JTT-751 for Treatment of Patients with Hyperphosphatemia on Peritoneal Dialysis
Background/Aims: JTT-751 (ferric citrate hydrate) is a novel iron-based phosphate approved in Japan for the treatment of hyperphosphatemia in dialysis and nondialysis patients with chronic kidney disease. Methods: In this phase 3, multicenter, open-label, dose-adjusted study, we investigated the efficacy and safety of JTT-751 in peritoneal dialysis patients. A total of 56 patients with serum phosphate ≥5.6 and (Source: Nephron Clinical Practice)
Source: Nephron Clinical Practice - November 10, 2014 Category: Urology & Nephrology Source Type: research
Fibroblast Growth Factor 23/Klotho Axis in Chronic Kidney Disease
Fibroblast growth factor-23 (FGF23) is a bone-derived hormone that regulates phosphate and 1,25-hydroxyvitamin D [1,25(OH)2D] metabolism. FGF23 binds to FGF receptor 1 with its coreceptor Klotho and maintains serum phosphate levels within the normal range by increasing renal phosphate excretion. In addition, FGF23 reduces the synthesis and accelerates the degradation of 1,25(OH)2D to reduce intestinal phosphate absorption. Moreover, FGF23 acts at the parathyroid gland to decrease parathyroid hormone synthesis and secretion. In chronic kidney disease (CKD), serum FGF23 levels rise exponentially as renal function declines lo...
Source: Nephron Clinical Practice - November 8, 2014 Category: Urology & Nephrology Source Type: research
Rituximab in Adult Minimal Change Disease and Focal Segmental Glomerulosclerosis
Treatment of nephrotic syndrome due to minimal change disease and focal segmental glomerulosclerosis remains a challenge since steroid dependence, steroid resistance and a relapsing disease course exhibits a high cumulative steroid dosage. The necessity of using alternative steroid-sparing immunosuppressive agents with potential toxic side effects also restricts their long-term use. Rituximab, a monoclonal antibody targeting CD20, has been increasingly used in the therapy of difficult-to-treat nephrotic syndrome. A clinical response has been shown for patients with steroid-dependent or frequently relapsing nephrotic syndro...
Source: Nephron Clinical Practice - November 8, 2014 Category: Urology & Nephrology Source Type: research
Lupus Nephritis: From Pathogenesis to Targets for Biologic Treatment
Conclusion: Systemic lupus is more a variable syndrome than a single disorder based on heterogeneous genetic variants and complex aberrant immune alterations. This makes it less likely that a single specific biological drug will be as efficient as currently used unselective immunosuppressive drugs. Autoantibody production and intrarenal immune complex formation are the hallmark of lupus nephritis. However, kidney injury and scarring also result from local amplification of tissue inflammation. Therefore, a combination of unselective immunosuppressive and biological drugs that block immune cell recruitment or proinflammatory...
Source: Nephron Clinical Practice - November 8, 2014 Category: Urology & Nephrology Source Type: research
Comparison of Different Methods of Erythrocyte Dysmorphism Analysis to Determine the Origin of Hematuria
Conclusion: We determined the best cutoff points to interpret erythrocyte dysmorphism and demonstrated that it is possible to discriminate the origin of hematuria by evaluating erythrocyte dysmorphism in urinalysis using either an optical or a phase-contrast microscope.Nephron Clin Pract (Source: Nephron Clinical Practice)
Source: Nephron Clinical Practice - November 8, 2014 Category: Urology & Nephrology Source Type: research
Periodontal Disease, Renal Dysfunction and Heightened Leukocytosis
Conclusion: Individual measures of periodontal disease are associated with renal function and heightened leukocytosis in CKD subjects. The significantly added inflammatory burden noted in CKD subjects with periodontal disease argue for targeting periodontitis treatment as part of our multifaceted approach to CKD patients.Nephron Clin Pract (Source: Nephron Clinical Practice)
Source: Nephron Clinical Practice - November 8, 2014 Category: Urology & Nephrology Source Type: research
Clinical and Biological Determinants of Sclerostin Plasma Concentration in Hemodialysis Patients
Conclusions: We confirm a higher concentration of sclerostin in HD patients, a positive association with age and a negative association with PTH. A positive association with phosphate, homocysteine and troponin calls for additional research. The clinical interest of sclerostin to assess vascular calcifications in HD is limited and no association was found between sclerostin and mortality.Nephron Clin Pract (Source: Nephron Clinical Practice)
Source: Nephron Clinical Practice - November 7, 2014 Category: Urology & Nephrology Source Type: research
Geriatric Assessment for Therapeutic Decision-Making Regarding Renal Replacement in Elderly Patients with Advanced Chronic Kidney Disease
Conclusions: Frailty assessment could be useful for decision-making about the treatment in elderly patients with CKD. CC may be a good treatment option.Nephron Clin Pract (Source: Nephron Clinical Practice)
Source: Nephron Clinical Practice - November 7, 2014 Category: Urology & Nephrology Source Type: research
Gabriel Richet (1916-2014), Founding Editor of Nephron
Nephron Clin Pract (Source: Nephron Clinical Practice)
Source: Nephron Clinical Practice - November 7, 2014 Category: Urology & Nephrology Source Type: research
Treatment with Haemodiafiltration Stabilises Vascular Stiffness (Measured by Aortic Pulse Wave Velocity) Compared to Haemodialysis
Conclusions: Aortic PWV, a measure of vascular stiffness, stabilised with haemodiafiltration. Our preliminary findings require further investigation to determine how haemodiafiltration may potentially improve vascular stiffness.Nephron Clin Pract (Source: Nephron Clinical Practice)
Source: Nephron Clinical Practice - November 7, 2014 Category: Urology & Nephrology Source Type: research
Platelet-Derived Growth Factor Receptor-β Expression in Human Peritoneum
Conclusions: As podoplanin-positive myofibroblasts express PDGFRβ, these cells might be related to pericytes (rather than other sources of fibroblasts). PDGFRβ might turn out to be a therapeutic target in EPS.Nephron Clin Pract (Source: Nephron Clinical Practice)
Source: Nephron Clinical Practice - November 7, 2014 Category: Urology & Nephrology Source Type: research
Is the Systemic Microvascular Endothelial Glycocalyx in Peritoneal Dialysis Patients Related to Peritoneal Transport
Conclusions: No relationships are present between the systemic endothelial glycocalyx, which was assessed by SDF, and peritoneal transport. In nonfast transporters, a reduction in blood vessel density caused by endothelial glycocalyx alterations or a thicker permeable phase of the glycocalyx delaying the access of small solutes to the small pores may be important.Nephron Clin Pract (Source: Nephron Clinical Practice)
Source: Nephron Clinical Practice - November 7, 2014 Category: Urology & Nephrology Source Type: research
Longitudinal Assessments of Erythropoietin-Stimulating Agent Responsiveness and the Association with Specific Clinical Outcomes in Dialysis Patients
Conclusions: In diabetic dialysis patients, we observed that time-varying erythropoietin resistance is associated with sudden death, infectious complications and all-cause mortality. Low 25-hydroxyvitamin D levels may contribute to a lower ESA responsiveness.Nephron Clin Pract (Source: Nephron Clinical Practice)
Source: Nephron Clinical Practice - November 7, 2014 Category: Urology & Nephrology Source Type: research
Effect of Nocturnal Haemodialysis on Body Composition
Conclusions: One year of NHD had no significant effect on body composition in comparison with CHD, despite a significantly higher protein intake in patients on NHD.Nephron Clin Pract (Source: Nephron Clinical Practice)
Source: Nephron Clinical Practice - November 7, 2014 Category: Urology & Nephrology Source Type: research
New Biologics for Glomerular Disease on the Horizon
The major advances achieved in immunology and cellular biology have led to the development of biotherapies that specifically target different mediators and pathways involved in the physiopathology of renal diseases. After the major breakthroughs obtained with B-cell depletion in autoantibody-mediated glomerulopathies, several other immunomodulation strategies are being tested in autoimmune glomerulonephritides, such as blockade of B-cell costimulation and activation, inhibition of complement pathways or modification of the T-B-lymphocyte crosstalk. Other drugs, inhibiting proinflammatory cytokines, are being developed in o...
Source: Nephron Clinical Practice - November 7, 2014 Category: Urology & Nephrology Source Type: research
