Bryan R Kestenbaum

..Parathyroidectomy (PTX) can dramatically reduce parathyroid hormone (PTH) and phosphate levels; however, the relationship between PTX and survival is not known...

..This review discusses PO(4) metabolism in the context of CKD, examines associations of PO(4) levels with adverse outcomes in the CKD setting, and suggests treatment strategies for moderating serum PO(4) levels...

..Secondary hyperparathyroidism, a disorder characterized by elevated serum parathyroid hormone levels, and alteration of calcium and phosphorus homeostasis are common metabolic complications of CKD that may impact cardiovascular health...

..Associations seemed stronger for participants with CKD; however, no significant interactions were detected. Resting electrocardiographic abnormalities are common in CKD and independently predict future clinical CV events in this setting...

..Kidney disease and hypertension commonly coexist, yet the direction of their association is still debated...

..Our study shows that coronary artery calcification is common in people with stage 3 disease, progresses rapidly, and may contribute to cardiovascular risk...

..05 for each). In conclusion, common genetic variants associate with serum phosphorus in the general population. Further study of the loci identified in this study may help elucidate mechanisms of phosphorus regulation...

..Mortality risk increased linearly with each subsequent 0.5-mg/dl increase in serum phosphate levels. Elevated serum phosphate levels were independently associated with increased mortality risk among this population of patients with CKD...

..We conducted a population-based cohort study to estimate the risks for cardiovascular and thromboembolic events in women with pregnancy-related hypertension...

....

..Higher phosphorus levels are associated with cardiovascular disease (CVD) events and mortality. Whether vascular stiffness may be responsible is unknown...

..It remains to be determined whether lowering phosphate concentrations will impact calcification risk in the setting of kidney disease...

..The association between black race and stroke differs by cardiac disease status; the reasons for this differing effect of race deserve further investigation...

..Compared with creatinine, CysC, a novel marker of renal function, has a stronger and more direct association with SBI in the elderly...

..High-protein diets, which are popular for weight loss, contain large quantities of phosphorus. Phosphorus excess and consequent changes in phosphorus regulatory hormones are implicated in vascular calcification and cardiovascular disease...

..However, correlates of UGIB among ESRD patients remain unknown. We conducted a cohort study of dialysis patients to ascertain risk factors for UGIB...

..CONCLUSIONS: In the MESA cohort, the metabolic syndrome and diabetes mellitus are associated with increased risk of AVC, and AVC prevalence is increased with increasing number of metabolic syndrome components...

..We conclude that common genetic variation in the CASR gene is associated with similar but milder features in the general population...

..These associations may explain the link between serum phosphorus levels and CVD events...

....

..Using eGFR and cystatin C, a novel marker of kidney function, the authors investigated the association of kidney function with multiple biomarkers in a diverse cohort...

..Surgical amelioration of secondary hyperparathyroidism may outweigh the risk of parathyroid hormone oversuppression in terms of bone health...

..We aimed to identify common genetic variants affecting vitamin D concentrations and risk of insufficiency...

..This study sought to determine the association of chronic kidney disease (CKD) with high ankle brachial index (ABI) measurement and to compare its strength with that of CKD with a low ABI...

..We hypothesized that kidney dysfunction would predict diastolic HF (DHF) better than systolic HF (SHF) in the Cardiovascular Health Study...

..45, 0.91). In contrast, the use of fibrates was not associated with reduced mortality (RR=1.29). CONCLUSIONS: Statin use was associated with a reduction in cardiovascular-specific death and total mortality in patients on dialysis...

..In conclusion, in older adults with HF, women had significantly better survival than men irrespective of race, suggesting that gender-based survival differences may be more important than race-based differences...

..The purpose of this study was to determine whether MetS is associated with increased risks for the development of new ("incident") AVC or for progression of established AVC as assessed by CT...

..The objective of this study was to determine whether elevated markers of inflammation are independently associated with longitudinal kidney function decline...

..Joint associations of albuminuria and impaired GFR with mortality have not been comprehensively evaluated in this population...

..Mounting evidence suggests that 1,25-dihydroxyvitamin D prevents the progression of chronic kidney disease (CKD). It is not clear whether "nutritional" forms of vitamin D affect GFR...

..This study was conducted to evaluate mineral metabolism markers as potential risk factors for calcific aortic valve disease...

..Disturbances in mineral metabolism are associated with lower bone mineral density and fracture; however, previous human studies have assessed individual mineral metabolism markers in isolation...

....

..However, these associations were markedly attenuated by age. In conclusion, abnormal lipoprotein levels in middle age are a powerful risk factor for early atherosclerosis, as manifested by prevalent CAC...

..We tested the hypothesis that higher levels of PA are associated with a lower risk of kidney function decline using longitudinal data from a large cohort of older adults...

..We evaluated whether combining inflammation markers and MetS provided additive information for incident CHF and if incorporating inflammation markers to the MetS definition added prognostic information...

..Obesity assessed in midlife has been associated with chronic kidney disease...

....

..AVC progression risk was associated with male gender and the baseline Agatston score. Additional research is needed to determine whether age- and stage-specific mechanisms underlie the risk of AVC progression...

..To our knowledge, the effect of kidney function on successful aging has not been examined...

..Rather, kidney dysfunction in elderly African Americans seems more attributable to differences in environmental and social factors...

..Abnormal lipoprotein metabolism has been implicated as a possible cause of these complications, but lipoproteins have not been described at the earliest stages of kidney disease...

..Accelerated development of atherosclerosis may underlie, in part, the increased cardiovascular risk associated with vitamin D deficiency...

....

..Albuminuria is a risk factor for chronic kidney disease progression, end-stage renal disease, cardiovascular events, and mortality. Animal studies suggested that vitamin D insufficiency may contribute to the pathogenesis of albuminuria...

..To examine the effect of antiretroviral agents and clinical factors on the development of tenofovir-associated kidney dysfunction...

..In conclusion, waist circumference predicts the subsequent development of microalbuminuria in type 1 diabetes. In contrast, no association of waist circumference with decline in creatinine clearance was observed...

..Hepatitis C virus (HCV) is associated with pathologic changes in the kidney. However, the association between HCV and renal dysfunction is not well defined...

..Although prior public health initiatives have focused primarily on cardiac disease among patients treated with dialysis, our data suggest that new initiatives are needed to control the high risk of stroke in this population...

..We sought to determine the association between CCB use and mortality among a cohort of ESRD patients...

..Calcitriol use was associated with a greater risk for hypercalcemia. In conclusion, oral calcitriol use is associated with lower mortality in nondialysis patients with CKD...

..We examined the effect of calcium plus vitamin D supplementation on the incidence of drug-treated diabetes in postmenopausal women...

..However, such studies are limited by the potential for confounding by indication. A large randomized controlled trial is now needed to test the hypothesis that vitamin D therapy improves clinical outcomes in patients with kidney disease...

..Diabetes mellitus and hypertension are closely linked, but the long-term blood pressure effects of glucose-lowering therapy and hyperglycemia are not clear...

..CONCLUSION: The high risk of hip fracture among dialysis patients is exceeded by that among renal transplant patients during the first 1 to 3 years after transplantation...

..Kidney disease is a risk factor for mortality and cardiovascular disease in older adults, but the separate and combined effects of albuminuria and cystatin C, a novel marker of glomerular filtration, are not known...

..These results suggest that a higher burden of CAC is unlikely to explain the association between mild to moderate kidney dysfunction and cardiovascular mortality...

..Factors influencing these rates were assessed as well...

..Whether less severe kidney dysfunction is associated with AVC and MAC is uncertain...

..It remains unknown, however, whether longitudinal declines in kidney function are independently associated with increased cardiovascular and all-cause mortality in older adults...

..Reasons for interindividual variation in steady-state serum phosphorus concentrations are largely unknown...

..We report PTX rates in the United States from 1990 to 1999 among persons with end-stage renal disease, accounting for changes in patient characteristics...

..Those requiring dialysis therapy are at substantially increased risk of fracture. However, fracture risk in patients with CKD not requiring dialysis has not been well studied...

..We examined the impact of allopurinol, the most commonly used urate-lowering drug, on the risk of mortality in hyperuricaemic patients...

..Additional study is needed on the clinically valid definition for and causes of anemia in the elderly and on the increased mortality at the extremes of hemoglobin concentrations...

..We hypothesized that mild and moderate decreases in kidney function, reflected in greater serum cystatin C concentrations, would be linearly associated with a greater prevalence of LVH...

..The association of cystatin C, a novel marker of renal function, with risk for developing complications related to peripheral arterial disease (PAD) has not been examined...

..A high AAI also appears to be associated with higher mortality risk in select populations. However, mortality and cardiovascular risk across the AAI spectrum have not been described in a more broadly defined population...

....

..We therefore explored whether serum cystatin C level is associated with carotid intima-media thickness (IMT) in ambulatory adults without clinical heart disease...

..We analyzed the United States Renal Data System to describe the occurrence of lymphoma following renal transplantation...

..CONCLUSION: Both PEM at baseline and worsening PEM over time are associated with a greater risk for CV death. This finding persists among dialysis patients without preexisting CVD at baseline...

..CONCLUSION: We were unable to confirm the results of previous studies with respect to tHcy level and individual MRI findings, although an association was seen for an MRI pattern combining infarcts and high white matter grade...

..Although the elderly are at increased risk for acute renal failure, few prospective studies have identified risk factors for acute renal failure in the elderly...

..Further studies are needed to evaluate potential mediators of this relationship and to assess whether interventions can decrease this risk...

..Uric acid levels are increased in patients with kidney dysfunction. We tested the hypothesis that uric acid may be associated with kidney disease progression...

..Muscle mass is not a major determinant of serum cystatin C levels, and its use to estimate GFR may lead to more congruent estimates of chronic kidney disease (CKD) across gender and racial/ethnic groups...

..The proposed study aims to shed light on the relationship between a common renal related metabolic disorder and the epidemic burden of CVD found among this patient population. ..

..Proposed analyses aim to clarify the roles of individual mineral markers with respect to CV health among older adults and to pave the way for future trials that target these markers as a means to improve CV outcomes. ..

..Proposed analyses aim to clarify the roles of individual mineral markers with respect to CV health among older adults and to pave the way for future trials that target these markers as a means to improve CV outcomes. ..

..Findings will help clarify optimal serum concentrations of phosphorous and vitamin D biomarkers with respect to cardiovascular health and inform clinical trials which target mineral metabolism to prevent and reduce CVD. ..