Effect of calcium-channel blockers on calcium--phosphate metabolism in patients with end-stage renal disease

Patients with end-stage renal disease show disturbances of calcium metabolism, including calcification of arterial walls. Such patients show increased mortality, in particular due to increased cardiovascular-associated deaths. The association of calcium channel blockers and mortality in patients undergoing haemodialysis was investigated. A total of 188 patients who were receiving haemodialysis as of July 1998 were followed up for 30 months. Baseline characteristics, including age, sex, laboratory and clinical data, medication and dialysis prescription, were obtained. As of December 2000, 51 of the patients (27%) had died. In the deceased group, age was significantly higher, body mass index was significantly lower, and smoking was significantly more frequent compared with the survival group (each P<0.001). The percentage of patients taking calcium channel blockers was significantly higher in the survival group. Cox proportional hazard regression analysis showed that haemodialysis patients assigned calcium channel blocker therapy had a significantly lower risk of mortality [relative risk 0.33 (95% confidence interval 0.17–0.67); P<0.001]. Thus, in haemodialysis patients who were at high risk of cardiovascular events, administration of calcium channel blockers was associated with lower mortality.

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Parathyroid Hormone Status in Patients with End Stage Renal Disease on Maintenance Haemodialysis

BIRDEM Medical Journal ◽

10.3329/birdem.v4i1.18547 ◽

2014 ◽

Vol 4 (1) ◽

pp. 13-17

Author(s):

SM Sajjad ◽

YA Zaman ◽

MA Rahim ◽

A Mahmuda ◽

WMM Haque ◽

...

Keyword(s):

Vitamin D ◽

Parathyroid Hormone ◽

Calcium Phosphate ◽

Renal Disease ◽

End Stage Renal Disease ◽

Maintenance Haemodialysis ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients ◽

Pth Level

Objective: To evaluate parathyroid hormone (PTH) status among end stage renal disease (ESRD) patients on maintenance haemodialysis (MHD). Methodology: This descriptive cross-sectional study was done in the Department of Nephrology, BIRDEM General Hospital, Dhaka, from April to September 2011. Results: A total of 50 patients were included in this study with a 3:2 male predominance. Mean age was 54.6 (range 34-76) years. Mean duration of ESRD was 3.73 years. All the patients were diabetic and other common co-morbidities were hypertension (76%), dyslipidaemia (56%), ischaemic heart disease (48%) and stroke (12%). They were receiving calcium (72%), vitamin D (40%), both calcium and vitamin D (38%) supplementation and 20% were not on any medication for treatment of chronic kidney disease mineral bone disorder (CKD-MBD). Mean pre-dialysis values of urea and creatinine were 30.28 mg/dl and 8.67 mg/dl respectively. Mean (± SD) serum level of calcium, phosphate and PTH were 8.32 (±1.26) mg/dl, 4.42 (±1.54) mg/dl and 125.45±117.71 pg/ml respectively. In 76% of the study subjects, PTH level was above normal. Significant difference (P=<0.05) in PTH levels was observed among patients with and without any medication for prevention of CKD-MBD but the levels were within the acceptable range. Serum calcium level in the study subjects had significant positive relationship with serum PTH level. It was also observed that PTH level had significant negative relationship with phosphate level. Conclusion: PTH level was higher in ESRD patients on MHD specially those who were not on any medication than those who took calcium, vitamin D or both but it was still within the acceptable reference range. In such patients, serum calcium, phosphate and PTH levels should be monitored periodically. DOI: http://dx.doi.org/10.3329/birdem.v4i1.18547 Birdem Med J 2014; 4(1): 13-17

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Cutaneous manifestations of end-stage renal disease

Journal of Skin and Sexually Transmitted Diseases ◽

10.25259/jsstd_41_2020 ◽

2020 ◽

Vol 0 ◽

pp. 1-6

Author(s):

Navya Vanaja Sahadevan ◽

Lissy Skaria ◽

Kunjumani Sobhanakumari

Keyword(s):

Calcium Phosphate ◽

Renal Disease ◽

End Stage Renal Disease ◽

Small Sample ◽

Dermatology Department ◽

Cutaneous Manifestations ◽

Treatment Comparison ◽

Phosphate Product ◽

Stage Renal Disease ◽

End Stage

Objectives: (1) To study the dermatological manifestations in patients with end-stage renal disease (ESRD) of diverse etiology and (2) to compare the dermatological manifestations in patients on conservative treatment and those receiving hemodialysis. Materials and Methods: One hundred patients with ESRD who attended the nephrology/dermatology department of a tertiary care center were examined for dermatological manifestations. Results: All the 100 patients evaluated had at least one cutaneous manifestation. Pallor was the most common cutaneous finding in our study (64%). Xerosis was observed in 61% and pruritus in 46%. Other common findings included diffuse hyperpigmentation (22%) and cutaneous infections (20%). Specific changes noted were acquired perforating dermatoses (7%) and nephrogenic systemic fibrosis (2%). Nail, oral mucosa, and hair were affected in 61%, 54%, and 29% cases, respectively. No significant association was noted between dermatological manifestations and modality of treatment. Comparison of serum calcium, serum phosphorus, and calcium-phosphate product was done with pruritus and a significant association was noted between pruritus and the serum levels of phosphate and calcium-phosphate product. Limitations: Small sample size and the single center study design were the major limitations. Conclusion: Dermatological manifestations are common among patients with ESRD. Early diagnosis and prompt management of the dermatological diseases may improve the quality of life of the affected.

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Calcium channel blocker use and mortality among patients with end-stage renal disease

Kidney International ◽

10.1046/j.1523-1755.2002.00355.x ◽

2002 ◽

Vol 61 (6) ◽

pp. 2157-2164 ◽

Cited By ~ 77

Author(s):

Bryan Kestenbaum ◽

Daniel L. Gillen ◽

Donald J. Sherrard ◽

Steven Seliger ◽

Adrianne Ball ◽

...

Keyword(s):

Renal Disease ◽

Calcium Channel ◽

Calcium Channel Blocker ◽

End Stage Renal Disease ◽

Channel Blocker ◽

Stage Renal Disease ◽

End Stage

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Calcinosis cutis in a renal transplant patient

BMJ Case Reports ◽

10.1136/bcr-2021-242610 ◽

2021 ◽

Vol 14 (5) ◽

pp. e242610

Author(s):

Nguyen T Nguyen ◽

Mohamed K M Shakir ◽

Thanh Duc Hoang

Keyword(s):

Calcium Phosphate ◽

Renal Transplant Patient ◽

Transplant Patient ◽

Phosphate Metabolism ◽

Calcinosis Cutis ◽

History Of ◽

Subcutaneous Tissues ◽

Stage Renal Disease ◽

End Stage ◽

Calcium Phosphate Metabolism

Calcinosis cutis is an unusual disorder characterised by calcium–phosphate deposition into cutaneous and subcutaneous tissues. There are five subtypes: dystrophic, metastatic, idiopathic, iatrogenic and calciphylaxis. Our objective was to report a patient with a history of haemodialysis-dependent end-stage renal disease (ESRD) who developed metastatic calcinosis cutis, which is usually associated with abnormalities of calcium–phosphate metabolism in renal failure. In our patient, the serum calcium and phosphate levels were normal. Additionally, we describe the diagnostic approach and the difficulties involved in the management of calcinosis cutis in patients with haemodialysis-dependent ESRD.

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