Abstract：
OBJECTIVE:It is uncertain whether increasing 25-hydroxyvitamin D (25-D) levels in chronic kidney disease (CKD) patients above those recommended by current guidelines result in progressive amelioration of secondary hyperparathyroidism. Our objective was to identify a potential therapeutic 25-D target which optimally lowers plasma parathyroid hormone (PTH) without producing excessive hypercalcemia or hyperphosphatemia in CKD. METHODS:We performed a cross-sectional analysis of 14,289 unselected stage 1-5 CKD patients from US primary care and nephrology practices utilizing a laboratory-based CKD clinical decision support service between September 2008 and May 2012. Estimated glomerular filtration rate (eGFR), plasma PTH, and serum 25-D, calcium, and phosphorus results were analyzed. RESULTS:In CKD stages 3-5, progressively higher 25-D pentiles contained progressively lower mean PTH levels. Regression analysis of log PTH on 25-D was significant in all CKD stages with no evidence of a decreasing effect of 25-D to lower PTH until 25-D levels of 42-48 ng/ml. Progressively higher 25-D concentrations were not associated with increased rates of hypercalcemia or hyperphosphatemia. CONCLUSIONS:We found evidence for an optimal level of 25-D above which suppression of PTH progressively diminishes. This level is more than twice that currently recommended for the general population. We found no association between these higher 25-D levels and hyperphosphatemia or hypercalcemia. Additional prospective trials seem appropriate to test the idea that 25-D levels around 40-50 ng/ml could be a safe and effective treatment target for secondary hyperparathyroidism in CKD.
journal_name
J Nephroljournal_title
Journal of nephrologyauthors
Ennis JL,Worcester EM,Coe FL,Sprague SMdoi
10.1007/s40620-015-0186-0subject
Has Abstractpub_date
2016-02-01 00:00:00pages
63-70issue
1eissn
1121-8428issn
1724-6059pii
10.1007/s40620-015-0186-0journal_volume
29pub_type
杂志文章,多中心研究abstract：:Preeclampsia (PE) is a protean syndrome causing a transitory kidney disease, characterised by hypertension and proteinuria, ultimately reversible after delivery. Its prevalence is variously estimated, from 3 to 5% to 10% if all the related disorders, including also pregnancy-induced hypertension (PIH) and HELLP syndro...
journal_title：Journal of nephrology
pub_type： 杂志文章,实务指引,评审
doi：10.1007/s40620-017-0390-1
更新日期：2017-06-01 00:00:00
abstract：BACKGROUND:Since dialysis has brought long-term survival to uremic patients, we can now speculate on more subtle problems derived from imbalance or sub-optimal regulation of some elements such as trace metals. We focused on the rubidium (Rb) status in dialysis patients (HD), as concerns about its possible deficiency ha...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2001-05-01 00:00:00
abstract：BACKGROUND:Lactic acidosis is a widely recognized, though rare, side effect of metformin. This paper describes five patients admitted to Chang Gung Memorial Hospital from 1 September 1998 to 31 May 2001 suffering severe lactic acidosis caused by metformin, and reviews the literature. PATIENTS:Five cases diagnosed as h...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2002-07-01 00:00:00
abstract：BACKGROUND:Previous studies have shown that bleeding times have positive predictive values of only 5% for perioperative bleeding in unselected populations. Nevertheless, performing bleeding times prior to all renal biopsies is common in nephrology practice. METHODS:We report complications of 112 renal biopsies done at...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2001-07-01 00:00:00
abstract：:There is little doubt that molecular biological intervention therapy has come of age and its potential is arousing tremendous excitement. A gene transfer technique, the HVJ-liposome method, is now applicable as a tool for the dissection of molecular aspects in the pathophysiology of renal diseases, and for gene therap...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：1998-01-01 00:00:00
abstract：:Epicardial adipose tissue (EAT) is localized between the myocardial surface and visceral layer of the pericardium. It is a metabolically active organ that secretes several cytokines which modulate cardiovascular morphology and function. EAT may interact locally with coronary arteries through paracrine secretion mechan...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：10.1007/s40620-018-0491-5
更新日期：2018-12-01 00:00:00
abstract：BACKGROUND:Benefits and risks of angiotensin converting enzyme inhibitors (ACE-I) in advanced chronic kidney disease (CKD) are controversial. We tested the role of ACE-I in slowing the progression of renal damage in a real-world elderly population with CKD stage 5. METHODS:We evaluated all patients consecutively refer...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-016-0290-9
更新日期：2016-12-01 00:00:00
abstract：:The pathogenesis of calcium-oxalate (CaOx) renal stones is still debated and a number of issues needs to be clarified. In particular, it is difficult to combine the intraluminal physical-chemical imbalance and fixed particle theory with the evidence that CaOx stones actually form and grow on Randall's plaque in the re...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2004-11-01 00:00:00
abstract：BACKGROUND:Peripheral artery disease (PAD) represents a major complication in chronic kidney disease (CKD) patients, but its early diagnosis is still problematic. Traditionally, ankle-arm blood pressure index (API) determined by means of a simple hand-held unidimensional Doppler device has been used for noninvasive dia...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2009-07-01 00:00:00
abstract：BACKGROUND:Gut-derived uremic toxins have been associated with adverse outcomes in chronic kidney disease (CKD). Alterations in bowel habits, including constipation, seem to play an additional role in uremic toxicity. The aim of this study is to investigate the association of bowel habits with gut-derived uremic toxins...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-020-00819-9
更新日期：2020-10-01 00:00:00
abstract：BACKGROUND:The clinical benefits of on-line hemodiafiltration (HDF) versus high-flux membranes hemodialysis (hf-HD) are still debated. In fact, although a superiority of one treatment over the other, especially in terms of mortality, did not emerge from the analysis of clinical trials, improved intradialytic vascular s...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-018-00581-z
更新日期：2019-06-01 00:00:00
abstract：:That systemic hypertension is involved in the progression of human renal disease is mostly suggested by the way anti-hypertensive treatment affects the course of the disease. Clinical evidence has been obtained from observational studies as well as from studies of dietary protein restriction. In addition, several tria...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2000-05-01 00:00:00
abstract：BACKGROUND:Chronic kidney disease (CKD) is an important risk factor for all-cause mortality. In the general population, physical activity is associated with reduced mortality. We examined the association of level of physical activity with mortality in patients with predominantly nondiabetic CKD stage 3-4. METHODS:We s...
journal_title：Journal of nephrology
pub_type： 杂志文章,多中心研究,随机对照试验
doi：
更新日期：2008-03-01 00:00:00
abstract：:We describe a patient with renal transplant who developed abdominal pain and acute nephritis in the course of the follow-up. A biopsy of colon lesions revealed CMV inclusions, renal biopsy revealed acute glomerulonephritis with positive CMV-DNA on polymerase chain reaction. The renal disease and bowel symptoms complet...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：1998-07-01 00:00:00
abstract：BACKGROUND:The patient characteristics and course of HlV/AIDS-associated nephropathy (HIVAN) are presented for a national sample of end-stage renal disease (ESRD). METHODS:375,152 patients in the United States Renal Data System were initiated on ESRD therapy between 1 January 1992 and 30 June 1997 and analyzed in an h...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2001-09-01 00:00:00
abstract：OBJECTIVE:To investigate the pregnancy outcomes for patients with stage 3-4 chronic kidney disease (CKD) and the effects of pregnancy on kidney function. METHODS:Clinical data of pregnant women with CKD in the Peking University First Hospital between January 1st 2005 and October 1st 2016 were retrospectively analysed....
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-018-0509-z
更新日期：2018-12-01 00:00:00
abstract：INTRODUCTION:Several studies have suggested an effect of calcineurin inhibitors on arterial compliance in kidney transplant recipients. We aimed to investigate whether the type of calcineurin inhibitor influences large and small artery compliance in these patients independently of other determinants. METHODS:Patients ...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2008-01-01 00:00:00
abstract：BACKGROUND:Previous in vitro experiments of human polycystic kidney disease (PKD) cells reported that caffeine is a risk factor for the promotion of cyst enlargement in patients with autosomal dominant PKD (ADPKD). The relentless progression of ADPKD inclines the majority of physicians to advocate minimization of caffe...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-017-0396-8
更新日期：2018-02-01 00:00:00
abstract：BACKGROUND:Uremic pruritus as a symptom that affects hemodialysis (HD) patients can decrease the quality of life and increase morbidity in these patients. The aim of this study was to evaluate the effects of turmeric on uremic pruritus in HD patients. SUBJECTS AND METHODS:This was a double-blind placebo-controlled tri...
journal_title：Journal of nephrology
pub_type： 杂志文章,随机对照试验
doi：10.1007/s40620-014-0039-2
更新日期：2014-04-01 00:00:00
abstract：:Recent molecular cloning experiments have identified the existence of four NBC isoforms (NBC1, 2, 3 and 4) and two NBC-related proteins AE4 and NCBE (Anion Exchanger 4 and Sodium-dependent Chloride-Bicarbonate Exchanger). Except for AE4 which does not transport Na, all are presumed to mediate the cotransport of Na+ an...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2002-03-01 00:00:00
abstract：BACKGROUND:Phosphorus is associated with mortality in patients with chronic kidney disease (CKD) not on dialysis, possibly through phosphorus-dependent vascular calcification. Although a phosphorus-restricted diet reduces serum phosphorus, it is unlikely that it reduces vascular calcification progression in CKD. This s...
journal_title：Journal of nephrology
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1007/s40620-014-0071-2
更新日期：2015-02-01 00:00:00
abstract：:The study was conducted to determine the association between mortality, rurality, and distance from the treatment facility of the patients with ESRD. The United States Renal Data System (USRDS) for the year 2007-08 was utilized to conduct analysis of 181,349 subjects. After adjusting for all other covariates, the odds...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-016-0324-3
更新日期：2016-12-01 00:00:00
abstract：BACKGROUND:Proteinuria results from increased glomerular permeability and is associated with retraction and effacement of the highly specialized interdigitating podocyte foot processes. In podocytes (glomerular epithelial cells [GECs]), p130Cas localizes diffusely to the cytoplasm and connects focal adhesion proteins a...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.5301/jn.5000261
更新日期：2013-09-01 00:00:00
abstract：:Chronic hypotension, defined by a systolic blood pressure < 100 mmHg in the interdialytic period, affects 5-10% of hemodialysis patients, and is more prevalent among patients on long-term hemodialysis. This complication requires a substantial amount of medical and nursing care before and during dialysis to control its...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2002-07-01 00:00:00
abstract：:A widely diffused method to measure the reabsorption by single segments of the nephron in humans is based on water diuresis (WD), assuming that the peak urine flow rate approximates proximal delivery (PD). However, back-diffusion of an unknown volume of solute-free water (CH2O-BD) from lumen to the interstitium even i...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：1999-09-01 00:00:00
abstract：:IgA nephropathy (IgAN) is characterised by the mesangial deposition of polymeric IgA1 (pIgA1). pIgA1 production is reduced in the mucosal immune system in IgAN and increased in the marrow; this switch may be secondary to a defect in gammadeltaT cell control of IgA production. However this does not explain the mechanis...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：1999-03-01 00:00:00
abstract：BACKGROUND AND AIMS:Reduction of intestinal load of phosphorus is important for the prevention and treatment of chronic kidney disease (CKD)-mineral and bone disorder (MBD). However, this strategy is limited by patients' poor adherence to dietary prescription and by the existence of hidden sources of phosphorus. In add...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-016-0306-5
更新日期：2016-12-01 00:00:00
abstract：:Thales was born into a noble family of Phoenician origin at the time of the 25th Olympiad (floruit 585 bc; he was 40 in the year of the solar eclipse. He had no teachers but had occasion to learn from Egyptian priests. He developed into a scholar and politician very much appreciated by Heraclitus, Herodotus and Democr...
journal_title：Journal of nephrology
pub_type： 传,历史文章,杂志文章
doi：
更新日期：2009-11-01 00:00:00
abstract：:The widely differing functions of vitamin D are based both on a wide diffusion of its specific receptor (VDR) and on the ability of many cells, in addition to renal tubular cells, to synthesize calcitriol for autocrine and paracrine functions. In the last few years, many published studies have added new insights into ...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：10.5301/JN.2011.7767
更新日期：2011-05-01 00:00:00
abstract：BACKGROUND:Carotid artery intima-media thickness (CIMT) has been used as a marker of atherosclerosis. An insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene is associated with various cardiovascular diseases. This study is aimed at evaluating early atherosclerotic involvement of caroti...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：1999-07-01 00:00:00
