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Nephrology in Veterinary Medicine.

Veterinary nephrology is a specialized field of veterinary medicine providing a high level of care for animals with all types of kidney disease. Veterinarians complete extensive training to become board-certified in veterinary nephrology-urology. Companion animal nephrology is the most advanced field; however, all species are afflicted by a variety of renal disorders. Most naturally occurring animal kidney diseases have similar disorders found in people; where veterinary research is lacking, clinical management is often modified from standard of care in people. Veterinarians have become adept

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… Initial lab work identified azotemia (BUN 164 mg/dl [reference range (RR), 7–27 mg/dl], creatinine 4.5 mg/dl [RR 0.5–1.8 mg/dl]), hyperphosphatemia (17.4 mg/dl [RR, 2.5–6.8 mg/dl]), and hypoalbuminemia (2.4 g/dl [RR, 2.6–3.9 g/dl]). … Recheck lab work performed 1 month later and found resolution of the azotemia (serum creatinine 1.5 mg/dl, BUN 22 mg/dl) and hyperphosphatemia (4.3 mg/dl). His proteinuria was significantly improved (urine protein:creatinine ratio [UPC], 0.88). …

Effect of Early Administration of Vitamin D on Clinical Outcome in Critically Ill Sepsis Patients: A Randomized Placebo-controlled Trial.

BackgroundAdministration of vitamin D to unselected heterogeneous critically ill patients did not demonstrate outcome benefit. The current study was undertaken to identify if early administration of vitamin D can reduce intensive care unit (ICU) length of stay and improve clinical outcomes in critically ill patients with sepsis.MethodsThis single-center randomized double-blind placebo-controlled trial was done in the ICU and emergency inpatient ward of a tertiary care teaching institute in New Delhi, India. A total of 126 adult patients aged 18 to 80 years of either sex diagnosed to have sepsi

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… consistently increased the serum values to optimum levels. 13 Amrein et al. found that a large single dose of 540,000 U of vitamin D given to vitamin D deficient patients was able to increase the levels to normal range within 2 days and was not associated with any adverse effects, like hypercalcemia, hyperphosphatemia … However, none of the patients developed symptomatic hyperkalemia or hyperphosphatemia requiring treatment in the 90 days follow-up. Since cutaneous vitamin D synthesis is sunlight dependent, it is often concluded that people with tropical sun exposure have higher levels of this hormone by default. …

Circulating Levels of Soluble α-Klotho and FGF23 in Childhood Cancer Survivors: Lack of Association with Nephro- and Cardiotoxicity-A Preliminary Study.

Background/Objectives: The survival rate among pediatric cancer patients has reached 80%; however, these childhood cancer survivors (CCSs) are at a heightened risk of developing chronic conditions in adulthood, particularly kidney and cardiovascular diseases. The aims of this study were to assess the serum α-Klotho and FGF23 levels in CCSs and to determine their association with nephro- and cardiotoxicity. Methods: This study evaluated a cohort of 66 CCSs who remained in continuous remission, with a mean follow-up of 8.41 ± 3.76 years. Results: The results of this study revealed that CCSs exhi

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… Fibroblast growth hormone-23 primarily contributes to left ventricle hypertrophy (LVH) and heart failure, while α-Klotho deficiency predominantly promotes arterial calcification and atherosclerosis in conjunction with hyperphosphatemia [ 14 ]. … Evidence from the literature suggests that a deficiency in soluble α-Klotho contributes to arterial calcification and atherosclerotic disease, either independently or through concomitant hyperphosphatemia. …

Exploring the top 30 drugs associated with drug-induced constipation based on the FDA adverse event reporting system.

ObjectiveThis project aims to identify the top 30 drugs most commonly associated with constipation and their signal values within the FDA Adverse Event Reporting System database.MethodsWe extracted adverse drug events (ADEs) related to constipation from the FAERS database spanning from January 1, 2004, to September 30, 2023. We compiled the 30 most frequently reported drugs based on the frequency of constipation events. We employed signal detection methodologies to ascertain whether these drugs elicited significant signals, including reporting odds ratio, proportional reporting ratio, multi-it

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… It is primarily used to treat hyperphosphatemia in adult patients with CKD ( Chen et al., 2023 ; Nain et al., 2023 ). … Efficacy and safety of ferric citrate on hyperphosphatemia among Chinese patients with chronic kidney disease undergoing hemodialysis: a phase III multicenter randomized open-label active-drug-controlled study. Am. J. …

Osteitis Fibrosa Cystica: The Hideous Face of Hyperparathyroidism.

Osteitis fibrosa cystica (OFC), the skeletal scourge of advanced hyperparathyroidism, unveils itself as a relentless destroyer of bone architecture, leaving behind a landscape of fragility and deformity. In the shadow of chronic kidney disease, where mineral imbalances reign, this rare but devastating entity emerges as a silent tormentor. We present the case of a hemodialysis patient who fell victim to this sinister complication, manifesting with excruciating bone pain, pathological fractures, and radiographic and histological evidence of cystic osteolytic lesions. Biological assessments revea

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… The primary pathogenic mechanism leading to sHPT is hyperphosphatemia and a deficiency in 1,25-dihydroxycholecalciferol, which results in hypocalcemia. This hypocalcemia, in turn, stimulates an increased production and secretion of PTH by the parathyroid glands. …

Nephrotoxicity in Bispecific Antibodies Recipients: Focus on T-Cell-Engaging Bispecific Antibodies.

Recently, bispecific antibodies (BsAbs) are evolving the landscape of cancer treatment and have significantly improved the outcomes of relapsed or refractory cancer patients. As increasing BsAbs entered clinical practice, specific toxicities have emerged, and renal side-effects have been described. However, there are a lack of studies analyzing the nephrotoxicity in the anti-cancer BsAbs recipients systematically. In this review, we demonstrate the etiologies, mechanisms, other risk factors and treatment options of kidney injury in the BsAbs recipients to provide a more comprehensive insight i

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… of 145 patients who received Odronextamab (CD20 x CD3) experienced grade 5 TLS. 6 , 10 Cancer, especially malignant hematologic cells, may contain up to four times more intracellular phosphate compared with normal mature lymphoid cells. 40 TLS is a metabolic disorder characterized by hyperuricemia, hyperphosphatemia … subsequently occur. 41 There is a high risk of kidney damage caused by precipitation of uric acid and calcium phosphate crystals in renal tubules. 42 Although TLS can usually be readily discriminated from CRS on the basis of characteristic laboratory abnormalities such as hyperuricemia, hyperkalemia, hyperphosphatemia …

Hypophosphatemia in cancer patients.

Dysregulation of phosphorus homeostasis resulting in hypophosphatemia is common in cancer patients and can result in serious complications and impact outcomes. Several factors, including critical illness, nutritional status, cancer type and therapy, influence the development of hypophosphatemia. Hypophosphatemia can develop as a result of phosphaturic mesenchymal tumors or as a paraneoplastic phenomenon. The clinical presentation for hypophosphatemia varies depending on the duration and severity of the hypophosphatemia and affects several organ systems. Among other serious effects, hypophospha

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… This rate-limiting last step is induced by PTH, hypocalcemia and hypophosphatemia and inhibited by FGF-23, hyperphosphatemia and hypercalcemia [ 39 , 40 ]. Calcitriol mainly acts on the kidneys to increase Ca 2+ reabsorption. … Hypophosphatemia results from phosphate lost in the effluent during CRRT and can develop even if hyperphosphatemia is present at the start of therapy. We summarized the common etiologies for hypophosphatemia in cancer patients based on the proposed mechanism in Figure 3 . …

Legal access to medications: a threat to Brazil's public health system?

BackgroundIn Brazil, health is fundamental human right guaranteed by the Constitution of 1988, which created the Brazilian Universal Health System (Sistema Único de Saúde - SUS). The SUS provides medications for outpatient care via policy of pharmaceutical assistance (PA) programmes. Despite the advances in PA policies which include the improvement in access to medications, there has been a significant increase in lawsuits related to health products and services. This study aimed to characterize the medication processes filed between 2010 and 2014 against the Secretary of State for Health of S

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… angioedema Prophylaxis of reinfection by the Hepatitis B virus following liver transplantation Aplastic anaemia Hereditary ichthyosis Psoriasis Asthma Hirsutism Psoriatic arthritis Autoimmune haemolytic anaemia HIV disease resulting in other diseases Pulmonary arterial hypertension Autoimmune hepatitis Hyperphosphatemia … Prophylaxis of reinfection by the Hepatitis B virus following liver transplantation Aplastic anaemia | Hereditary ichthyosis | Psoriasis Asthma | Hirsutism | Psoriatic arthritis Autoimmune haemolytic anaemia | HIV disease resulting in other diseases | Pulmonary arterial hypertension Autoimmune hepatitis | Hyperphosphatemia …

Infection related membranoproliferative glomerulonephritis secondary to anaplasmosis: A case report.

BACKGROUND: Anaplasmosis is a tick-borne disease with a range of clinical manifestations, from a flu-like illness with fever and myalgias to a severe systemic disease with multisystem organ failure. Although renal involvement is not a common presentation, there have been few cases reporting acute kidney injury from Anaplasmosis. CASE SUMMARY: We present a 55-year-old female with anaplasmosis who developed acute kidney injury due to membranoproliferative glomerulonephritis (MPGN). The patient originally presented with cough and shortness of breath. She was admitted to the hospital with a diagn

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… To control metabolic acidosis, sodium bicarbonate was added, and sevelamer was used for hyperphosphatemia. However, due to her current medical conditions and poor prognosis, the patient opted for comfort care, and she ultimately passed away. …

Cytokine release syndrome and tumor lysis syndrome in a multiple myeloma patient treated with palliative radiotherapy: A case report and review of the literature.

UNLABELLED: We present the case of a 53-year-old woman treated with analgesic radiotherapy for a multiple myeloma bone lesion of the forearm. After a first fraction of 5 Gray (Gy), she presented with an acute respiratory syndrome with fever a few hours after the treatment. The same symptoms occurred after the second fraction 3 days later. The patient recovered quickly thanks to intravenous hydration and suspension of the radiotherapy. Biological tests revealed a tumor lysis syndrome. We concluded that the clinical symptoms could be defined as cytokine release syndrome. This is the second time

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… A complete blood test revealed the followings elements: hyperkalemia 5.5 mmol/L, hypocalcemia 2 mmol/L, hyperphosphatemia 2.21 mmol/L, creatinine 128 µmol/L versus 70 µmol/L before radiotherapy, uric acid 305 µmol/L versus 132 µmol/L ( Fig. 3 ). We decided to increase hydration (2L/24 h). …

Palliative care for patients with malignancy and end-stage renal failure on peritoneal dialysis.

BackgroundMany patients on peritoneal dialysis experience a poor quality of life because of a high burden of comorbid conditions. Dialysists must pay more attention to reducing a patient's pain and suffering, both physical and psychological and improve the quality of life for the patients as much as possible. A consensus regarding eligibility for palliative care and the delivery of these inventions does not currently exist.ObjectiveThe present study aimed to describe the implementation of palliative care for end-stage renal failure patients on peritoneal dialysis.DesignA report on three cases.

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… Secondary hyperparathyroidism, hyperphosphatemia, increased calcium-phosphate deposition in the skin, dry skin, inadequate dialysis, anemia, iron deficiency, and low-grade hypersensitivity to products used in the dialysis procedure have been identified as possible causes of pruritus in dialysis patients …

Patterns and Outcomes of Permanent Vascular Access in End-Stage Kidney Disease: A Multicenter Experience.

Background End-stage kidney disease (ESKD) is a growing health problem worldwide, with hemodialysis serving as the main treatment when transplantation is not feasible. Permanent vascular access is essential for effective dialysis, yet its patterns and outcomes remain variable across patient populations. Aim This multicenter study aimed to describe the patterns of vascular access use and evaluate the outcomes of permanent vascular access in patients with ESKD undergoing hemodialysis. Methods A retrospective multicenter cross-sectional study (January-June 2024) was conducted at two tertiary hosp

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… Laboratory abnormalities such as hyperphosphatemia, anemia, and thrombocytosis also compromise patency [ 8 , 9 ]. … 63 2003 12472802 10.1046/j.1523-1755.2003.00740.x 30 Factors associated with dysfunction of autogenous arteriovenous fistula in patients with maintenance hemodialysis: a retrospective study Ann Palliat Med Li Y Cui W Wang J Zhang C Luo T 4047 4054 10 2021 33832310 10.21037/apm-20-2196 31 Effect of hyperphosphatemia …

Immune Dysfunction in Uremia 2020.

Cardiovascular disease and infections are major causes for the high incidence of morbidity and mortality of patients with chronic kidney disease. Both complications are directly or indirectly associated with disturbed functions or altered apoptotic rates of polymorphonuclear leukocytes, monocytes, lymphocytes, and dendritic cells. Normal responses of immune cells can be reduced, leading to infectious diseases or pre-activated/primed, giving rise to inflammation and subsequently to cardiovascular disease. This review summarizes the impact of kidney dysfunction on the immune system. Renal failur

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… In ESRD, FGF23 fails to sustain phosphate homeostasis and hyperphosphatemia and increased FGF23 levels stimulate the development of hypertension, vascular calcification, and left ventricular hypertrophy [ 138 ]. … In CKD, secondary hyperparathyroidism leads to elevated FGF-23 serum levels, decreased calcitriol production in the kidney, reduced intestinal calcium absorption, and hyperphosphatemia. …

Видимая интоксикация витамином D из-за парапротеина.

76-летний мужчина представил вскоре после коленной артропластики с болезнью, тошнотой и тяжелыми паратироидными гормонально-независимыми гиперкальцемией. Первоначальная лабораторная оценка показала заметно повышенную 25-гидроксивитаминовую концентрацию D (>250 нмоль/л [>100 нг/мл]; ссылка >50 нмоль/л [>20 нг/мл]), предполагающую отравление витамином D. Однако этот диагноз показался неправдоподобным, поскольку пациент ежедневно использовал только 400 холекалциферола, фосфат сыворотки оставался нормальным, а некоторые свойства кальция, дисфункции Renal, анемии и болезни костей указывали на лежащ

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… Besides hypercalcemia and suppressed PTH, patients typically exhibit hyperphosphatemia due to increased intestinal calcium and phosphate absorption [ 1 ]. …

Acute Kidney Injury Associated with Anticancer Therapies: Small Molecules and Targeted Therapies.

Molecular targeted therapy has revolutionized cancer treatment by significantly improving patient survival compared with standard conventional chemotherapies. The use of these drugs targets specific molecules or targets, which block growth and spread of cancer cells. Many of these therapies have been approved for use with remarkable success in breast, blood, colorectal, lung, and ovarian cancers. The advantage over conventional chemotherapy is its ability to deliver drugs effectively with high specificity while being less toxic. Although known as "targeted," many of these agents lack specifici

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… Blocking FGFR disrupts these homeostatic mechanisms, leading to increased serum phosphorus levels. 11 Hyperphosphatemia is, therefore, a common adverse event associated with FGFR inhibitors, observed in approximately 74% of patients. 12 Such patients might have no symptoms to at most metastatic calcinosis … In the absence of confirming data in the literature, it is reasonable to suggest replacing warfarin anticoagulants in patients who develop hyperphosphatemia to prevent the development of calciphylaxis. …

Clinical approaches to osteoporosis in patients with chronic kidney disease: A comprehensive review.

Chronic kidney disease (CKD) induces secondary osteoporosis, characterized by an imbalance between bone formation and resorption due to kidney dysfunction; the result is a reduction in both bone mineral density and quality. This condition is compounded by disruption of bone metabolic turnover, abnormalities in bone microstructure and collagen cross-linking, and compromised bone quality, all of which contribute to increased bone fragility. Reduced kidney function is complicated by secondary hyperparathyroidism, which exacerbates bone fragility. Managing osteoporosis in patients with CKD is chal

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… In CKD stage G4 and beyond, hyperphosphatemia is observed. The initial increase in FGF23 promotes phosphate excretion by the renal tubules, as well as inhibiting activation of vitamin D, resulting in reduced intestinal absorption of phosphate. … Hypocalcemia can directly impair muscle contraction and strength, while hyperphosphatemia can contribute to vascular calcifications and reduced muscle perfusion, leading to muscle weakness. …

Множественная миелома с психической нефропатией и негативом Бенса-Джонса Протеинурии: Редкое клиническое представление.

Множественная миелома (MM) — злокачественное расстройство плазменных клеток, которое обычно вызывает анемию, боль в костях, гиперкальцемию и почечную недостаточность. Мы сообщаем о случае 55-year-old Мужчина, у которого были в основном острые повреждения почек (АКИ), пинентопенция и системное воспаление без классических особенностей гиперкальцемии или литических повреждений костей. В частности, мочевые белки Бенса-Джонса были отрицательными, несмотря на заметно повышенную сыворотку каппа и аномальный белковый электрофорез (SPEP). Биопсия костного мозга выявила скромный плазмоцитоз, в то время

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… Urea | 171 mg/dL | 10–50 mg/dL | Elevated Creatinine | 9.34 mg/dL | 0.5–0.9 mg/dL | Markedly elevated Sodium | 150 mmol/L | 135–145 mmol/L | Hypernatremia Potassium | 3.4 mmol/L | 3.5–5.0 mmol/L | Hypokalemia Calcium | 8.1 mg/dL | 8.6–10 mg/dL | Hypocalcemia Phosphate | 6.5 mg/dL | 2.5–4.5 mg/dL | Hyperphosphatemia …

Hypocalcemia in cancer patients: An exploratory study.

IntroductionCalcium has several physiological functions and when it registers abnormal serum levels those functions may be impacted with potentially severe consequences. There is much research on hypercalcemia in cancer patients, but there are no recent studies on the prevalence of hypocalcemia in those patients. However, there has been an evolution in oncology, namely, new drugs that may directly or indirectly result in hypocalcemia. The primary aim was to explore the association of hypocalcemia with the diverse types of cancer. The secondary aim was to study the influence that hypocalcemia m

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… A hospital survey of hypocalcemia and hyperphosphatemia in malignancy. Tumori. 1991;77:311–314. [18] Schattner A, Dubin I, Huber R, et al. Hypocalcaemia of malignancy. Neth J Med. 2016;74:231–239. [19] Ford PA, Glickman J, Mastoris JD. …

Supportive Care in Older Lymphoma Patients to Reduce Toxicity and Preserve Quality of Life

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… TLS is due to the fast lysis of malignant cells determining hyperuricemia, hyperkaliemia, hypocalcemia and hyperphosphatemia. Uric acid and calcium phosphate crystals in the renal tubules may lead to acute renal failure. … Laboratory TLS is defined as two or more of the following metabolic abnormalities: hyperuricemia, hyperkaliemia, hyperphosphatemia or hypocalcemia. …

POSTER PRESENTATIONS

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