Serum FGF23 levels may not be associated with serum phosphate and 1,25-dihydroxyvitamin D levels in patients with Fanconi syndrome-induced hypophosphatemia
Fibroblast growth factor 23 (FGF23) is regulated by sustained phosphate supplementation and restriction. However, few studies have investigated FGF23 levels in patients with Fanconi syndrome. Therefore, we evaluated intact and C-terminal FGF23 and FGF23-associated parameters in four patients with Fanconi syndrome. Serum intact and C-terminal FGF23 levels were extremely low. Although serum phosphate and 1,25-dihydroxyvitamin D levels improved to or above the normal range within 1 year of treatment with oral phosphate and calcitriol, serum FGF23 levels remained low. Serum FGF23 levels in patients with Fanconi syndrome might ...
Source: CKJ: Clinical Kidney Journal - September 25, 2016 Category: Urology & Nephrology Authors: Goto, S., Fujii, H., Kono, K., Watanabe, K., Nakai, K., Nishi, S. Tags: FGF23 Source Type: research
FGF23 is associated with early post-transplant hypophosphataemia and normalizes faster than iPTH in living donor renal transplant recipients: a longitudinal follow-up study
Conclusions
Post-transplant FGF23 levels settle faster than those of iPTH. However, 11% of patients continued to have hyperparathyroidism even after 12 months. (Source: CKJ: Clinical Kidney Journal)
Source: CKJ: Clinical Kidney Journal - September 25, 2016 Category: Urology & Nephrology Authors: Prasad, N., Jaiswal, A., Agarwal, V., Kumar, S., Chaturvedi, S., Yadav, S., Gupta, A., Sharma, R. K., Bhadauria, D., Kaul, A. Tags: FGF23 Source Type: research
FGF23 in kidney transplant: the strange case of Doctor Jekyll and Mister Hyde
During the last decade, a new view into the molecular mechanisms of chronic kidney disease-mineral bone disorder (CKD-MBD) has been proposed, with fibroblast growth factor 23 (FGF23) as a novel player in the field. Enhanced serum FGF23 levels cause a reduction in serum phosphate, together with calcitriol suppression and consequent hyperparathyroidism (HPT). In contrast, reduced serum FGF23 levels are associated with hyperphosphatemia, higher calcitriol levels and parathyroid hormone (PTH) suppression. In addition, serum FGF23 levels are greatly increased and positively correlated with serum phosphate levels in CKD patients...
Source: CKJ: Clinical Kidney Journal - September 25, 2016 Category: Urology & Nephrology Authors: Cianciolo, G., Cozzolino, M. Tags: FGF23 Source Type: research
Frequently relapsing anti-glomerular basement membrane antibody disease with changing clinical phenotype and antibody characteristics over time
We report an atypical case of frequently relapsing anti-GBM antibody disease with both anti-GBM antibody–positive flares with pulmonary and renal involvement, and anti-GBM antibody–negative flares that were pulmonary limited with no histologic renal disease. This is the first report of alternating disease phenotype and anti-GBM antibody status over time. Disease severity paralleled the detection of anti-GBM antibodies but was independent of IgG subtype staining along the GBM. This case suggests a role for changing subpopulations of pathogenic antibodies as an explanation for variation in disease phenotype and a...
Source: CKJ: Clinical Kidney Journal - September 25, 2016 Category: Urology & Nephrology Authors: Gu, B., Magil, A. B., Barbour, S. J. Tags: ATYPICAL ANTI-GBM DISEASE Source Type: research
Multiple recurrences of anti-glomerular basement membrane disease with variable antibody detection: can the laboratory be trusted?
We present the case of multiple recurrences of anti-GBM disease with varying serum anti-GBM antibody findings. A 33-year-old female tobacco user presenting with hematuria was diagnosed with anti-GBM disease by renal biopsy. Five years later, she presented with alveolar hemorrhage and positive anti-GBM antibody. She presented a third time with alveolar hemorrhage but undetectable anti-GBM antibody. With each occurrence, symptoms resolved with plasmapheresis, intravenous methylprednisone and oral cyclophosphamide. The relationship between anti-GBM antibody findings and disease presentation is complex. Clinicians should be aw...
Source: CKJ: Clinical Kidney Journal - September 25, 2016 Category: Urology & Nephrology Authors: Liu, P., Waheed, S., Boujelbane, L., Maursetter, L. J. Tags: ATYPICAL ANTI-GBM DISEASE Source Type: research
Atypical anti-glomerular basement membrane disease: lessons learned
Anti-glomerular basement membrane (GBM) disease usually pursues a self-limited course, at least from the immunological perspective. In addition, circulating antibodies to cryptic, conformational epitopes within the NC1 domain of the alpha 3 chain of Type IV Collagen are commonly found at the zenith of the clinical disease. However, exceptions to these general rules do occur, as exemplified by two remarkable cases reported in this issue of the Clinical Kidney Journal. The possible explanations for and the lessons learned from these uncommon occurrences are discussed in this short commentary. (Source: CKJ: Clinical Kidney Journal)
Source: CKJ: Clinical Kidney Journal - September 25, 2016 Category: Urology & Nephrology Authors: Glassock, R. J. Tags: ATYPICAL ANTI-GBM DISEASE Source Type: research
Announcements
(Source: CKJ: Clinical Kidney Journal)
Source: CKJ: Clinical Kidney Journal - July 21, 2016 Category: Urology & Nephrology Tags: ANNOUNCEMENTS Source Type: research
Severe acute interstitial nephritis after combination immune-checkpoint inhibitor therapy for metastatic melanoma
(Source: CKJ: Clinical Kidney Journal)
Source: CKJ: Clinical Kidney Journal - July 21, 2016 Category: Urology & Nephrology Authors: Murakami, N., Borges, T. J., Yamashita, M., Riella, L. V. Tags: ERRATUM Source Type: research
Urinary bile casts in bile cast nephropathy secondary to severe falciparum malaria
Conclusions
Prolonged duration of illness and increased bilirubin cause BCN among patients with severe falciparum malaria with jaundice and AKI, which is associated with high mortality and morbidity. (Source: CKJ: Clinical Kidney Journal)
Source: CKJ: Clinical Kidney Journal - July 21, 2016 Category: Urology & Nephrology Authors: Mohapatra, M. K., Behera, A. K., Karua, P. C., Bariha, P. K., Rath, A., Aggrawal, K. C., Nahak, S. R., Gudaganatti, S. S. Tags: HAEMODIALYSIS Source Type: research
Intradialytic hypertension during chronic haemodialysis and subclinical fluid overload assessed by bioimpedance spectroscopy
Conclusions
The prevalence of IDH in our treatment centres is much higher than previously reported. Subclinical fluid overload may be a major contributing factor to the mechanism of this condition. The use of BIS identifies patients who may benefit from additional UF. (Source: CKJ: Clinical Kidney Journal)
Source: CKJ: Clinical Kidney Journal - July 21, 2016 Category: Urology & Nephrology Authors: Sebastian, S., Filmalter, C., Harvey, J., Chothia, M.-Y. Tags: HAEMODIALYSIS Source Type: research
Low-molecular weight heparin infusion as anticoagulation for haemodialysis
Conclusions
LMWH infusion is feasible and safe. The method avoids early excessive anticoagulation caused by bolus injection and reduces the LMWH dose. Future studies should be conducted to evaluate LMWH infusion in extended haemodialysis treatment. (Source: CKJ: Clinical Kidney Journal)
Source: CKJ: Clinical Kidney Journal - July 21, 2016 Category: Urology & Nephrology Authors: Wong, S. S.-M., Lau, W.-Y., Chan, P.-K., Wan, C.-K., Cheng, Y.-L. Tags: HAEMODIALYSIS Source Type: research
Incidence and outcome of encapsulating peritoneal sclerosis
Conclusions
The incidence of EPS is reassuringly low provided PD exposure is not prolonged and this supports ongoing use of PD. However, continuing PD beyond 3 years results in an exponential rise in the risk of developing EPS and deciding whether this risk is acceptable should be made on an individual patient basis. (Source: CKJ: Clinical Kidney Journal)
Source: CKJ: Clinical Kidney Journal - July 21, 2016 Category: Urology & Nephrology Authors: Petrie, M. C., Traynor, J. P., Mactier, R. A. Tags: PERITONEAL DIALYSIS Source Type: research
Newer antibiotics for the treatment of peritoneal dialysis-related peritonitis
Peritonitis is a debilitating infectious complication of peritoneal dialysis (PD). Drug-resistant bacterial peritonitis typically has a lower response rate to antibiotics. In the past 15 years, newer antibiotics with activities against drug-resistant Gram-positive bacteria have been developed. In most circumstances, peritonitis due to methicillin-resistant staphylococci responds to vancomycin. If vancomycin cannot be used due to allergy and/or non-susceptibility, there is increasing evidence that linezolid and daptomycin are the drugs of choice. It is reasonable to start linezolid orally or intravenously, but subsequent do...
Source: CKJ: Clinical Kidney Journal - July 21, 2016 Category: Urology & Nephrology Authors: Ma, T. K.-W., Leung, C. B., Chow, K. M., Kwan, B. C.-H., Li, P. K.-T., Szeto, C. C. Tags: PERITONEAL DIALYSIS Source Type: research
Nephrologists' likelihood of referring patients for kidney transplant based on hypothetical patient scenarios
Conclusions
The variability in transplant referral is related to patients' age and geographic location as well as the nephrologists' affiliation with an academic institution and time since completion of training. Future educational interventions should emphasize the benefits of kidney transplant and PKT for all population groups regardless of geographic location and age and should target nephrologists in non-academic settings who are 10 or more years from their fellowship training. (Source: CKJ: Clinical Kidney Journal)
Source: CKJ: Clinical Kidney Journal - July 21, 2016 Category: Urology & Nephrology Authors: Tandon, A., Wang, M., Roe, K. C., Patel, S., Ghahramani, N. Tags: END-STAGE RENAL DISEASE Source Type: research
Discriminative value of frailty screening instruments in end-stage renal disease
Conclusions
Although the GFI showed the highest sensitivity, it is not yet possible to propose a firm choice for one of these screening instruments or specific items due to the small scale of the study. Since there is a high prevalence of frailty in ESRD patients, translation and testing of the effectiveness of screening using the GFI in the prognostication and prevention of development or deterioration of frailty in this population should be the next step. (Source: CKJ: Clinical Kidney Journal)
Source: CKJ: Clinical Kidney Journal - July 21, 2016 Category: Urology & Nephrology Authors: van Munster, B. C., Drost, D., Kalf, A., Vogtlander, N. P. Tags: END-STAGE RENAL DISEASE Source Type: research
