scholarly journals Cinacalcet-Associated Resolution of Primary Hyperparathyroidism in a Patient With Normal Kidney Function

2020 ◽  
Vol 8 ◽  
pp. 232470962093683 ◽  
Author(s):  
Son Nguyen ◽  
Elvira O. Gosmanova ◽  
Aidar R. Gosmanov
Keyword(s):  
Bone Mineral Density ◽  
Chronic Kidney Disease ◽  
Primary Hyperparathyroidism ◽  
Kidney Function ◽  
Calcium Supplementation ◽  
Normal Kidney ◽  
Mineral Density ◽  
Calcium Supplements ◽  
Normal Kidney Function

Cinacalcet use is associated with risk of hypocalcemia; however, this risk has been mostly demonstrated in patients with chronic kidney disease. In this article, we describe a case of a 59-year-old male with primary hyperparathyroidism (PHPT), hypercalciuria, osteopenia, and normal kidney function who was started on cinacalcet for the management of recurrent hypercalcemia following prior unsuccessful parathyroidectomy. Within 6 months following cinacalcet commencement, he developed symptomatic and biochemical hypocalcemia requiring discontinuation of the medication and initiation of calcium supplementation. Over more than 3 years of follow-up, his calcium supplementation was gradually tapered off and then discontinued. He is presently eucalcemic and euparathyroid off calcium supplements while also demonstrating normalization of hypercalciuria and bone mineral density. These data indicate that our patient has experienced resolution of PHPT after brief exposure to cinacalcet. We recommend that low starting cinacalcet doses should be considered for treatment of hypercalcemia in patients with PHPT who underwent unsuccessful parathyroidectomy along with close clinical and biochemical follow-up.

scholarly journals Estimating the proportion of bone mineral density loss in patients with normal kidney function among South Indian population

2020 ◽  
Author(s):  
Kevin Neil Aranha ◽  
Rahul P Kotian ◽  
Arathy Mary John
Keyword(s):  
Bone Mineral Density ◽  
Serum Creatinine ◽  
Trabecular Bone ◽  
Kidney Function ◽  
Bone Mineral ◽  
Z Score ◽  
Normal Kidney ◽  
Mineral Density ◽  
Normal Kidney Function ◽  
T Score

Abstract Background: Bone Mineral density (BMD) is considered as one of the golden tool to measure the bone quality in which two measurements namely T- Score and Z –score are used to report the BMD test results. Whenever there is deterioration of BMD it is associated with low skeletal mass. Creatinine is a chemical waste molecule that is generated from this muscle metabolism. Creatinine is a good marker for muscle mass. However, limited studies have been done which tell us the association between BMD loss and serum creatinine (SCr) levels.Methodology: 200 participants who were referred for CECT abdomen and pelvis were scanned using 128 slice Philips Brilliance CT. Using BMD software, four different vertebral bodies from L1-L4 were taken and ROI was placed at the central portion of the trabecular bone, two reference ROI’s, one in retro spinal muscle and one in fat tissue were also placed. To measure CT attenuation value, a ROI graphic tool was drawn at the trabecular bone. Average HU of BMD, T score and Z score values were taken from L1-L4.Statistical Analysis: The data was analysed using SSPS version 16.0. For assessment of normal BMD values, the results of measurements were averaged for age, creatinine level, T score and Z score and descriptive statistics was calculated. Spearman’s correlation coefficient was used to estimate the correlation between serum creatinine with T score and Z score.Results: T Score and SCr correlated negatively at -0.25. The correlation between Z Score and SCr was also negatively correlated at -0.187.Conclusion: It was evident from the study findings, that there is a non-association between SCr and T Score levels which showed that BMD of a person was not associated with normal kidney function. Thus, SCr levels cannot be used as a biomarker for osteoporosis or osteopenia.

scholarly journals Mesangial C4d Deposits in Early IgA Nephropathy

2017 ◽  
Vol 13 (2) ◽  
pp. 258-264 ◽  
Author(s):  
Alfons Segarra ◽  
Katheryne Romero ◽  
Irene Agraz ◽  
Natalia Ramos ◽  
Alvaro Madrid ◽  
...  
Keyword(s):  
Iga Nephropathy ◽  
Kidney Function ◽  
Prognostic Value ◽  
Kidney Biopsy ◽  
Interquartile Range ◽  
Repeated Treatment ◽  
Creatinine Ratio ◽  
Normal Kidney ◽  
Normal Kidney Function

Background and objectivesThe prognostic value of mesangial C4d deposits in IgA nephropathy has been analyzed in patients with reduced GFR but has not been analyzed in those with normal kidney function. The main objective of the study was to analyze the prognostic value of C4d deposits and association with response to treatment in patients with IgA nephropathy and normal GFR.Design, setting, participants, & measurementsThis retrospective cohort study included 190 patients with idiopathic IgA nephropathy diagnosed by kidney biopsy between 1988 and 2005. The patients had GFR≥80 ml/min per 1.73 m2 at the time of diagnosis, and they had a paraffin-embedded kidney biopsy with eight glomeruli available.ResultsIn total, 170 (89%) and 20 (11%) patients were >18 and <18 years old, respectively; median (interquartile range) follow-up was 15 (12–22) years. Mesangial C4d deposit prevalence was 20% (38 of 190). At diagnosis, C4d-positive versus -negative patients had higher protein-to-creatinine ratio (median [interquartile range]: 1.94 g/g [0.9–3.1] versus 1.45 g/g [0.9–2.2]; P=0.04). During follow-up, C4d-positive patients showed a higher number of nephritic flares (median [range]: 1.4 [0–5] versus 0.9 [0–2]; P=0.04), had a higher protein-to-creatinine ratio (median [interquartile range]: 1.32 g/g [0.7–1.7] versus 0.89 g/g [0.1–1.3]; P<0.01), were more prone to receive repeated treatment with corticosteroids (45% versus 24%; P<0.01), and showed a larger reduction in eGFR (−1.6 versus −0.8 ml/min per 1.73 m2 per year; P=0.04). Furthermore, the presence of mesangial C4d deposits was an independent predictor of long-term kidney survival.ConclusionsC4d deposits may be one of the earliest poor prognostic variables available for patients with idiopathic IgA nephropathy and normal kidney function at the time of diagnosis. However, Cd4 deposits alone are not associated with the response to angiotensin blockers or corticosteroid treatment.

scholarly journals Increased Microalbuminuria Risk in Male Cigarette Smokers: Results from the “Olivetti Heart Study” after 8 Years Follow-Up

2019 ◽  
Vol 44 (1) ◽  
pp. 33-42 ◽  
Author(s):  
Antonio  Barbato ◽  
Lanfranco  D’Elia ◽  
Ludovica  Perna ◽  
Anna  Molisso ◽  
Roberto  Iacone ◽  
...  
Keyword(s):  
Cigarette Smoke ◽  
Kidney Function ◽  
Adult Population ◽  
Population Sample ◽  
Diabetic Patients ◽  
Normal Kidney ◽  
Male Adult ◽  
Normal Kidney Function ◽  
Heart Study

Background/Aims: Association between cigarette smoke and albuminuria (UA) was already demonstrated in cross-sectional studies and in selected population samples (i.e diabetic patients). This study aims to evaluate, prospectively, the relationship between cigarette smoke and UA in a male adult population sample, with basal normal kidney function, participating in the Olivetti Heart Study (OHS). Methods: Among 994 participants, examined in both 1994-95 and 2002-04, were selected those resulted in both visits smokers (n=221) and non-smokers (n=416) and with basal normal kidney function (GFR> 60 mL/min) and basal albumin/creatinine ratio (ACR< 30 mg/g). Results: At baseline, the prevalence of hypertension was 41%, diabetes affected 6.3% and obesity 17% of the whole sample. Smokers showed statistically significant lower levels of systolic (SBP) and diastolic blood pressure (DBP) and BMI (p< 0.001) compared to non-smokers. There were not basal differences in UA, GFR and metabolic profile. However, at follow-up examination, smokers showed a statistically significant increase in SBP and DBP (p< 0.05), but not in GFR and BMI. Moreover, smokers showed a higher risk compared to non-smokers to be in the higher median levels group of UA (OR: 2.17, C.I.95%: 1.51-3.13; p < 0.001), even after correction for major confounding factors. Further adjustment for basal antihypertensive and hypoglycemic treatment did not change these patterns of association. Conclusion: In a selected male adult population sample, cigarette smoke was independently associated with the development of higher levels of albuminuria over time.

Primary hyperparathyroidism: whole-body bone mineral density in surgically treated Danish patients: a three-year follow-up study

Bone ◽  
1999 ◽  
Vol 25 (5) ◽  
pp. 597-602 ◽  
Author(s):  
P Christiansen ◽  
T Steiniche ◽  
K Brixen ◽  
I Hessov ◽  
F Melsen ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Primary Hyperparathyroidism ◽  
Bone Mineral ◽  
Whole Body ◽  
Mineral Density ◽  
Follow Up Study ◽  
Body Bone

P0881ANEMIA SIGNIFICANTLY INCREASES RISK OF OSTEOPOROSIS IN PATIENTS WITH NON-DIALYSIS CHRONIC KIDNEY DISEASE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Seonyeong Lee ◽  
Yooju Nam ◽  
Hyung Woo Kim ◽  
Jae Hyun Chang ◽  
Tae-Hyun Yoo
Keyword(s):  
Bone Mineral Density ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Bone Mineral ◽  
Mineral Density ◽  
Multivariable Logistic Regression Model ◽  
Chronic Anemia ◽  
Increased Risk ◽  
Anemia Group

Abstract Background and Aims Anemia was frequently observed in chronic renal failure patients. The risk of osteoporosis is higher in patients with chronic anemia. Chronic anemia also showed a close relationship with bone mineral density. However, few studies have been done whether anemia affects bone mineral density with chronic kidney disease(CKD) patient. Therefore, the aim of our study is to evaluate the relationship between anemia and bone mineral density(BMD) in a large sample of non-dialysis CKD cohort. Method We performed an observational study in 2,089 patients who measured hemoglobin and BMD with non-dialysis CKD enrolled in the KoreaN cohort study for Outcome in patients With Chronic Kidney Disease (KNOW-CKD). Anemia was defined as hemoglobin(Hb) levels of &lt; 13.0 g/dL for males and 12.0 g/dL for females, respectively. BMD was estimated by dual energy x-ray absorptiometry system. The observed variable was decline of BMD during follow up. Results The mean age was 53.6 ± 12.2 years and 1,292(61.1%) patients were males. The BMD score was positively correlated with hemoglobin levels (β, 0.007; 95% CI, 0.003-0.012; P 0.002), but inversely with prevalence of anemia (β, -0.03; 95% CI, -0.042--0.008; P 0.004). In the multivariable logistic regression model, the prevalence of osteoporosis was significantly higher in the anemia group than that in the normal hemoglobin levels (odds ratio [OR], 1.67; 95% confidence interval [CI], 1.11-2.51, P=0.014). Among 881 patients except unavailable following BMD, 396 (19.7%) patients developed the decline of BMD during a median follow-up duration of 48 (interquartile range, 46-49) months. In the fully adjusted multivariable Cox models, risk of developing the decline of BMD was significantly higher in the anemia group (HR, 1.38; 95% CI, 1.02-1.87; P= 0.036) as compared to normal hemoglobin group. Conclusion We found that anemia is independently and significantly correlated with an increased risk of osteoporosis with non-dialysis CKD. Our study suggests that prompt correction of anemia in CKD patients could be beneficial to preserving bone mineral density.

THE ROLE OF FBROBLAST GROWTH FACTOR 23 (FGF 23) IN THE MINERAL AND BONE DISORDER (MBD) OF THE PATENTS WITH CHRONIC KIDNEY DISEASE

2016 ◽  
pp. 9-14
Author(s):  
Huu Vu Quang Nguyen ◽  
Tam Vo
Keyword(s):  
Chronic Kidney Disease ◽  
Growth Factor ◽  
Kidney Disease ◽  
Kidney Function ◽  
Mineral Metabolism ◽  
Fibroblast Growth Factor 23 ◽  
Normal Kidney ◽  
Mineral And Bone Disorder ◽  
Normal Kidney Function ◽  
Fgf 23

Fibroblast growth factor 23 (FGF23) is a key regulator of phosphorus metabolism whose effects in patients with chronic kidney disease (CKD) have only recently begun to be appreciated. Recent study of this phosphaturic hormone has revealed new path-ways of mineral regulation in both individuals with normal kidney function and in patients with CKD. While the effects of FGF23 on mineral metabolism in CKD appears to be similar to its effects in individuals with normal kidney function, elevated levels of the protein in the CKD population have also been linked to kidney disease progression, altered skeletal histology, and increased mortality rates, relationships that have not been examined in the general population.Thus, potential differences in FGF23 metabolism accompany the elevated levels found in CKD patients and, although the exact pathophysiological consequences remain mostly unknown, elevated FGF23 levels appear to contribute to major complications of CKD that plague both adults and children. Key words: FGF23, chronic kidney

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