Tag Archive for: chronic kidney disease

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Which phosphate transporters should be targeted to reduce hyperphosphatemia?

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NaPi-IIb, a type II sodium-dependent phosphate transporter, is considered a dominant transporter in rodents for phosphate absorption in the small intestine. However, the regulation of its expression in chronic kidney disease (CKD) is still ambiguous. A recent study measured protein expression level of NaPi-Iib in CKD-rats by mass spectrometry to evaluate the extent of phosphate transport via this molecule. The results showed that  the contribution of NaPi-IIb to intestinal phosphate absorption dramatically decreases in CKD, suggesting that in order to improve handling of hyperphosphatemia in CKD it is mandatory to inhibit other phosphate transporters as well.

Read the full article here: https://academic.oup.com/ndt/advance-article/doi/10.1093/ndt/gfaa156/5900877

 

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Dysregulated turnover of collagen type III is an important determinant of chronic kidney disease progression

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Collagen type III (COL3) is one of the most abundant extracellular matrix components in the human body; decreased urinary levels of a degradation fragment of COL3 (C3M) were associated with the severity of CKD in patients with immunoglobulin A nephropathy and kidney allograft failure. Genovese et al. assessed the relationship between fragments reflecting active formation (PRO-C3) and degradation (C3M) of COL3 and CKD disease progression and mortality in 500 patients from the Renal Impairment in Secondary Care study. In a paper recently published in Clinical Kidney Journal they concluded that products of COL3 formation and degradation were independently associated with CKD progression and mortality, thus representing an opportunity to link pathological processes with targeted treatments against fibrosis.

Read full text at https://academic.oup.com/ckj/advance-article/doi/10.1093/ckj/sfz174/5704451

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Serum bicarbonate as a cardiovascular risk factor

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Cardiovascular disease (CVD) remains the leading cause of death in chronic kidney disease (CKD) patients. Metabolic acidosis is a risk factor for CVD and increases overall mortality risk in CKD patients, but also in the general population. An editorial by D. E. Wesson in Nephrology Dialysis Transplantation (NDT) explores available evidence on the mechanisms through which acidosis increases CVD risk and explains possible interventions to correct acid-base balance and thus reduce the risk.

Read full article at: https://academic.oup.com/ndt/advance-article/doi/10.1093/ndt/gfz297/5719358

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Clinical considerations and strategies for treating hypertension in CKD patients

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Hypertension is both a major cause and consequence of chronic kidney disease (CKD). It is associated with increased risk of cardiac events, stroke and kidney disease progression. The latest National Kidney Foundation Clinical Practice Guidelines recommend a blood pressure goal of <130mmHg systolic and <80mmHg diastolic for all CKD patients, regardless of the level of albuminuria. Several non-pharmacological interventions are recommended to achieve this, including weight loss, salt intake restriction and physical activity. As for pharmacological treatment, a combination of renin-angiotensin system (RAS) blocker (either ACE inhibitor or ARB, in case of ACE inhibitor intolerance) with a calcium channel blocker or a diuretic is recommended as initial therapy in patients with CKD stage 3 or higher. A combination of two RAS blockers is not recommended

Read the article https://academic.oup.com/ndt/advance-article/doi/10.1093/ndt/gfz279/5700448

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World Diabetes Day: Chronic Kidney Disease due to diabetes is a serious public health threat!

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Diabetes is one of the key drivers of chronic kidney disease and the most frequent reason why patients are in need of renal replacement therapy. Conversely, outcomes for dialysis patients with diabetes are rather poor. For these reasons, the ERA-EDTA aims to raise awareness of the threat of kidney disease on World Diabetes Day on November 14. It is important to prevent diabetes wherever possible and if not, to take great care to ensure that kidney health is protected in diabetic patients. SGLT2 inhibitors have the potential to treat CKD in patients with diabetes.

“On World Diabetes Day (WDD) we support diabetes associations in their important goal of raising awareness for the risk factors of diabetes. But we also have to maintain kidney health in patients with diabetes for as long as possible” says Carmine Zoccali, President of the ERA-EDTA.

Read more here

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Over 850 million people worldwide have some form of kidney disease

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On a world scale the total number of individuals with chronic kidney disease (CKD), acute kidney injury (AKI), and those on renal replacement therapy (RRT) exceeds 850 million, a truly concerning figure that is twice the estimated number of people with diabetes worldwide and >20 times higher than the number of individuals affected by AIDS/HIV worldwide. Thus kidney diseases are one of the most common diseases worldwide.

Find out more on NDT here

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