:2006-05-01 00:00:00
abstract::Renal iron handling was characterized in three experimental models of the nephrotic syndrome: puromycin aminonucleoside, adriamycin and nephrotoxic serum. In adriamycin-induced nephrotic syndrome, which has previously been shown to result from alterations in pore size of the filtration barrier, the transferrin leak wa...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1990.130
更新日期:1990-06-01 00:00:00
abstract::Serum calcitriol and the free calcitriol index together with factors considered to regulate calcitriol production were measured in eleven patients with moderate chronic renal failure (MCRF) and eleven age- and sex-matched normal subjects. Although the serum dialysable calcium levels were similar in the two groups, the...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1988.58
更新日期:1988-03-01 00:00:00
abstract:BACKGROUND:Lipoprotein glomerulopathy (LPG) is characterized by intraglomerular lipoprotein thrombosis and high plasma concentrations of apolipoprotein (apo) E. An apo E variant, apo E2 (Arg145Pro) Sendai, was recently identified in three patients with LPG. We detected a novel point mutation in the apo E gene in a pati...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.1999.00572.x
更新日期:1999-08-01 00:00:00
abstract::X-ray crystal interferometer-based X-ray phase-contrast microtomography (phase-contrast microtomography) is able to image microstructures within soft tissue without the use of a contrast agent. Here we determined the feasibility of using this technique in the non-destructive inspection of formalin-fixed kidney tissue ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.2009.42
更新日期:2009-05-01 00:00:00
abstract::Melamine, a widely used chemical found in many products in daily use, became a public health concern due to melamine-associated urinary stone formation in children. In adults, it is still unknown whether low-dose melamine exposure may also cause urolithiasis. To address this question, we studied 211 Taiwanese patients...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.2011.154
更新日期:2011-10-01 00:00:00
abstract::Prevention of nephrolithiasis (NL) is now medically feasible and widely recommended. However, diagnosis and treatment of remediable causes of stones requires testing and drugs that impose a cost; this cost is balanced by the presumed reductions in stone related events and medical encounters. In order to assess the bal...
journal_title:Kidney international
pub_type: 临床试验,杂志文章
doi:10.1038/ki.1996.489
更新日期:1996-11-01 00:00:00
abstract::In adult male Wistar rats we investigated whether cell proliferation contributes to salt load-induced hypertrophy of distal tubules. In one treatment group salt transport in the thick ascending limb (TAL) was inhibited by furosemide (7.5 mg/100 g body wt/24 hr, via osmotic minipump) and stimulated in the successive di...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1995.225
更新日期:1995-06-01 00:00:00
abstract::The acute renal effects of hypoxemia and the ability of theophylline to prevent these effects were assessed in anesthetized and mechanically-ventilated newborn and adult rabbits. Renal blood flow (RBF) and glomerular filtration rate (GFR) were determined by the clearance of para-aminohippuric acid and inulin, respecti...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1988.114
更新日期:1988-06-01 00:00:00
abstract::Approximately 500 monogenic causes of chronic kidney disease (CKD) have been identified, mainly in pediatric populations. The frequency of monogenic causes among adults with CKD has been less extensively studied. To determine the likelihood of detecting monogenic causes of CKD in adults presenting to nephrology servic...
journal_title:Kidney international
pub_type: 杂志文章,多中心研究
doi:10.1016/j.kint.2018.10.031
更新日期:2019-04-01 00:00:00
abstract::Transcriptome analysis of a rat polycystic kidney disease (PKD) model: importance of genes involved in extracellular matrix metabolism. PKD is a common genetic cause of chronic renal failure, and is characterized by the accumulation of fluid-filled cysts in the kidneys and other organs. Abnormalities in the expression...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/sj.ki.5000309
更新日期:2006-05-01 00:00:00
abstract::Serum fibroblast growth factor 23 (FGF23) is a novel phosphaturic factor and important for the regulation of inorganic phosphate (Pi) homeostasis. In this study, we examined an acute effect of oral Pi loading on serum FGF23 levels to clarify the role in rapid adjustment of serum Pi level. We performed a randomized, do...
journal_title:Kidney international
pub_type: 杂志文章,随机对照试验
doi:10.1038/sj.ki.5002000
更新日期:2006-12-01 00:00:00
abstract::In this issue, McMahon et al. report that, by combining phenotypic, metabolomic, and genetic data, they could better detect chronic kidney disease at the early stages and provide insight into its pathobiology. The most significant findings of the study are that several urinary metabolites (e.g., glycine and histidine)...
journal_title:Kidney international
pub_type: 评论,杂志文章
doi:10.1016/j.kint.2017.03.022
更新日期:2017-06-01 00:00:00
abstract::It is unknown whether mild chronic kidney disease (CKD) is associated with adverse cardiovascular (CV) prognosis after accounting for coronary artery disease (CAD). Here we evaluated the interplay between CKD and CAD in predicting CV death or myocardial infarction (MI) and all-cause death. We included 1541 consecutive...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.2014.426
更新日期:2015-07-01 00:00:00