Abstract:
:The partial correction of anemia and the normalization of phosphate and blood pressure are the mainstay of treatment of patients with chronic kidney disease (CKD). Available anti-hypertensive drugs, erythropoiesis stimulating agents (ESAs) and iron supplements have resolved quite satisfactorily the goal of controlling hypertension and partially correcting anemia. Unfortunately, the treatment of hyperphosphatemia is still far from resolved. Phosphate binders have poor tolerability and/or limited efficacy, leading to the prescription of many tablets that achieve only a mild-to-moderate effect. Moreover, increased consumption of tablets is associated with increased low tolerability, thus jeopardizing patient compliance and, in turn, the efficacy of phosphate binding. Compared to calcium-free binders, the cheaper calcium salts increase the risk of hypercalcemia, calciphylaxis and vascular calcification and possibly all-cause mortality. Calcium-free phosphate binders decrease serum phosphate levels without increasing the serum calcium concentration. The higher phosphate-binding efficacy of lanthanum carbonate compared to sevelamer should be balanced against its lack of pleiotropic effects on lipid metabolism and inflammation and the accumulation in bones. New iron-based phosphate binders are available. In addition to their phosphate binding capacity, they could also be useful to treat anemia. Iron citrate is seeking for such an indication because its iron absorption is significant. This could be of clinical importance, particularly in CKD patients not on dialysis, obviating the need for extra oral iron administration and possibly favoring compliance. In conclusion, the use of iron-based phosphate binders with significant iron absorption properties could represent a novel paradigm for correcting anemia and hyperphosphatemia in CKD patients.
journal_name
J Nephroljournal_title
Journal of nephrologyauthors
Locatelli F,Del Vecchio Ldoi
10.1007/s40620-017-0421-ysubject
Has Abstractpub_date
2017-12-01 00:00:00pages
755-765issue
6eissn
1121-8428issn
1724-6059pii
10.1007/s40620-017-0421-yjournal_volume
30pub_type
杂志文章,评审abstract:BACKGROUND:In older patients with chronic kidney disease (CKD), the risk of progression to end stage renal disease and cardiovascular death both differ compared to younger patients. This likely reflects differences in case mix and co-morbid burdens. We sought to establish the extent to which age itself is an independen...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.1007/s40620-018-0529-8
更新日期:2018-12-01 00:00:00
abstract::The kidney does not usually present specific lesions in cystic fibrosis (CF), although in recent years renal involvement has been reported, particularly amyloidosis and immune complex glomerulonephritis. IgA nephropathy is rare. We report four cases of IgA nephropathy out of five renal biopsies performed in the last t...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:Patients with IgA nephropathy and histological vasculitic/crescentic lesions have a poor prognosis. We performed a retrospective study to assess whether treatment with steroids and immunosuppressants would preserve renal function by healing these lesions and thereby prevent progression to glomerular sclerosi...
journal_title:Journal of nephrology
pub_type: 临床试验,杂志文章
doi:
更新日期:2000-09-01 00:00:00
abstract::Patients with type 2 diabetes run a high risk for progressive renal function loss. Many interventions have been tested to reduce the risk, but we are nowadays still confronted with a high unmet need. To improve on this unmet need, we will have to change the current strategies in drug discovery, clinical trials and cli...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.1007/s40620-020-00820-2
更新日期:2020-12-01 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:Inadvertent sodium (Na(+)) flux may occur during renal replacement therapy (RRT) in ICU. The objective of this study was to estimate sodium flux during RRT. METHODS:Between September 2011 to December 2012 we studied 60 ICU patients receiving extended daily dialysis (EDD, Fresenius 4008S) or continuous renal...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.1007/s40620-014-0041-8
更新日期:2014-08-01 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::Reduced glomerular filtration rate and albuminuria do not account for the total risk of developing end-stage renal disease (ESRD), suggesting that other factors might be involved in progressive renal function worsening. Among these, cardiovascular disease, even subclinical, could play a role. The role of left ventricu...
journal_title:Journal of nephrology
pub_type: 社论,评审
doi:10.5301/jn.5000114
更新日期:2012-11-01 00:00:00
abstract::In 1998, the Italian Ministry of Health urged the Italian Society of Nephrology (SIN) to draft recommendations for uniform decision-making procedures in the field of dialysis. In accordance with the Ministry's specifications, at the time the Society approved diagnostic protocols regarding clinical questions, but witho...
journal_title:Journal of nephrology
pub_type: 指南,杂志文章,实务指引
doi:
更新日期:2001-03-01 00:00:00
abstract::Glomerulonephritis rarely appears associated with Hodgkin's disease or non-Hodgkin's lymphoma (NHL). We present a patient with a relapse of a non-Hodgkin's lymphoma which first presented as nephrotic syndrome due to focal segmental glomerulosclerosis (FSGS). This case report discusses the unusual association of non-Ho...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Plasmin has recently been reported to be associated with renal fibrosis in experimental models, but its role in human renal diseases is unclear. METHODS:Fifty-seven patients with IgA nephropathy (IgAN) were evaluated retrospectively. Plasmin in their renal biopsy tissues was assessed by in situ zymography u...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.1007/s40620-015-0205-1
更新日期:2016-02-01 00:00:00
abstract::Hemolytic uremic syndrome (HUS) is a rare disease characterized by microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure. It is usually secondary to infections by strains of Escherichia coli (STEC) that produce Shiga-like toxin. In about 10% of patients, no STEC infections are reported. In these ...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.5301/jn.5000146
更新日期:2012-11-01 00:00:00
abstract::Sudden cardiac death (SCD) is a major cause of concern in end stage renal disease (ESRD), contributing to 70% of cardiovascular mortality and 27% of all-cause mortality in dialysis patients. Yet its mechanisms and pathogenesis remain largely obscure. This review discusses the potential reasons for an exaggerated risk ...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.1007/s40620-014-0151-3
更新日期:2015-04-01 00:00:00
abstract::Replacement of dietary saturated fat with unsaturated fat has been recommended for prevention of cardiovascular disease (CVD) in the general population. Less is known of the health risks in individuals with chronic kidney disease (CKD), of a diet with an unhealthy fat profile, in general characterized by insufficient ...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.5301/jn.5000284
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:Early initiation of therapy is warranted for patients with idiopathic membranous nephropathy (IMN) who have severe proteinuria. Therapy with tacrolimus (TAC) or intravenous cyclophosphamide (CYC) may be an option in treating such patients. METHODS:This prospective cohort study included patients with IMN who...
journal_title:Journal of nephrology
pub_type: 临床试验,杂志文章
doi:
更新日期:2008-07-01 00:00:00
abstract::The term thin glomerular basement membrane disease (TBMD) refers to a condition characterised by thinning of the GBM at electron microscopy examination and, clinically, by isolated hematuria, frequently occurring in other family members, with no extra-renal manifestations. Progression towards chronic renal failure (CR...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Drug-related problems (DRPs) are common in chronic kidney disease (CKD) patients. We developed a 2-step consultation including a clinical pharmacist (CP) session and a nephrologist conventional care consultation to explore the feasibility of a pilot drug-oriented disease management program in controlling iat...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.5301/jn.5000063
更新日期:2012-09-01 00:00:00
abstract::Evidence-based medicine provides tools to evaluate dialysis outcomes by integrating knowledge obtained from interventional and observational studies. This is illustrated in relation to three important topics: dialysis membranes, dialysis dose and anemia. Clinical trials and observational evidence support each other in...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND:Malnutrition is common and associated with poor outcomes in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). Recently, the geriatric nutritional risk index (GNRI) was reported as a novel tool for evaluating nutritional status. However, the association between GNRI and renal outc...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.1007/s40620-019-00676-1
更新日期:2020-08-01 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::We followed up 128 patients with crescentic glomerulonephritis (CGN), having sufficient clinical and histopathological data for a mean period of 34 +/- 28 months. There were 49 males and 79 females, mean age 22.7 +/- 14 years. We studied the effects of clinical, laboratory and histopathological parameters on kidney fu...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2002-05-01 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::Jaundice and pancreatitis are serious complications in post renal transplantations; hepatotropic viruses and drugs are commonly implicated. We describe ascaris infestation causing pancreatitis and obstructive jaundice in a renal transplant patient. ...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:An increased number of major histocompatibility complex (MHC) class II-positive cells (OX-6+ cells) were observed in the glomerulus and periglomerular interstitium during the course of anti-glomerular basement membrane (anti-GBM) crescentic glomerulonephritis (GN) in WKY rats. This study aimed to demonstrate...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2007-05-01 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::The clinical manifestations of diabetic nephropathy are similar in type 1 and type 2 diabetes, while the renal lesions may differ. Indeed, diabetic glomerulopathy is the predominant renal lesion in type 1 diabetes, although also tubular, interstitial and arteriolar lesions are present in the advanced stages of renal d...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.1007/s40620-020-00797-y
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Pericardial effusion in uremic patients (UPE) was first described by R. Bright in 1836. It is generally agreed that patients require emergency pericardial drainage when tamponade signs are present, but in patients with no tamponade the optimal timing for drainage remains unclear. METHODS:To define patients ...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.1007/s40620-014-0107-7
更新日期:2015-02-01 00:00:00
abstract::A symposium on kidney stones and mineral metabolism held on December 2017 in Brussels, Belgium was the first international multidisciplinary conference of the International Collaborative Network on Kidney Stones and Mineral Metabolism. This meeting addressed epidemiology, underlying pathophysiological mechanisms, gene...
journal_title:Journal of nephrology
pub_type:
doi:10.1007/s40620-019-00587-1
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:The detailed mechanisms and treatment methods of chronic kidney disease (CKD) in patients with chronic heart failure (CHF) are not fully understood. We conducted a prospective study in CHF patients manifesting CKD to examine if AST-120 (Kremezin) improves cardiac and renal functions. METHODS:Twenty outpatie...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:We tested the hypothesis that the universal application of myocardial scanning with single-photon emission computed tomography (SPECT) would result in better risk stratification in renal transplant candidates (RTC) compared with SPECT being restricted to patients who, in addition to renal disease, had other ...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2010-05-01 00:00:00