S M Moe

..These results demonstrate marked abnormalities in kidney, intestine, and bone in early CKD-MBD. While phosphate binders were effective in lowering urine phosphorus, they had little effect on end organs after 1 week of administration...

..The international adoption of these recommendations will greatly enhance communication, facilitate clinical decision-making, and promote the evolution of evidence-based clinical practice guidelines worldwide...

..Cinacalcet modulates the calcium-sensing receptor on the parathyroid gland to reduce secretion of parathyroid hormone and lower serum calcium, phosphorus and calcium-phosphorus product in haemodialysis patients...

..This suggests protective mechanisms, or naturally occurring inhibitors, of calcification may be important...

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..The combination of the acceleration of vascular calcification together with impaired defense mechanisms creates a uremic milieu primed for extra-osseous calcification...

..Further understanding of the pathophysiology of uremic vascular calcification is needed to design effective therapeutic strategies to intervene with this devastating condition in ESRD patients...

..This nidus can then mineralize if the balance of pro-mineralizing factors outweighs inhibitory factors...

..The purpose of the present study was to determine the natural history of coronary artery and aorta calcification by spiral computed tomography (CT) in patients who undergo a renal transplant and patients on haemodialysis...

..The unique aspects of the approach to renal osteodystrophy in PD patients are the focus of this review...

..The coexistence of vascular risk factors and abnormal bone represent a double threat to the well being of patients with CKD...

..Additional advances in imaging techniques have facilitated the diagnosis of arterial calcification, a critical initial step in the translation of this knowledge to patient care...

..The pathogenesis and clinical manifestations of these components of CKD-MBD are described in detail in this issue of Advances in Chronic Kidney Disease...

..This provides the rationale for recommendations to restrict dietary phosphate intake to 800 mg/d. However, the protein source of the phosphate may also be important...

..Thus, it is best to prevent the calcium overload in the first place by avoiding high-dose calcium-based phosphate binders and optimizing bone remodeling...

..The optimal treatment of secondary hyperparathyroidism in chronic kidney disease (CKD) is unknown...

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..The use of a common, internationally accepted terminology should ease the comparison of studies in this field and eventually improve patient care worldwide...

..This model should help identify early changes in the course of chronic kidney disease that may lead to CKD-MBD...

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..Data showed that hepatitis C may be causally linked to some glomerular diseases, and patients who are positive for hepatitis C have increased risk of albuminuria...

..Together these factors increase risk and complicate the management of vascular calcification...

..Therefore, calcium-based phosphate binders should be avoided in many, if not most, patients who are undergoing dialysis...

..In addition, the development of new, more physiologically relevant therapies, which may lead to successful management of secondary HPT, is reviewed...

..5 mg/dL, a Ca x P product of <55 mg/dL, and a PTH of around 150-200 pg/mL with the intact assay. Ten years ago, those goals would have been impossible. However, new pharmacologic agents will make their achievement much more realistic...

..Patients with ESRD are known to have excessive vascular calcification, but this has previously been attributed to the non-cell-mediated process of metastatic calcification...

..Thus, patients with low PTH levels are unlikely to experience the proimmune effects of vitamin D therapy without more profound and potentially adverse oversuppression of PTH...

..One of the key transcriptional regulators of osteoblast differentiation is Cbfa1. Thus, we hypothesized that this may be a key factor in arterial calcification...

..The purpose of the present study was to utilize an alternative machine, spiral CT, to assess calcification in end-stage renal disease (ESRD) patients...

..Thus beta(2)M itself may elicit the release of inflammatory mediators from synovial fibroblasts even in the absence of cellular infiltrates...

..We hypothesized that one of the mechanisms by which beta2m induces joint destruction is to induce the release of matrix metalloproteinase-1 (MMP-1), but not tissue inhibitor of metalloproteinase-1 (TIMP-1), from synovial fibroblasts...

..To evaluate the symbiotic relationship between musculoskeletal cells in the intact joint utilizing a coculture system and to determine if the model can be utilized to evaluate potential treatments for articular diseases...

..Our studies support that lowering of elevated serum phosphorus, calcium, and Ca x P product, together with aggressive wound care may contribute to the successful outcome of patients with CUA...

..Future therapies and guidelines should, therefore, also emphasize the need for earlier detection and management of CKD, shaped by the results of valid clinical trials...

..CONCLUSION: beta2m directly increases the expression of VCAM-1 by synovial fibroblasts, indicating that synovial fibroblasts may play a key role in the pathogenesis of beta(2)m amyloidosis...

..However, prospective randomized trials in CKD patients are necessary to fully understand the impact of calcitriol and analog therapy on vascular calcification...

..015). CONCLUSION: This cross-sectional cohort study found a high prevalence of calcidiol deficiency and insufficiency in patients with moderate and severe CKD not on dialysis therapy regardless of geographic location...

..Histologic examination suggests that the calcification is associated with increased expression of osteopontin by smooth muscle cells...

..The purpose of the present study was to determine the intrapatient variation of C-reactive protein, IL-6, fetuin-A and albumin in a population of dialysis patients...

..Conversely, in human monocyte/macrophages, AGE-beta(2)M stimulates cytokine release whereas beta(2)M is less potent...

..BMP-2 is also increased in uremic serum and can upregulate RUNX2 and calcification in vitro in VSMCs...

..However, no prospective trials have evaluated whether interventions that modify these laboratory parameters result in a reduction in adverse cardiovascular outcomes...

..However, it is possible that with the continuing advances in optimizing the beta(2)M removal efficiency of the different membranes, the frequency and severity of the disease can be substantially decreased...

..In conclusion, our results suggest that mineralization in VSMCs requires both active MVs and an interaction of the MVs with type I collagen, and both steps require annexin activity...

..The benefit of R-568 alone suggests calcium-sensing receptor modulation may have additional inhibitory effects on late-stage cyst growth resulting from a direct modulation of intracellular calcium...

..We have demonstrated that beta2m increases the expression of vascular cell adhesion molecule (VCAM-1) and cyclooxygenase-2 (COX-2) in human osteoarthritic synovial fibroblasts (SFLs)...

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..Short daily hemodialysis (SDHD) is an alternative to thrice-weekly HD because of its putative physiologic benefits. The purpose of this study was to investigate the effect of SDHD on the pharmacokinetics and pharmacodynamics of vancomycin...

..These results demonstrate that the RhoA/ROCK signaling pathway is an important negative regulator of vascular calcification...

..The authors conducted a 3-way, randomized, crossover study to determine the effects of sevelamer hydrochloride and calcium acetate on the relative oral bioavailability of ciprofloxacin...

..This regulated uptake may be a mechanism by which fetuin-A inhibits VSMC calcification in the presence of excess calcium...

..Dialysis patients have accelerated atherosclerosis, with extensive calcification of both the intima and media. Cross-sectional studies have implicated hyperphosphatemia in this process, but the mechanism is unclear...

..Further understanding of the mechanism by which diabetes induces this complication is needed to design effective therapeutic strategies to intervene with this process...

..In addition, it is likely that circulating inhibitors of calcification are also important. Further understanding of the pathophysiology of vascular calcification is needed to intervene appropriately...

..Further understanding of the pathophysiology of uremic vascular calcification is needed to design effective therapeutic strategies to intervene with this devastating condition in patients with stage V chronic kidney disease...

..Vascular calcification is common in diabetes but the pathogenesis is poorly understood...

..Further understanding of the pathophysiological state of uremic vascular calcification is needed to design effective therapeutic strategies to intervene with this devastating condition in the ESRD population...

..There is reason to believe that hemodialysis patients are at risk for inadequate omega-3 intake and, consequently, low blood levels...

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..The unknown is what type and how much to give, and whether this approach is safe, especially in patients with low levels of PTH...

..Bisphosphonates reduce skeletal loss and fracture risk, but their use has been limited in patients with chronic kidney disease. This study shows skeletal benefits of zoledronic acid in an animal model of chronic kidney disease...

..Calciphylaxis is a rare condition with dismal prognosis that affects patients with ESRD. Sodium thiosulfate (STS) may play a therapeutic role but its proposed efficacy is based on case reports and thus subject to publication bias...

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..Further studies are warranted to demonstrate evidence for the use of serial screening echocardiography in this high-risk population...

..In this cross-sectional study, we aim to determine the usefulness of standardizing blood handling for optimal interpretation of PTH in patients with chronic kidney disease...

..The calcimimetic AMG 073 increases the sensitivity of the parathyroid calcium-sensing receptor to extracellular calcium, thereby reducing PTH secretion. Consequently, AMG 073 may provide a novel therapy for secondary hyperparathyroidism...

..We report the results of two identical randomized, double-blind, placebo-controlled trials evaluating the safety and effectiveness of the calcimimetic agent cinacalcet hydrochloride...

..All patients with cardiovascular disease should be screened for evidence of kidney disease with these two determinations...

..These studies, Dr. Moe, and the strong clinical research support at Indiana Unviersity provide an excellent training environment for the development of future investigators in patient oriented research. ..

..Both of these problems may be linked. The purpose of this study is to determine if a commonly used group of drugs, bisphosphonates, may help both bone and heart/blood vessel disease and determine the mechanism the drugs work. ..