Abstract：
:Chronic kidney disease-mineral and bone disorder (CKD-MBD) is characterized by bone abnormalities, vascular calcification, and an array of laboratory abnormalities. The latter classically include disturbances in the parathyroid hormone/vitamin D axis. More recently, fibroblast growth factor 23 (FGF23) and klotho also have been identified as important regulators of mineral metabolism. Klotho deficiency and high circulating FGF23 levels precede secondary hyperparathyroidism in CKD patients. Levels of FGF23 and parathyroid hormone increase along the progression of CKD to maintain mineral homeostasis and to overcome end-organ resistance. It is hard to define when the increase of both hormones becomes maladaptive. CKD-MBD is associated with adverse outcomes including cardiovascular disease and mortality. This review summarizes the complex pathophysiology of CKD-MBD and outlines which laboratory abnormalities represent biomarkers of disease severity, which laboratory abnormalities are predictors of cardiovascular disease, and which laboratory abnormalities should be considered (direct) uremic toxins exerting organ damage. This information may help to streamline current and future therapeutic efforts.
journal_name
Semin Nephroljournal_title
Seminars in nephrologyauthors
Evenepoel P,Rodriguez M,Ketteler Mdoi
10.1016/j.semnephrol.2014.02.007subject
Has Abstractpub_date
2014-03-01 00:00:00pages
151-63issue
2eissn
0270-9295issn
1558-4488pii
S0270-9295(14)00031-Xjournal_volume
34pub_type
杂志文章,评审abstract：:Prolonged hyperuricemia is associated with the development of hypertension, renal arteriolosclerosis, glomerulosclerosis, and tubulointerstitial injury. It confers a greater risk than proteinuria for developing chronic renal disease and is associated with the development of hypertension. Mild chronic hyperuricemia wit...
journal_title：Seminars in nephrology
pub_type： 杂志文章,评审
doi：10.1016/j.semnephrol.2004.09.004
更新日期：2005-01-01 00:00:00
abstract：:The importance of hypertension as a cardiovascular risk factor increases progressively with aging, but diastolic blood pressure plateaus at age 50, which leads to a rise in pulse pressure in the elderly. Thus, isolated systolic hypertension with a widened pulse pressure is the most common type of hypertension seen in ...
journal_title：Seminars in nephrology
pub_type： 杂志文章
doi：
更新日期：2002-01-01 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：:Exposure is a critically important aspect to consider in the study and management of drug-induced kidney injury. Although blood concentrations of kidney toxicants often may provide a valid surrogate measure of kidney exposure, the kidney has several unique physiological and biochemical properties that lend themselves ...
journal_title：Seminars in nephrology
pub_type： 杂志文章,评审
doi：10.1016/j.semnephrol.2018.12.006
更新日期：2019-03-01 00:00:00
abstract：:The catecholamines dopamine and norepinephrine, play a central role in the regulation of sodium homeostasis and blood pressure. Dopamine inhibits tubular Na+, K(+)-ATPase activity and increases sodium excretion. Norepinephrine stimulates Na+, K(+)-ATPase activity and decreases urinary sodium excretion. The signaling p...
journal_title：Seminars in nephrology
pub_type： 杂志文章,评审
doi：
更新日期：1993-01-01 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：:Acid-base balance is critical for normal life. Acute and chronic disturbances impact cellular energy metabolism, endocrine signaling, ion channel activity, neuronal activity, and cardiovascular functions such as cardiac contractility and vascular blood flow. Maintenance and adaptation of acid-base homeostasis are most...
journal_title：Seminars in nephrology
pub_type： 杂志文章,评审
doi：10.1016/j.semnephrol.2019.04.004
更新日期：2019-07-01 00:00:00
abstract：:Antineutrophil cytoplasmic autoantibodies (ANCA) are the likely cause for necrotizing small-vessel vasculitis and crescentic glomerulonephritis. Unlike other forms of crescentic glomerulonephritis induced by immune complexes or anti-glomerular basement membrane antibodies that have conspicuous vessel wall immunoglobul...
journal_title：Seminars in nephrology
pub_type： 杂志文章,评审
doi：10.1016/j.semnephrol.2013.08.006
更新日期：2013-11-01 00:00:00
abstract：:A major challenge facing the nephrology community in the United States is the training of adequate numbers of nephrologists to meet patient care and research needs. There is particular cause for concern because of the increasing incidence and prevalence of patients with chronic kidney disease. Data on the clinical and...
journal_title：Seminars in nephrology
pub_type： 杂志文章,评审
doi：10.1016/j.semnephrol.2009.06.011
更新日期：2009-09-01 00:00:00
abstract：:Our understanding of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis has developed greatly since the discovery of ANCA, directed against neutrophil components, in 1982. Observations in human disease, and increasingly sophisticated studies in vitro and in rodent models in vivo, have allowed a nuanced u...
journal_title：Seminars in nephrology
pub_type： 杂志文章,评审
doi：10.1016/j.semnephrol.2017.05.016
更新日期：2017-09-01 00:00:00
abstract：:The apical membrane epithelial Na(+) channel subunit (ENaC) in series with the basolateral Na(+)/K(+)-adenosine triphosphatase mediates collecting duct Na(+) reabsorption. Aldosterone induces αENaC gene transcription, which appears to be rate limiting for ENaC activity in this segment. Although this response has long ...
journal_title：Seminars in nephrology
pub_type： 杂志文章,评审
doi：10.1016/j.semnephrol.2013.05.010
更新日期：2013-07-01 00:00:00
abstract：:Cell-based therapy, designed to promote angiogenesis and improve organ function, has been under investigation for the treatment of ischemic heart disease for more than 10 years. Although believed to work primarily by repairing the microvasculature, this form of therapy has not been examined in the setting of chronic k...
journal_title：Seminars in nephrology
pub_type： 杂志文章
doi：10.1016/j.semnephrol.2012.07.012
更新日期：2012-09-01 00:00:00
abstract：:The vacuolar H(+)-ATPase is a multisubunit protein consisting of a peripheral catalytic domain (V(1)) that binds and hydrolyzes adenosine triphosphate (ATP) and provides energy to pump H(+) through the transmembrane domain (V(0)) against a large gradient. This proton-translocating vacuolar H(+)-ATPase is present in bo...
journal_title：Seminars in nephrology
pub_type： 杂志文章,评审
doi：10.1016/j.semnephrol.2006.07.004
更新日期：2006-09-01 00:00:00
abstract：:This review emphasizes four major areas of pediatric hypertension. Because hypertension is the most common reason student athletes fail the sports pre-participation examinations, we have attempted to provide a rationale approach to the decision process to permit a hypertensive child to partake in leisure and competiti...
journal_title：Seminars in nephrology
pub_type： 杂志文章,评审
doi：
更新日期：1998-05-01 00:00:00
abstract：:The progressive decline of glomerular filtration rate in chronic kidney disease patients is associated with a significant reduction in food intake. Approximately one third of chronic dialysis patients complain of a fair or poor appetite and this is related directly to poor patient outcomes. Appetite regulation involve...
journal_title：Seminars in nephrology
pub_type： 杂志文章
doi：10.1016/j.semnephrol.2008.10.003
更新日期：2009-01-01 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：:Membranous nephropathy remains the most common cause of the nephrotic syndrome in adults. Most patients do well with long-term natural history studies reporting a 10-year renal survival of 70% to 90% but the remainder progress to end stage renal failure. This plus the associated morbidity of those with persistent high...
journal_title：Seminars in nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2000-05-01 00:00:00
abstract：:An important component of nephrology research is the discovery of novel proteins that control cellular and molecular events that contribute to normal kidney cell biology and disease. Identifying perturbation of normal cellular protein expression and interactions within signaling networks is critical for understanding ...
journal_title：Seminars in nephrology
pub_type： 杂志文章,评审
doi：10.1016/j.semnephrol.2007.09.008
更新日期：2007-11-01 00:00:00
abstract：:The very limited ability of adult podocytes to proliferate in vivo is clinically significant because podocytes form a vascular barrier that is functionally critical to the nephron, podocyte hypoplasia is a characteristic of disease, and inadequate regeneration of podocytes is a major cause of persistent podocyte hypop...
journal_title：Seminars in nephrology
pub_type： 杂志文章,评审
doi：10.1016/j.semnephrol.2014.06.008
更新日期：2014-07-01 00:00:00
abstract：:Nephrogenic systemic fibrosis is a new disease whose incidence has peaked and receded over the past decade. It occurs in the presence of significant renal impairment, either acute or chronic (MDRD creatinine clearance of <30 mL/min/1.73 m(2)), and is associated with the administration of gadolinium-based contrast (GBC...
journal_title：Seminars in nephrology
pub_type： 杂志文章,评审
doi：10.1016/j.semnephrol.2011.05.010
更新日期：2011-05-01 00:00:00
abstract：:Peritoneal dialysis (PD) may be a feasible, safe, and complementary alternative to hemodialysis not only in the chronic setting, but also in the acute setting. It previously was widely accepted for acute kidney injury (AKI) treatment, but its practice decreased in favor of other types of extracorporeal therapies. The ...
journal_title：Seminars in nephrology
pub_type： 杂志文章,评审
doi：10.1016/j.semnephrol.2016.10.011
更新日期：2017-01-01 00:00:00
abstract：:Traditionally, renal ischemia has been regarded as central to the pathogenesis of sepsis-associated acute kidney injury (SA-AKI). Accordingly, hemodynamic management of SA-AKI has emphasized restoration of renal perfusion, whereas, experimentally, ischemia reperfusion models have been emphasized. However, in human bei...
journal_title：Seminars in nephrology
pub_type： 杂志文章,评审
doi：10.1016/j.semnephrol.2015.01.007
更新日期：2015-01-01 00:00:00
abstract：:Acute kidney injury (AKI) represents a common and devastating problem in clinical medicine. A major reason is the lack of early biomarkers for AKI, and hence an unacceptable delay in initiating therapy. Fortunately, the application of innovative technologies has uncovered several novel biomarkers. The most promising o...
journal_title：Seminars in nephrology
pub_type： 杂志文章,评审
doi：10.1016/j.semnephrol.2008.05.010
更新日期：2008-09-01 00:00:00
abstract：:One of the most important and lethal effects of animal venoms is nephrotoxicity. In Latin America, severe acute kidney injury has been reported after accidents with poisonous arthropods such as bees, caterpillars of the genus Lonomia, and spiders of the genus Loxosceles. In this article the characteristics of these ve...
journal_title：Seminars in nephrology
pub_type： 杂志文章,评审
doi：10.1016/j.semnephrol.2008.04.006
更新日期：2008-07-01 00:00:00
abstract：:In aggregate, the evidence reviewed here supports a very important role for PDGF expression and action at local glomerular and interstitial sites in human kidney development and disease. PDGF delivered by platelets, or produced by endogenous cells of the kidney is capable of stimulating responses including proliferati...
journal_title：Seminars in nephrology
pub_type： 杂志文章,评审
doi：
更新日期：1993-01-01 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：:Although calcitriol has been shown to have an important role in the pathogenesis of hyperparathyroidism, its use as a therapeutic agent often has been limited by calcemic and phosphatemic toxicity. Vitamin D analogs and the synthetic prohormones, with the potential to have lesser effects on calcium and phosphorus, hav...
journal_title：Seminars in nephrology
pub_type： 杂志文章
doi：10.1016/j.semnephrol.2004.06.013
更新日期：2004-09-01 00:00:00
abstract：:In humans, idiopathic hypercalciuria is associated with stone formation. To study the mechanisms that are responsible for the excess urine calcium excretion in ways that are difficult to impossible in humans, we have developed a rat model of idiopathic hypercalciuria. Hypercalciuric rats were successively inbred for m...
journal_title：Seminars in nephrology
pub_type： 杂志文章,评审
doi：
更新日期：1996-09-01 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：:Recent breakthroughs in genomics have led to a critical reappraisal of factors once thought to initiate common complex forms of kidney disease. The tenet that diabetes mellitus and hypertension routinely initiate kidney disease whenever blood glucose concentrations or systemic blood pressures reach critical levels for...
journal_title：Seminars in nephrology
pub_type： 杂志文章
doi：10.1016/j.semnephrol.2010.01.002
更新日期：2010-03-01 00:00:00
