Disordered serum essential element levels are associated with increased risk of kidney tumors

Background: Calcium (Ca) is an essential element that plays a critical role in many biological processes. In dialysis patients, the regulation of Ca balance is highly complex, given the absence of kidney function, endocrine disturbances and the use of drugs such as phosphate binders, vitamin D analogues, and calcimimetics. Also, the use of different dialysate Ca (DCa) baths has profound effect on Ca balance, which depends both on the difference between the Ca concentration in the bath and the serum of the patients, as on the ultrafiltration volume. Summary: The choice of DCa may have important short- and long-term consequences. While lower DCa (especially < 2.5 mEq/L) concentrations have been associated with an increased risk of sudden cardiac death in observational studies, DCa in the higher ranges (3.0 mEq/L and above) may contribute to vascular pathology. Intra-dialytic hemodynamics may also be affected by the choice of DCa. In general, lower DCa concentrations are associated with an increase, and higher DCa concentrations with a decrease in parathyroid hormone (PTH) levels. Preliminary data has suggested that a DCa of 2.75 mEq/L may help in obtaining a net zero intradialytic Ca balance in individual patients, but clinical experience is still limited. Key Message: The optimal Ca balance depends on multiple parameters including blood Ca levels, PTH and the use of phosphate binders and vitamin D analogues, as well as on the risk of hemodynamic stability and cardiac arrhythmias. Therefore, DCa prescription should be individualised. A DCa of 2.75 mEq/L may be useful adjunct for dialysis providers.

Download Full-text

Biofortification of UK food crops with selenium

Proceedings of The Nutrition Society ◽

10.1079/pns2006490 ◽

2006 ◽

Vol 65 (2) ◽

pp. 169-181 ◽

Cited By ~ 256

Author(s):

Martin R. Broadley ◽

Philip J. White ◽

Rosie J. Bryson ◽

Mark C. Meacham ◽

Helen C. Bowen ◽

...

Keyword(s):

Essential Element ◽

Food Crops ◽

Immune Functions ◽

Crop Varieties ◽

Increased Risk ◽

Enrich Food ◽

Low Levels ◽

The Uk ◽

Agronomic Biofortification ◽

Se Status

Se is an essential element for animals. In man low dietary Se intakes are associated with health disorders including oxidative stress-related conditions, reduced fertility and immune functions and an increased risk of cancers. Although the reference nutrient intakes for adult females and males in the UK are 60 and 75 μg Se/d respectively, dietary Se intakes in the UK have declined from >60 μg Se/d in the 1970s to 35 μg Se/d in the 1990s, with a concomitant decline in human Se status. This decline in Se intake and status has been attributed primarily to the replacement of milling wheat having high levels of grain Se and grown on high-Se soils in North America with UK-sourced wheat having low levels of grain Se and grown on low-Se soils. An immediate solution to low dietary Se intake and status is to enrich UK-grown food crops using Se fertilisers (agronomic biofortification). Such a strategy has been adopted with success in Finland. It may also be possible to enrich food crops in the longer term by selecting or breeding crop varieties with enhanced Se-accumulation characteristics (genetic biofortification). The present paper will review the potential for biofortification of UK food crops with Se.

Download Full-text

The Efficiency of Recombinant Alpha Eptacog in Haemostatis Management of Haemophilic Patients with Elective Arthroplasty

Revista de Chimie ◽

10.37358/rc.17.8.5794 ◽

2017 ◽

Vol 68 (8) ◽

pp. 1931-1934

Author(s):

Oana Viola Badulescu ◽

Razvan Tudor ◽

Mihaela Blaj ◽

Bogdan Mihnea Ciuntu ◽

Paul Dan Sirbu

Keyword(s):

Hemophilia A ◽

Essential Element ◽

Coagulation Factor ◽

Factor Ix ◽

Total Arthroplasty ◽

Total Endoprosthesis ◽

Increased Risk ◽

Degrees Of Severity ◽

Severe Coagulopathy

Haemophilia is considered to be the most severe coagulopathy, characterized by a deficiency either of factor VIII (hemophilia A) or coagulation factor IX (hemophilia B), presenting various degrees of severity depending on the residual factor level. Haemarthrosis is the most common clinical expression of a haemophiliac patient. Its repetitive character will cause irreversible lesions in the joints, which mark the beginning of a chronic condition - haemophiliac arthropathy, which slowly develops throughout the patient�s life, leading eventually to ankylosis. Over time, these joints will require total prosthesis, in order to improve locomotor activity. Achieving effective hemostasis is an essential element for the possibility of performing this type of surgery, due to the increased risk of bleeding, of a vital nature, at this category of patients. A series of clinical trials have been carried out to research the role of the Eptacog Alpha Recombinant treatment in the reduction of bleeding in haemophiliac patients with present inhibitors, to whom total arthroplasty is carried out at the level of various joints. In this regard, this paper aims to highlight the effectiveness of Eptacog Alpha Recombinant in the management of haemostasis in haemophiliac patients, with indication of total endoprosthesis.

Download Full-text

Staged, Open, No-Ischemia Nephron-Sparing Surgery for Bilateral-Multiple Kidney Tumors in a Patient with Birt-Hogg-Dubé Syndrome

Case Reports in Medicine ◽

10.1155/2012/639629 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Ahmet Tefekli ◽

Ayşe Deniz Akkaya ◽

Kamil Peker ◽

Terman Gümüş ◽

Metin Vural ◽

...

Keyword(s):

Kidney Cancer ◽

Papillary Renal Cell Carcinoma ◽

Minimal Invasive ◽

Nephron Sparing Surgery ◽

Renal Tumors ◽

Invasive Treatment ◽

Kidney Tumors ◽

Lung Cysts ◽

Increased Risk ◽

Nephron Sparing

Hereditary kidney cancer patients with bilateral multiple kidney tumors represent challenges in the era of rapidly growing minimal invasive treatment techniques. Birt-Hogg-Dubé Syndrome (BHDS) is an autosomal dominant genodermatosis characterized by a triad of benign skin tumors (fibrofolliculomas, trichodiscomas, acrochordons) together with an increased risk of developing malignant renal tumors and pulmonary disease such as pneumothoraces and multiple lung cysts. The morbidity and mortality of the affected patients is determined by the presence of the kidney tumors, which tend to be multifocal and bilateral, as observed in other hereditary kidney cancer syndromes like von Hippel-Lindau disease, familial leiomyomatosis, and hereditary papillary renal cell carcinoma. Herein, a patient with BHDS, presenting with synchronous bilateral multiple kidney tumors, is reported. The report describes the management of kidney tumors with two-stage open nephron-sparing surgery in which the nonvascular clamping technique was utilized.

Download Full-text

A History of Large for Gestational Age at Birth and Future Risk for Pediatric Neoplasms: A Population-Based Cohort Study

Journal of Clinical Medicine ◽

10.3390/jcm9051336 ◽

2020 ◽

Vol 9 (5) ◽

pp. 1336

Author(s):

Roy Kessous ◽

Eyal Sheiner ◽

Daniella Landau ◽

Tamar Wainstock

Keyword(s):

Gestational Age ◽

Cumulative Incidence ◽

Population Based ◽

Large For Gestational Age ◽

Kidney Tumors ◽

Childhood Malignancy ◽

Increased Risk ◽

Childhood Neoplasms ◽

Future Risk

Objective: The aim of this study was to evaluate the association between large for gestational age (LGA) at birth and future risk of childhood neoplasm. Study design: a population-based cohort to compare the long-term risk (up to the age of 18 years) of childhood neoplasms (benign and malignant) in children that were born LGA vs. those that were appropriate for gestational age (AGA), between the years 1991–2014. Childhood neoplasms diagnosis were defined according to international classification of disease 9 (ICD-9) codes recorded medical files. Kaplan–Meier survival curves were used in order to compare cumulative incidence of oncological morbidity over the study period. The Cox proportional hazards model was used to control for confounders. Results: 231,344 infants met the inclusion criteria; out of those 10,369 were diagnosed LGA at birth. Children that were LGA at birth had a higher incidence of leukemia (OR 2.25, 95%CI 1.08–4.65, p = 0.025) as well as kidney tumors (OR = 4.7, 95%CI = 1.02–21.9, p = 0.028). In addition, cumulative incidence over time of childhood malignancies, leukemia, and kidney tumors were significantly higher in LGA children (Log Rank = 0.010, 0.021, and 0.028, respectively). In a Cox regression model controlling for other perinatal confounders, LGA at birth remained independently associated with an increased risk for childhood malignancy (adjusted HR 1.51, 95%CI 1.02–2.23, p = 0.039). Conclusion: LGA at birth is associated with increased long-term risk for childhood malignancy and specifically leukemia and kidney tumors. This possible link may help to improve current knowledge regarding potential exposures that are associated with childhood cancer development.

Download Full-text