scholarly journals Cardiovascular Safety of Anti-Sclerostin Therapy in Chronic Kidney Disease

Metabolites ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 770
Author(s):  
Daniel Cejka
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Adverse Effects ◽  
Experimental Evidence ◽  
Cardiovascular Health ◽  
Clinical Evidence ◽  
Current Understanding ◽  
Cardiovascular Safety ◽  
Resorptive Activity

The significance of sclerostin for bone and cardiovascular health in patients with chronic kidney disease (CKD) is complex and incompletely understood. Experimental evidence suggests that anti-sclerostin therapy shows diminished efficacy on bone in the setting of CKD. Limited clinical evidence suggests that the osteoanabolic and anti-resorptive activity is attenuated, but hypocalcemia is more prevalent in patients with advanced CKD (eGFR < 30 mL/min) treated with anti-sclerostin (romosozumab) therapy as compared to patients without kidney disease. Furthermore, sclerostin is prominently expressed in uremic arteries. Whether the inhibition of sclerostin has adverse effects on cardiovascular health in CKD is currently unknown. This review summarizes the current understanding of the physiology and pathophysiology of sclerostin in CKD, with a focus on the cardiovascular safety of anti-sclerostin therapy in patients with or without CKD.

scholarly journals Vitamin K and D Supplementation and Bone Health in Chronic Kidney Disease—Apart or Together?

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 809
Author(s):  
Marta Ziemińska ◽  
Beata Sieklucka ◽  
Krystyna Pawlak
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Vitamin K ◽  
Bone Health ◽  
Clinical Evidence ◽  
Mechanisms Of Action ◽  
Preclinical Studies ◽  
Normal Bone ◽  
Combined Supplementation

Vitamin K (VK) and vitamin D (VD) deficiency/insufficiency is a common feature of chronic kidney disease (CKD), leading to impaired bone quality and a higher risk of fractures. CKD patients, with disturbances in VK and VD metabolism, do not have sufficient levels of these vitamins for maintaining normal bone formation and mineralization. So far, there has been no consensus on what serum VK and VD levels can be considered sufficient in this particular population. Moreover, there are no clear guidelines how supplementation of these vitamins should be carried out in the course of CKD. Based on the existing results of preclinical studies and clinical evidence, this review intends to discuss the effect of VK and VD on bone remodeling in CKD. Although the mechanisms of action and the effects of these vitamins on bone are distinct, we try to find evidence for synergy between them in relation to bone metabolism, to answer the question of whether combined supplementation of VK and VD will be more beneficial for bone health in the CKD population than administering each of these vitamins separately.

Adverse Effects of Proton Pump Inhibitors in Chronic Kidney Disease

2016 ◽  
Vol 176 (6) ◽  
pp. 866 ◽  
Author(s):  
Maria Fusaro ◽  
Sandro Giannini ◽  
Maurizio Gallieni
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Adverse Effects ◽  
Proton Pump Inhibitors ◽  
Proton Pump

scholarly journals Efficacy and Cardiovascular Safety of Roxadustat in Dialysis-Dependent Chronic Kidney Disease: Pooled Analysis of Four Phase 3 Studies

2021 ◽  
Author(s):  
Jonathan Barratt ◽  
Wladyslaw Sulowicz ◽  
Michael Schömig ◽  
Ciro Esposito ◽  
Michael Reusch ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Pooled Analysis ◽  
Cardiovascular Safety ◽  
Phase 3

Effects of low-dose meloxicam in cats with chronic kidney disease

2020 ◽  
pp. 1098612X2093575
Author(s):  
Kate KuKanich ◽  
Christopher George ◽  
James K Roush ◽  
Sherry Sharp ◽  
Giosi Farace ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Growth Factor ◽  
Kidney Disease ◽  
Adverse Effects ◽  
Transforming Growth Factor Beta ◽  
Low Dose ◽  
Transforming Growth Factor ◽  
Joint Disease ◽  
Cystatin B

Objectives Meloxicam therapy may benefit cats with degenerative joint disease, and retrospective studies suggest it could slow kidney disease progression and increase survival. This study aimed to prospectively evaluate the renal effects of low-dose meloxicam treatment (0.02 mg/kg/day) over 6 months in cats with chronic kidney disease (CKD). Methods Twenty-one cats with stable International Renal Interest Society stage 2 or 3 CKD were recruited and randomized to placebo or meloxicam groups. Cats were evaluated at baseline and at 1, 3 and 6 months, including blood pressure, chemistry, symmetric dimethylarginine (SDMA), glomerular filtration rate (GFR), urinalysis, urine protein:creatinine ratio (UPC), urine transforming growth factor-beta (ß):creatinine ratio, urine clusterin, urine cystatin B and serum inosine. Results No statistical difference was observed in systolic blood pressure, blood urea nitrogen, creatinine, SDMA, GFR, urine transforming growth factor-ß:creatinine ratio, urine clusterin, urine cystatin B or serum inosine in cats receiving meloxicam vs placebo. Mean UPC was greater in the meloxicam group (0.33) than the placebo group (0.1) at 6 months ( P = 0.006). Four cats had meloxicam discontinued owing to potential (mainly gastrointestinal) adverse effects. Conclusions and relevance No decline in renal excretory function was observed when meloxicam was administered to cats with CKD. However, gastrointestinal adverse effects were observed, and cats that received meloxicam had greater proteinuria at 6 months than cats that received placebo. As proteinuria is associated with negative outcomes (progression of azotemia and hypertension) in cats with CKD, this finding suggests that meloxicam should be used with caution in cats with CKD and UPC monitored. Until further research is available, clinicians should weigh the risk of potential increased proteinuria against quality of life benefits when considering meloxicam for analgesia in cats with renal disease.

Adverse Effects of Proton Pump Inhibitors in Chronic Kidney Disease

2016 ◽  
Vol 176 (6) ◽  
pp. 868
Author(s):  
Francesco Iannuzzella ◽  
Mattia Corradini ◽  
Sonia Pasquali
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Adverse Effects ◽  
Proton Pump Inhibitors ◽  
Proton Pump
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