No abstract available.
Humans ; Hyperphosphatemia* ; Patient Education as Topic*

No abstract available.
Humans ; Hyperphosphatemia* ; Mortality* ; Renal Dialysis*

No abstract available.
Humans ; Hyperphosphatemia* ; Mortality* ; Renal Dialysis*

Introduction: This is a prospective, post marketing surveillance study that aims to determine the efficacy and safety of sevelamer carbonate in hyperphosphatemic chronic kidney disease (CKD) patients in the Philippines. Methods: Adult CKD patients with serum phosphorous levels >1.78 mmol/L and whose physician had decided to treat with sevelamer carbonate 800 mg were enrolled in the study and followed-up for a minimum of three visits from baseline within a six-month period. The primary endpoint was the change in serum phosphorous levels from baseline to the sixth month. Adverse events were noted and recorded during the treatment period. Results: There were 233 patients included in the study from five centers in Metro Manila from 2010 to 2013. Of the 233 patients, 199 were on chronic dialysis, 33 were not on dialysis, and 1 had no data. There was a statistically significant (P-value <0.0001) reduction in serum phosphorous levels from baseline after treatment with sevelamer carbonate. There were 16 patients reported to have adverse drug reactions, 13 of whom had serious adverse events (SAE) and three were non-serious. Of the 13 patients with SAEs, only one was possibly/probably related to sevelamer carbonate and all three non-SAEs were possibly/definitely related to sevelamer carbonate. Conclusion The results showed sevelamer carbonate to be effective in lowering serum phosphorous levels and the most common adverse events were related to the gastrointestinal tract (1.4%). There were sixteen patients with adverse events, three of which were non-serious, while 13 were reported to be serious adverse events. Only one was probably related to the drug.
Renal Insufficiency, Chronic ; Hyperphosphatemia ; Sevelamer

Pseudohypoparathyroidism(PHP) is an inherited metabolic disorder characterized by hypocalcemia, hyperphosphatemia and an impaired phosphaturic response to exogenous parathormone(PTH), which are caused by end organ resistance to the action of PTH. Most of these patients have, in addition, the skeletal abnormalities of Albright hereditary osteodystrophy. We report two cases of PHP, suspicious type Ia, in sibling who were presented with multiple subcutaneous soft tissue calcification similar to that seen in tumoral calcinosis and had short stature, round face, brachydactyly and metabolic abnormalities(hypocalcemia, hyperphosphatemia, increased serum PTH, and decreased 24hr urinary basal cAMP)
Brachydactyly ; Calcinosis ; Humans ; Hyperphosphatemia ; Hypocalcemia ; Pseudohypoparathyroidism* ; Siblings*

Pseudohypoparathyroidism (PHP) is a rare clinical syndrome characterized by hypocalcemia, hyperphosphatemia and increase of serum parathyroid hormone in association with unique clinical features. We recently experienced a typical PHP type Ia patient who presented with recurrent seizure and muscle spasms and electroencephalogram (EEG) showed generalized spike-and-wave discharges. With the correction of hypocalcemia, seizures did not recur and epileptiform discharges disappeared. We suggest that the possibility of PHP should be considered in patients with seizures showing hypocalcemia and hyperphosphatemia.
Electroencephalography ; Humans ; Hyperphosphatemia ; Hypocalcemia ; Parathyroid Hormone ; Pseudohypoparathyroidism ; Seizures ; Spasm

BACKGROUND: The patency of arteriovenous access is important for stable and effective hemodialysis, and long-term technical survival is best achieved with a native arteriovenous fistula (AVF). However, maintaining AVF patency remains a challenge. This study was designed to determine the independent prognostic factors for AVF patency according to hemodialysis duration. METHODS: The primary study end point was unassisted patency of the AVF, which was defined as the time from the first fistula surgery to the first AVF failure. AVF failure was defined as an event that required percutaneous intervention or surgery to revise or replace the fistula, which occurred at least 2 months after fistula formation. RESULTS: We enrolled 478 patients with a mean age of 55.5+/-14.0 years, and mean duration of dialysis was 2.5+/-2.1 years. There were 109 cases (22.8%) of AVF failure. The factors related to AVF patency differed according to hemodialysis duration. Using a Cox-adjusted model, we observed a significant correlation between the incidence of AVF failure and diabetes within the initial 12 months of hemodialysis. Uncontrolled hyperphosphatemia (mean serum phosphorus>5.5 mg/dL during hemodialysis) was associated with patency loss of AVF after 1 year of hemodialysis. CONCLUSION: Various factors were associated with the development of patency loss of AVF as hemodialysis duration differed, and a preventive role of hyperphosphatemia control in AVF survival needs further clinical study.
Arteriovenous Fistula* ; Dialysis ; Fistula ; Humans ; Hyperphosphatemia* ; Incidence ; Renal Dialysis*

PURPOSE: To evaluate the long-term safety of polyethylene glycol (PEG) 4000 in children with constipation, particularly the biochemical aspects of safety. METHODS: Medical records were evaluated, and 100 children, who had been taking PEG 4000 for more than 6 months, and who had been under clinical and biochemical monitoring, were enrolled. Ages; 6.11+/-3.12 years, Duration of therapy; 16.93+/-7.02 months, dose of PEG 4000; 0.72+/-0.21 g/kg/d. RESULTS: None of the children complained of clinical adverse effect. The first biochemical test was performed at 8.05 months after beginning of PEG 4000. Serum phosphate (SP) value was high in 10 children, and leucopenia was noted in one child. The second test was performed in 44 children at 7.57 months after the first test. The SP value was high in four children, including the three children whose initial SP value was high and one new child. Six out of 10 children with high initial SP value became normal and one was lost. Hypernatremia was noted in one child. The third test was done in 15 children at 7.5 months after the second test. The SP value of the new child from the second test was high, but became normal after finishing treatment. Two out of 3 children with high SP value at the second test became normal and one was lost. The fourth test was done in 2 children few months after the third test. All of the results were normal. There were no relation between duration of therapy and hyperphosphatemia, or between dose of PEG 4000 and hyperphosphatemia. CONCLUSIONS: PEG 4000 is safe for long-term therapy in children with constipation with respect to biochemical parameters.
Child ; Constipation ; Humans ; Hypernatremia ; Hyperphosphatemia ; Medical Records ; Polyethylene Glycols

Tumoral calcinosis is a periarticular calcific lesion and rare complication in patients with maintenance hemodialysis. The pathogenesis of tumoral calcinosis is poorly understood but may be due to elevated serum phosphorus, a high calcium phosphorus (Ca x P) product or secondary hyperparathyroidism in hemodialysis patients. A 30-year-old man presented with pain and palpable mass of left shoulder. He had been on maintenance hemodialysis with high flux dialyzer for 10 years. Laboratory finding showed hyperphosphatemia and elevated intact PTH concentration. A shoulder X-ray and CT scan demonstrated a massive calcification. Following partial resection, pain was relieved. Here we report a case of tumoral calcinosis of shoulder in a hemodialysis patient with untreated hyperphosphatemia and secondary hyperparathyroidism.
Adult ; Calcinosis ; Calcium ; Humans ; Hyperparathyroidism ; Hyperparathyroidism, Secondary ; Hyperphosphatemia ; Phosphorus ; Renal Dialysis ; Shoulder

Over the last 15 years, our knowledge and understanding of the underlying mechanisms involved in the regulation of calcium and phosphate homeostasis in chronic kidney disease have advanced dramatically. Contrary to general opinion in the 20th century that moderate hypercalcemia and hyperphosphatemia were acceptable in treating secondary hyperparathyroidism, the calcium and phosphate load is increasingly perceived to be a major trigger of vascular and soft tissue calcification. The current treatment options are discussed in view of historical developments and the expectations of the foreseeable future, focusing on the early treatment of hyperphosphatemia. At present, we lack in disputable evidence that active intervention using currently available drugs is of benefit to patients in chronic kidney disease stages 3 and 4.
Calcium ; Homeostasis ; Humans ; Hypercalcemia ; Hyperparathyroidism, Secondary ; Hyperphosphatemia ; Prognosis ; Renal Insufficiency, Chronic