23 results on '"Pendón Ruiz de Mier MV"'
Search Results
2. Assessment of Inorganic Phosphate Intake by the Measurement of the Phosphate/Urea Nitrogen Ratio in Urine
- Author
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Arnold J. Felsenfeld, María Dolores López-Zamorano, Cristina Membrives-González, Francisco Caravaca, Rafael Santamaria, Noemi Vergara, Eugenio J De la Torre, Sagrario Soriano, Rodrigo López-Baltanás, Mariano Rodriguez, Maria Victoria Pendon-Ruiz de Mier, Cristian Rodelo-Haad, Juan R. Muñoz-Castañeda, Alejandro Martin-Malo, [Pendón-Ruiz de Mier,MV, Vergara,N, Rodelo-Haad,C, Membrives-González,C, López-Baltanás,R, Muñoz-Castañeda,JR, Martín-Malo,A, Soriano,S, Santamaría,R, Rodríguez,M] Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Reina Sofia University Hospital, Nephrology Service, University of Cordoba, Cordoba, Spain. [Pendón-Ruiz de Mier,MV, Santamaría,R] Spanish Renal Research Network (REDinREN), Institute of Health Carlos III, Madrid, Spain. [López-Zamorano,MD] Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain. [Muñoz-Castañeda,JR, Rodríguez,M] EUTOXandCKD-MBD groups of the ERA-EDTA, Spanish Renal Research Network (REDinREN), Institute of Health Carlos III, Madrid, Spain. [Caravaca,F] Nephrology Service, Infanta Cristina Hospital, Badajoz, Spain. [Felsenfeld,AJ] Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System and the David Geffen School of Medicine, University of California, Los Angeles, USA. [De la Torre,EJ] General Medicine, Miguelturra Clinic, Ciudad Real, Spain., and This work was supported by a Spanish government grant from the Programa Nacional I+D+I 2013–2016 and Instituto de Salud Carlos III (ISCIII) Grants PI18/0138, PI17/01010 co-financing from European Funds (FEDER), Consejería de Salud and EUTOX and REDinREN from the ISCIII. J.R.M.-C. is senior researcher supported by the Nicolás Monardes Programme, Consejería de Salud-Servicio Andaluz de Salud (Junta de Andalucía).
- Subjects
Factor de crecimiento fibroblástico 23 ,Male ,phosphate intake ,030232 urology & nephrology ,Urine ,030204 cardiovascular system & hematology ,Intestinal absorption ,Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] ,chemistry.chemical_compound ,Eating ,0302 clinical medicine ,FGF23 ,Organisms::Eukaryota::Animals [Medical Subject Headings] ,Urea ,Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Rodentia::Muridae::Murinae::Rats::Rats, Wistar [Medical Subject Headings] ,Insuficiencia renal crónica ,Persons::Persons::Age Groups::Adult::Aged [Medical Subject Headings] ,Nutrition and Dietetics ,Chemicals and Drugs::Organic Chemicals::Urea [Medical Subject Headings] ,Urea nitrogen ,Middle Aged ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cross-Sectional Studies [Medical Subject Headings] ,phosphaturia ,Hormona paratiroidea ,Female ,lcsh:Nutrition. Foods and food supply ,PTH ,Adult ,Hipofosfatemia familiar ,Urinary system ,Check Tags::Male [Medical Subject Headings] ,lcsh:TX341-641 ,Phenomena and Processes::Physiological Phenomena::Nutritional Physiological Phenomena::Diet [Medical Subject Headings] ,Article ,Phosphates ,03 medical and health sciences ,Inorganic phosphate ,Animal science ,medicine ,CKD ,Animals ,Humans ,Rats, Wistar ,Persons::Persons::Age Groups::Adult [Medical Subject Headings] ,Aged ,Persons::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings] ,Chemicals and Drugs::Biological Factors::Intercellular Signaling Peptides and Proteins::Fibroblast Growth Factors [Medical Subject Headings] ,medicine.disease ,Phosphate ,Diet ,Rats ,Chemicals and Drugs::Inorganic Chemicals::Acids::Acids, Noncarboxylic::Phosphorus Acids::Phosphoric Acids::Phosphates [Medical Subject Headings] ,Fibroblast Growth Factor-23 ,Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Rodentia::Muridae::Murinae::Rats [Medical Subject Headings] ,Cross-Sectional Studies ,chemistry ,Check Tags::Female [Medical Subject Headings] ,Metabolic syndrome ,Food Science ,Kidney disease - Abstract
In chronic kidney disease (CKD) patients, it would be desirable to reduce the intake of inorganic phosphate (P) rather than limit the intake of P contained in proteins. Urinary excretion of P should reflect intestinal absorption of P(inorganic plus protein-derived). The aim of the present study is to determine whether the ratio of urinary P to urinary urea nitrogen (P/UUN ratio) helps identify patients with a high intake of inorganic P.A cross-sectional study was performed in 71 patients affected by metabolic syndrome with CKD (stages 2&ndash, 3) with normal serum P concentration. A 3-day dietary survey was performed to estimate the average daily amount and the source of P ingested. The daily intake of P was 1086.5 ±, 361.3 mg/day, 64% contained in animal proteins, 22% in vegetable proteins, and 14% as inorganic P. The total amount of P ingested did not correlate with daily phosphaturia, but it did correlate with the P/UUN ratio (p <, 0.018). Patients with the highest tertile of the P/UUN ratio >, 71.1 mg/g presented more abundant inorganic P intake (p <, 0.038).The P/UUN ratio is suggested to be a marker of inorganic P intake. This finding might be useful in clinical practices to identify the source of dietary P and to make personalized dietary recommendations directed to reduce inorganic P intake.
- Published
- 2021
- Full Text
- View/download PDF
3. Control of hyperparathyroidism with the intravenous calcimimetic etelcalcetide in dialysis patients adherent and non-adherent to oral calcimimetics
- Author
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M. Victoria Pendón-Ruiz de Mier, Mariano Rodriguez, Maria Dolores Arenas, Cristian Rodelo-Haad, [Arenas,MD] Nephrology Department, Vithas Perpetuo Socorro International, Alicante, Spain. [Arenas,MD] Nefrologia Clínica y Dialisis, Consorci Parc de Salut Mar, Barcelona, Spain. [Rodelo-Haad,C, Pendón-Ruiz de Mier,MV, Rodriguez,M] Maimonides Biomedical Research Institute of Cordoba (IMIBIC)/Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain. [Rodelo-Haad,C, Rodriguez,M] Nephrology Service, Reina Sofia University Hospital, Cordoba, Spain. [Rodelo-Haad,C, Rodriguez,M] RETICs-REDinREN (National Institute of Health Carlos III), Madrid, Spain., and M.V.P.-R.d.M. is the recipient of a research contract sup ported by the Rio Hortega Programme from the National Institute of Health Carlos III.
- Subjects
Cinacalcet ,Calcimimetic ,medicine.medical_treatment ,030232 urology & nephrology ,Parathyroid hormone ,Diseases::Endocrine System Diseases::Parathyroid Diseases::Hyperparathyroidism::Hyperparathyroidism, Secondary [Medical Subject Headings] ,030204 cardiovascular system & hematology ,Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] ,0302 clinical medicine ,adherence ,Cumplimiento de la medicación ,Etelcalcetide ,etelcalcetide ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Questionnaires [Medical Subject Headings] ,Chemicals and Drugs::Inorganic Chemicals::Phosphorus Compounds::Phosphorus Acids::Phosphoric Acids::Phosphates [Medical Subject Headings] ,Chemicals and Drugs::Inorganic Chemicals::Calcium Compounds [Medical Subject Headings] ,Persons::Persons::Patients [Medical Subject Headings] ,Nephrology ,Hormona paratiroidea ,Pacientes ,Secondary hyperparathyroidism ,Hemodialysis ,medicine.symptom ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Chemistry Techniques, Analytical::Dialysis [Medical Subject Headings] ,PTH ,medicine.drug ,medicine.medical_specialty ,Urology ,cinacalcet ,Asymptomatic ,Hiperparatiroidismo secundario ,Calcio ,03 medical and health sciences ,medicine ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Renal Replacement Therapy::Renal Dialysis [Medical Subject Headings] ,AcademicSubjects/MED00340 ,Transplantation ,Hyperparathyroidism ,calcium ,business.industry ,Adhesión celular ,Diálisis ,Original Articles ,medicine.disease ,Chemicals and Drugs::Hormones, Hormone Substitutes, and Hormone Antagonists::Hormones::Peptide Hormones::Parathyroid Hormone [Medical Subject Headings] ,Adherence ,Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Health Behavior::Patient Compliance::Medication Adherence [Medical Subject Headings] ,Calcium ,business - Abstract
Background In dialysis patients, non-adherence to oral cinacalcet adds complexity to the control of secondary hyperparathyroidism. The present study aims to evaluate the use of intravenous calcimimetic, etelcalcetide, in the control of secondary hyperparathyroidism in patients adherent and non-adherent to oral calcimimetics. Method The Simplified Medication Adherence Questionnaire was used to identify non-adherence. Almost half of the patients were non-adherent to the treatment with cinacalcet. Twenty-five patients (15 non-adherent) were switched from cinacalcet to etelcalcetide and were followed-up monthly for 8 months. Results Cinacalcet was discontinued for 1 week before the initiation of etelcalcetide. After this period, the serum PTH levels increased by2-fold in adherent patients, whereas it did not change in non-adherent patients suggesting that they were not taking the medication. Etelcalcetide progressively reduced serum parathyroid hormone (PTH) (mean ± standard deviation) from 818 ± 395 to 367 ± 289 pg/mL (P Conclusion The lack of adherence to cinacalcet is a possible cause of the apparent lack of response to oral calcimimetic. The use of etelcalcetide ensures compliance and control of secondary hyperparathyroidism in both non-adherent and adherent patients.
- Published
- 2020
4. The Role of Disturbed Mg Homeostasis in Chronic Kidney Disease Comorbidities
- Author
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Rodelo-Haad, Cristian, Pendón-Ruiz de Mier, M. Victoria, Díaz-Tocados, Juan Miguel, Martin-Malo, Alejandro, Santamaria, Rafael, Muñoz-Castañeda, Juan Rafael, Rodríguez, Mariano, [Rodelo-Haad,C, Pendón-Ruiz de Mier,MV, Díaz-Tocados,JM, Martin-Malo,A, Santamaria,R, Muñoz-Castañeda,JR, Rodríguez,M] Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain. [Rodelo-Haad,C, Rodríguez,M] University of Córdoba, Córdoba, Spain. [Rodelo-Haad,C, Rodríguez,M] Nephrology Service, Reina Sofia University Hospital, Córdoba, Spain. [Rodelo-Haad,C, Rodríguez,M] Spanish Renal Research Network (REDinREN), Institute of Health Carlos III, Madrid, Spain., and JRM-C is a senior researcher supported by the Nicolás Monardes Program from Consejeria de Salud-SAS (Junta de Andalucía). This study was supported by grants from the National Institute of Health Carlos III (FIS 17/01010, and FIS 18/0138), the Consejeria de Salud of Junta de Andalucía (PI-0136-2016), the REDinREN from the National Institute of Health Carlos III, the EUTox Workgroup, and the EDTA CKD-MBD group. The sponsors had no influence in study design, data collection, and analysis, decision to publish, or preparation of the manuscript.
- Subjects
Diseases::Nutritional and Metabolic Diseases::Metabolic Diseases::Calcium Metabolism Disorders::Calcinosis::Vascular Calcification [Medical Subject Headings] ,Diseases::Male Urogenital Diseases::Urologic Diseases::Kidney Diseases::Renal Insufficiency::Renal Insufficiency, Chronic [Medical Subject Headings] ,Diseases::Endocrine System Diseases::Diabetes Mellitus [Medical Subject Headings] ,Enfermedades óseas ,Mineral metabolism and bone disease ,Chemicals and Drugs::Inorganic Chemicals::Minerals [Medical Subject Headings] ,Cardiovascular disease ,Anatomy::Cardiovascular System::Blood Vessels::Arteries::Coronary Vessels [Medical Subject Headings] ,Chemicals and Drugs::Inorganic Chemicals::Elements::Metals, Alkaline Earth::Magnesium [Medical Subject Headings] ,Diseases::Female Urogenital Diseases and Pregnancy Complications::Female Urogenital Diseases::Urologic Diseases::Kidney Diseases::Renal Insufficiency::Renal Insufficiency, Chronic [Medical Subject Headings] ,Magnesio ,Diseases::Cardiovascular Diseases::Vascular Diseases::Hypertension [Medical Subject Headings] ,Chronic kidney disease ,Technology and Food and Beverages::Food and Beverages::Food::Dietary Supplements [Medical Subject Headings] ,Hypomagnesemia ,Magnesium ,Diseases::Musculoskeletal Diseases::Bone Diseases [Medical Subject Headings] ,Enfermedades cardiovasculares ,Phenomena and Processes::Metabolic Phenomena::Metabolism::Oxidative Stress [Medical Subject Headings] ,Diseases::Cardiovascular Diseases [Medical Subject Headings] ,Phenomena and Processes::Physiological Phenomena::Physiological Processes::Homeostasis [Medical Subject Headings] ,Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Inflammation [Medical Subject Headings] - Abstract
Some of the critical mechanisms that mediate chronic kidney disease (CKD) progression are associated with vascular calcifications, disbalance of mineral metabolism, increased oxidative and metabolic stress, inflammation, coagulation abnormalities, endothelial dysfunction, or accumulation of uremic toxins. Also, it is widely accepted that pathologies with a strong influence in CKD progression are diabetes, hypertension, and cardiovascular disease (CVD). A disbalance in magnesium (Mg) homeostasis, more specifically hypomagnesemia, is associated with the development and progression of the comorbidities mentioned above, and some mechanisms might explain why low serum Mg is associated with negative clinical outcomes such as major adverse cardiovascular and renal events. Furthermore, it is likely that hypomagnesemia causes the release of inflammatory cytokines and C-reactive protein and promotes insulin resistance. Animal models have shown that Mg supplementation reverses vascular calcifications; thus, clinicians have focused on the potential benefits that Mg supplementation may have in humans. Recent evidence suggests that Mg reduces coronary artery calcifications and facilitates peripheral vasodilation. Mg may reduce vascular calcification by direct inhibition of the Wnt/β-catenin signaling pathway. Furthermore, Mg deficiency worsens kidney injury induced by an increased tubular load of phosphate. One important consequence of excessive tubular load of phosphate is the reduction of renal tubule expression of α-Klotho in moderate CKD. Low Mg levels worsen the reduction of Klotho induced by the tubular load of phosphate. Evidence to support clinical translation is yet insufficient, and more clinical studies are required to claim enough evidence for decision-making in daily practice. Meanwhile, it seems reasonable to prevent and treat Mg deficiency. This review aims to summarize the current understanding of Mg homeostasis, the potential mechanisms that may mediate the effect of Mg deficiency on CKD progression, CVD, and mortality. Yes
- Published
- 2020
5. Comparative effects of calcitriol and calcimimetic on bone health in renal insufficiency.
- Author
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Díaz-Tocados JM, Rodríguez-Ortiz ME, Herencia C, López-Baltanás R, Jurado-Montoya D, García-Saez RM, Valdés-Díaz K, Martínez-Moreno JM, Santamaría R, Pendón-Ruiz de Mier MV, Rodelo-Haad C, Frazão JM, Felsenfeld AJ, Rodríguez M, Almadén Y, and Muñoz-Castañeda JR
- Subjects
- Animals, Rats, Male, Hyperparathyroidism, Secondary drug therapy, Hyperparathyroidism, Secondary etiology, Hyperparathyroidism, Secondary metabolism, Bone and Bones metabolism, Bone and Bones drug effects, Rats, Wistar, Renal Insufficiency drug therapy, Renal Insufficiency metabolism, Osteogenesis drug effects, Renal Insufficiency, Chronic drug therapy, Renal Insufficiency, Chronic metabolism, Renal Insufficiency, Chronic complications, Cell Differentiation drug effects, Calcium metabolism, Calcitriol pharmacology, Calcimimetic Agents pharmacology, Calcimimetic Agents therapeutic use, Parathyroid Hormone pharmacology, Osteoblasts drug effects, Osteoblasts metabolism
- Abstract
Calcitriol and calcimimetics are used to treat hyperparathyroidism secondary to chronic kidney disease (CKD). Calcitriol administration and the subsequent increase in serum calcium concentration decrease parathyroid hormone (PTH) levels, which should reduce bone remodeling. We have previously reported that, when maintaining a given concentration of PTH, the addition of calcimimetics is associated with an increased bone cell activity. Whether calcitriol administration affects bone cell activity while PTH is maintained constant should be evaluated in an animal model of renal osteodystrophy. The aim of the present study was to compare in CKD PTH-clamped rats the bone effects of calcitriol and calcimimetic administration. The results show that the administration of calcitriol and calcimimetic at doses that induced a similar reduction in PTH secretion produced dissimilar effects on osteoblast activity in 5/6 nephrectomized (Nx) rats with secondary hyperparathyroidism and in Nx rats with clamped PTH. Remarkably, in both rat models, the administration of calcitriol decreased osteoblastic activity, whereas calcimimetic increased bone cell activity. In vitro, calcitriol supplementation inhibited nuclear translocation of β-catenin and reduced proliferation, osteogenesis, and mineralization in mesenchymal stem cells differentiated into osteoblasts. In conclusion, besides the action of calcitriol and calcimimetics at parathyroid level, these treatments have specific effects on bone cells that are independent of the PTH level., (© 2024 The Author(s). The FASEB Journal published by Wiley Periodicals LLC on behalf of Federation of American Societies for Experimental Biology.)
- Published
- 2024
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6. Cognitive Impairment Related to Chronic Kidney Disease Is Associated with a Decreased Abundance of Membrane-Bound Klotho in the Cerebral Cortex.
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Rodríguez-Ortiz ME, Jurado-Montoya D, Valdés-Díaz K, García-Sáez RM, Torralbo AI, Obrero T, Vidal-Jiménez V, Jiménez MJ, Carmona A, Guerrero F, Pendón-Ruiz de Mier MV, Rodelo-Haad C, Canalejo A, Rodríguez M, Soriano-Cabrera S, and Muñoz-Castañeda JR
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- Animals, Male, Rats, Disease Models, Animal, Fibroblast Growth Factor-23 metabolism, Fibroblast Growth Factors metabolism, Kidney metabolism, Rats, Wistar, Cerebral Cortex metabolism, Cognitive Dysfunction metabolism, Cognitive Dysfunction etiology, Glucuronidase metabolism, Klotho Proteins metabolism, Renal Insufficiency, Chronic metabolism
- Abstract
Cognitive impairment (CI) is a complication of chronic kidney disease (CKD) that is frequently observed among patients. The aim of this study was to evaluate the potential crosstalk between changes in cognitive function and the levels of Klotho in the brain cortex in an experimental model of CKD. To induce renal damage, Wistar rats received a diet containing 0.25% adenine for six weeks, while the control group was fed a standard diet. The animals underwent different tests for the assessment of cognitive function. At sacrifice, changes in the parameters of mineral metabolism and the expression of Klotho in the kidney and frontal cortex were evaluated. The animals with CKD exhibited impaired behavior in the cognitive tests in comparison with the rats with normal renal function. At sacrifice, CKD-associated mineral disorder was confirmed by the presence of the expected disturbances in the plasma phosphorus, PTH, and both intact and c-terminal FGF23, along with a reduced abundance of renal Klotho. Interestingly, a marked and significant decrease in Klotho was observed in the cerebral cortex of the animals with renal dysfunction. In sum, the loss in cerebral Klotho observed in experimental CKD may contribute to the cognitive dysfunction frequently observed among patients. Although further studies are required, Klotho might have a relevant role in the development of CKD-associated CI and represent a potential target in the management of this complication.
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- 2024
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7. Dietary Mg Supplementation Decreases Oxidative Stress, Inflammation, and Vascular Dysfunction in an Experimental Model of Metabolic Syndrome with Renal Failure.
- Author
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López-Baltanás R, Rodríguez-Ortiz ME, Díaz-Tocados JM, Martinez-Moreno JM, Membrives C, Rodelo-Haad C, Pendón Ruiz de Mier MV, Rodríguez M, Canalejo A, Almadén Y, and Muñoz-Castañeda JR
- Abstract
Background: Metabolic syndrome (MetS) and chronic kidney disease (CKD) are commonly associated with cardiovascular disease (CVD) and in these patients Mg concentration is usually decreased. This study evaluated whether a dietary Mg supplementation might attenuate vascular dysfunction through the modulation of oxidative stress and inflammation in concurrent MetS and CKD., Methods: A rat model of MetS (Zucker strain) with CKD (5/6 nephrectomy, Nx) was used. Nephrectomized animals were fed a normal 0.1%Mg (MetS+Nx+Mg0.1%) or a supplemented 0.6%Mg (MetS+Nx+Mg0.6%) diet; Sham-operated rats with MetS receiving 0.1%Mg were used as controls., Results: As compared to controls, the MetS+Nx-Mg0.1% group showed a significant increase in oxidative stress and inflammation biomarkers (lipid peroxidation and aortic interleukin-1b and -6 expression) and Endothelin-1 levels, a decrease in nitric oxide and a worsening in uremia and MetS associated pathology as hypertension, and abnormal glucose and lipid profile. Moreover, proteomic evaluation revealed changes mainly related to lipid metabolism and CVD markers. By contrast, in the MetS+Nx+Mg0.6% group, these parameters remained largely similar to controls., Conclusion: In concurrent MetS and CKD, dietary Mg supplementation reduced inflammation and oxidative stress and improved vascular function.
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- 2023
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8. Chronic kidney disease and vascular risk - what's new?
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Santamaría Olmo R, Pendón Ruiz de Mier MV, and Rodelo Haad C
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- Humans, Renal Insufficiency, Chronic epidemiology
- Published
- 2022
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9. Assessment of Inorganic Phosphate Intake by the Measurement of the Phosphate/Urea Nitrogen Ratio in Urine.
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Pendón-Ruiz de Mier MV, Vergara N, Rodelo-Haad C, López-Zamorano MD, Membrives-González C, López-Baltanás R, Muñoz-Castañeda JR, Caravaca F, Martín-Malo A, Felsenfeld AJ, De la Torre EJ, Soriano S, Santamaría R, and Rodríguez M
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- Adult, Aged, Animals, Cross-Sectional Studies, Female, Fibroblast Growth Factor-23, Humans, Male, Middle Aged, Rats, Rats, Wistar, Diet, Eating, Phosphates administration & dosage, Phosphates urine, Urea urine
- Abstract
In chronic kidney disease (CKD) patients, it would be desirable to reduce the intake of inorganic phosphate (P) rather than limit the intake of P contained in proteins. Urinary excretion of P should reflect intestinal absorption of P(inorganic plus protein-derived). The aim of the present study is to determine whether the ratio of urinary P to urinary urea nitrogen (P/UUN ratio) helps identify patients with a high intake of inorganic P.A cross-sectional study was performed in 71 patients affected by metabolic syndrome with CKD (stages 2-3) with normal serum P concentration. A 3-day dietary survey was performed to estimate the average daily amount and the source of P ingested. The daily intake ofPwas1086.5 ± 361.3mg/day; 64% contained in animal proteins, 22% in vegetable proteins, and 14% as inorganic P. The total amount of P ingested did not correlate with daily phosphaturia, but it did correlate with the P/UUN ratio ( p < 0.018). Patients with the highest tertile of the P/UUN ratio >71.1 mg/g presented more abundant inorganic P intake ( p < 0.038).The P/UUN ratio is suggested to be a marker of inorganic P intake. This finding might be useful in clinical practices to identify the source of dietary P and to make personalized dietary recommendations directed to reduce inorganic P intake.
- Published
- 2021
- Full Text
- View/download PDF
10. The Role of Disturbed Mg Homeostasis in Chronic Kidney Disease Comorbidities.
- Author
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Rodelo-Haad C, Pendón-Ruiz de Mier MV, Díaz-Tocados JM, Martin-Malo A, Santamaria R, Muñoz-Castañeda JR, and Rodríguez M
- Abstract
Some of the critical mechanisms that mediate chronic kidney disease (CKD) progression are associated with vascular calcifications, disbalance of mineral metabolism, increased oxidative and metabolic stress, inflammation, coagulation abnormalities, endothelial dysfunction, or accumulation of uremic toxins. Also, it is widely accepted that pathologies with a strong influence in CKD progression are diabetes, hypertension, and cardiovascular disease (CVD). A disbalance in magnesium (Mg) homeostasis, more specifically hypomagnesemia, is associated with the development and progression of the comorbidities mentioned above, and some mechanisms might explain why low serum Mg is associated with negative clinical outcomes such as major adverse cardiovascular and renal events. Furthermore, it is likely that hypomagnesemia causes the release of inflammatory cytokines and C-reactive protein and promotes insulin resistance. Animal models have shown that Mg supplementation reverses vascular calcifications; thus, clinicians have focused on the potential benefits that Mg supplementation may have in humans. Recent evidence suggests that Mg reduces coronary artery calcifications and facilitates peripheral vasodilation. Mg may reduce vascular calcification by direct inhibition of the Wnt/β-catenin signaling pathway. Furthermore, Mg deficiency worsens kidney injury induced by an increased tubular load of phosphate. One important consequence of excessive tubular load of phosphate is the reduction of renal tubule expression of α-Klotho in moderate CKD. Low Mg levels worsen the reduction of Klotho induced by the tubular load of phosphate. Evidence to support clinical translation is yet insufficient, and more clinical studies are required to claim enough evidence for decision-making in daily practice. Meanwhile, it seems reasonable to prevent and treat Mg deficiency. This review aims to summarize the current understanding of Mg homeostasis, the potential mechanisms that may mediate the effect of Mg deficiency on CKD progression, CVD, and mortality., (Copyright © 2020 Rodelo-Haad, Pendón-Ruiz de Mier, Díaz-Tocados, Martin-Malo, Santamaria, Muñoz-Castañeda and Rodríguez.)
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- 2020
- Full Text
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11. Hemodiafiltration with ultrafiltrate regeneration reduces free light chains without albumin loss in multiple myeloma patients.
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Pendón-Ruiz de Mier MV, Ojeda R, Álvarez-Lara MA, Navas A, Alonso C, Caballero-Villarraso J, Aljama P, Álvarez MA, Soriano S, Rodríguez M, and Martín-Malo A
- Subjects
- Acute Kidney Injury etiology, Acute Kidney Injury therapy, Aged, Aged, 80 and over, Creatinine blood, Female, Humans, Male, Middle Aged, Multiple Myeloma complications, Acute Kidney Injury blood, Hemodiafiltration methods, Immunoglobulin kappa-Chains blood, Immunoglobulin lambda-Chains blood, Multiple Myeloma blood, Serum Albumin analysis
- Abstract
Background: Acute kidney injury (AKI) occurs in 12-20% of multiple myeloma (MM) patients. Several studies have shown a reduction of free light chains (FLC) using hemodialysis with High-Cut-Off membranes. However, this technique entails albumin loss. Hemodiafiltration with ultrafiltrate regeneration is a technique that includes a process of adsorption. The aim of this study was to evaluate the effectiveness of hemodiafiltration with ultrafiltrate regeneration in reducing FLC levels without causing albumin loss., Methods: This is an observational study (2012 to 2018) including nine patients with MM (5 kappa, 4 lambda) and AKI. All patients were treated with chemotherapy and hemodiafiltration with ultrafiltrate regeneration. Blood Samples (pre and post-dialysis) and ultrafiltrate were collected pre and post-resin at 5 min after initiation of the session and 5 min before the end of the procedure., Results: The serum levels of kappa and lambda were reduced by a 57.6 ± 10% and 33.5 ± 25% respectively. Serum albumin concentration remained unchanged after the procedure. In the ultrafiltrate, the mean FLC reduction ratio shortly after initiation of the dialysis procedure was: 99.2 and 97.06% for kappa and lambda respectively, and only 0.7% for albumin; and at the end of the session the percent reduction was: 63.7 and 33.62% for kappa and lambda respectively, and 0.015% for albumin. Patients clinical outcome was: 33.3% recovered renal function, 22.2% died during the first year and 44.4% required maintenance dialysis., Conclusions: Hemodiafiltration with ultrafiltrate regeneration reduces FLC levels without producing a significant loss of albumin; and, FLC removal is maintained throughout the session. Therefore, hemodiafiltration with ultrafiltrate regeneration may be considered an effective adjunctive therapy in patients with MM.
- Published
- 2020
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12. Magnesium: An old player revisited in the context of CKD-MBD.
- Author
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Pendón-Ruiz de Mier MV, Rodelo-Haad C, Díaz-Tocados JM, Muñoz-Castañeda JR, and Rodríguez M
- Subjects
- Chronic Kidney Disease-Mineral and Bone Disorder blood, Chronic Kidney Disease-Mineral and Bone Disorder pathology, Dietary Supplements, Humans, Magnesium administration & dosage, Magnesium blood, Chronic Kidney Disease-Mineral and Bone Disorder prevention & control, Magnesium pharmacology
- Abstract
Chronic kidney disease (CKD) is associated with a wide number of abnormalities in mineral metabolism. Often, these alterations are the leading players in the development of comorbidities associated with CKD, which are risk factors of mortality. In this context, mineral and bone disorder associated with CKD (CKD-MBD) are highlighted, connecting bone, renal, and cardiovascular disorders. Many studies have been led to propose strategies to avoid, reduce, or slow down CKD-MBD progression using different compositions of metallic elements-based P binders such as aluminum, magnesium, or calcium. Magnesium, the aim of this review, has been used by nephrologists to treat CKD-MBD with a variable acceptation due mainly to different results on bone homeostasis. Nowadays, we have new evidence about the efficacy of magnesium supplementation on vascular calcification, renal function, and bone disorders, suggesting potential beneficial effects of Magnesium in the management of CKD-MBD., (Copyright © 2019 Elsevier B.V. All rights reserved.)
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- 2020
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13. Parathyroidectomy in dialysis patients: Indications, methods, and consequences.
- Author
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Rodríguez-Ortiz ME, Pendón-Ruiz de Mier MV, and Rodríguez M
- Subjects
- Biomarkers blood, Humans, Hyperparathyroidism, Secondary etiology, Hyperparathyroidism, Secondary surgery, Kidney Failure, Chronic complications, Kidney Failure, Chronic therapy, Parathyroidectomy, Renal Dialysis
- Abstract
Secondary hyperparathyroidism, characterized by increased PTH synthesis and secretion, is often seen in advanced stages of chronic kidney disease. Excessive proliferation of parathyroid cells leads to the development of diffuse hyperplasia that subsequently progresses to nodular histology. Refractory hyperparathyroidism occurs when parathyroid glands fail to respond to medical therapy. Parathyroidectomy (PTX), surgical resection of parathyroid glands, is usually performed in cases of persistent serum levels of PTH above 1000 pg/mL associated with hypercalcemia or when hyperparathyroidism is refractory to conservative therapy. Parathyroidectomy can be carried out using different procedures: subtotal PTX or total PTX with or without parathyroid autotransplantation. Parathyroid surgery may have undesirable consequences due to PTH oversuppression, such as the development of adynamic bone disease; hungry bone syndrome is quite common after this surgery. However, PTX improves survival and parameters of mineral metabolism. Parathyroidectomy needs to be considered in those patients with severe hyperparathyroidism with a poor response to pharmacological treatment and with distinct undesirable effects of PTH on bone and mineral metabolism parameters., (© 2019 Wiley Periodicals, Inc.)
- Published
- 2019
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14. Calcimimetics maintain bone turnover in uremic rats despite the concomitant decrease in parathyroid hormone concentration.
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Díaz-Tocados JM, Rodríguez-Ortiz ME, Almadén Y, Pineda C, Martínez-Moreno JM, Herencia C, Vergara N, Pendón-Ruiz de Mier MV, Santamaría R, Rodelo-Haad C, Casado-Díaz A, Lorenzo V, Carvalho C, Frazão JM, Felsenfeld AJ, Richards WG, Aguilera-Tejero E, Rodríguez M, López I, and Muñoz-Castañeda JR
- Subjects
- Animals, Disease Models, Animal, Humans, Hyperparathyroidism, Secondary blood, Hyperparathyroidism, Secondary etiology, Male, Osteoblasts drug effects, Parathyroid Hormone administration & dosage, Parathyroid Hormone blood, Parathyroid Hormone metabolism, Rats, Rats, Wistar, Receptors, Calcium-Sensing metabolism, Biphenyl Compounds administration & dosage, Bone Remodeling drug effects, Calcimimetic Agents administration & dosage, Hyperparathyroidism, Secondary drug therapy, Kidney Failure, Chronic complications, Phenethylamines administration & dosage
- Abstract
Calcimimetics decrease parathyroid hormone (PTH) secretion in patients with secondary hyperparathyroidism. The decrease in PTH should cause a reduction in bone turnover; however, the direct effect of calcimimetics on bone cells, which express the calcium-sensing receptor (CaSR), has not been defined. In this study, we evaluated the direct bone effects of CaSR activation by a calcimimetic (AMG 641) in vitro and in vivo. To create a PTH "clamp," total parathyroidectomy was performed in rats with and without uremia induced by 5/6 nephrectomy, followed by a continuous subcutaneous infusion of PTH. Animals were then treated with either the calcimimetic or vehicle. Calcimimetic administration increased osteoblast number and osteoid volume in normal rats under a PTH clamp. In uremic rats, the elevated PTH concentration led to reduced bone volume and increased bone turnover, and calcimimetic administration decreased plasma PTH. In uremic rats exposed to PTH at 6-fold the usual replacement dose, calcimimetic administration increased osteoblast number, osteoid surface, and bone formation. A 9-fold higher dose of PTH caused an increase in bone turnover that was not altered by the administration of calcimimetic. In an osteosarcoma cell line, the calcimimetic induced Erk1/2 phosphorylation and the expression of osteoblast genes. The addition of a calcilytic resulted in the opposite effect. Moreover, the calcimimetic promoted the osteogenic differentiation and mineralization of human bone marrow mesenchymal stem cells in vitro. Thus, calcimimetic administration has a direct anabolic effect on bone that counteracts the decrease in PTH levels., (Copyright © 2019 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.)
- Published
- 2019
- Full Text
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15. FGF23, Biomarker or Target?
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Rodelo-Haad C, Santamaria R, Muñoz-Castañeda JR, Pendón-Ruiz de Mier MV, Martin-Malo A, and Rodriguez M
- Subjects
- Animals, Biomarkers metabolism, Fibroblast Growth Factor-23, Fibroblast Growth Factors chemistry, Fibroblast Growth Factors genetics, Humans, Hyperparathyroidism, Secondary metabolism, Fibroblast Growth Factors metabolism
- Abstract
Fibroblast growth factor 23 (FGF23) plays a key role in the complex network between the bones and other organs. Initially, it was thought that FGF23 exclusively regulated phosphate and vitamin D metabolism; however, recent research has demonstrated that an excess of FGF23 has other effects that may be detrimental in some cases. The understanding of the signaling pathways through which FGF23 acts in different organs is crucial to develop strategies aiming to prevent the negative effects associated with high FGF23 levels. FGF23 has been described to have effects on the heart, promoting left ventricular hypertrophy (LVH); the liver, leading to production of inflammatory cytokines; the bones, inhibiting mineralization; and the bone marrow, by reducing the production of erythropoietin (EPO). The identification of FGF23 receptors will play a remarkable role in future research since its selective blockade might reduce the adverse effects of FGF23. Patients with chronic kidney disease (CKD) have very high levels of FGF23 and may be the population suffering from the most adverse FGF23-related effects. The general population, as well as kidney transplant recipients, may also be affected by high FGF23. Whether the association between FGF23 and clinical events is causal or casual remains controversial. The hypothesis that FGF23 could be considered a therapeutic target is gaining relevance and may become a promising field of investigation in the future.
- Published
- 2019
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16. Increased Phosphaturia Accelerates The Decline in Renal Function: A Search for Mechanisms.
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Santamaría R, Díaz-Tocados JM, Pendón-Ruiz de Mier MV, Robles A, Salmerón-Rodríguez MD, Ruiz E, Vergara N, Aguilera-Tejero E, Raya A, Ortega R, Felsenfeld A, Muñoz-Castañeda JR, Martín-Malo A, Aljama P, and Rodríguez M
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Animals, Antioxidants metabolism, Cell Line, Female, Glomerular Filtration Rate drug effects, Glomerular Filtration Rate physiology, Glucuronidase metabolism, HEK293 Cells, Humans, Hyperphosphatemia metabolism, Hyperphosphatemia physiopathology, Hypophosphatemia, Familial metabolism, Kidney drug effects, Kidney metabolism, Klotho Proteins, Male, Melatonin pharmacology, Metabolic Syndrome metabolism, Metabolic Syndrome physiopathology, Middle Aged, Oxidative Stress drug effects, Oxidative Stress physiology, Phosphates metabolism, Proteinuria metabolism, Proteinuria physiopathology, Rats, Rats, Wistar, Rats, Zucker, Reactive Oxygen Species metabolism, Renal Insufficiency, Chronic metabolism, Renal Insufficiency, Chronic physiopathology, Young Adult, Hypophosphatemia, Familial physiopathology, Kidney physiopathology
- Abstract
In chronic kidney disease (CKD), high serum phosphate concentration is associated with cardiovascular disease and deterioration in renal function. In early CKD, the serum phosphate concentration is normal due to increased fractional excretion of phosphate. Our premise was that high phosphate intake even in patients with early CKD would result in an excessive load of phosphate causing tubular injury and accelerating renal function deterioration. In CKD 2-3 patients, we evaluated whether increased phosphaturia accelerates CKD progression. To have a uniform group of patients with early CKD, 95 patients with metabolic syndrome without overt proteinuria were followed for 2.7 ± 1.6 years. The median decline in eGFR was 0.50 ml/min/1.73 m
2 /year. Patients with a more rapid decrease in eGFR had greater phosphaturia. Moreover, the rate of decrease in eGFR inversely correlated with the degree of phosphaturia. Additionally, phosphaturia independently predicted renal function deterioration. In heminephrectomized rats, a high phosphate diet increased phosphaturia resulting in renal tubular damage associated with inflammation, oxidative stress and low klotho expression. Moreover, in rats with hyperphosphatemia and metabolic syndrome antioxidant treatment resulted in attenuation of renal lesions. In HEK-293 cells, high phosphate promoted oxidative stress while melatonin administration reduced ROS generation. Our findings suggest that phosphate loading in early CKD, results in renal damage and a more rapid decrease in renal function due to renal tubular injury.- Published
- 2018
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17. Prevalence and Survival of Cancer After Pancreas-Kidney Transplantation.
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Pendón-Ruiz de Mier MV, Agüera ML, Navarro MD, Rodriguez-Benot A, and Aljama P
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- Adult, Female, Graft Survival, Humans, Kaplan-Meier Estimate, Kidney Transplantation mortality, Male, Middle Aged, Pancreas Transplantation mortality, Prevalence, Retrospective Studies, Survival Rate, Immunocompromised Host, Kidney Transplantation adverse effects, Neoplasms epidemiology, Neoplasms immunology, Pancreas Transplantation adverse effects
- Abstract
Background: Malignancy is an important cause of mortality in solid organ transplantation. There have been few studies of de novo solid organ malignancy (NSOM) after pancreas-kidney transplantation (PKT). The aim of this study was analyze the prevalence of NSOM and transplant outcomes., Methods: We studied the development of NSOM after PKT in our center from May 1990 to February 2017. We analyzed demographic characteristics, prevalence of cancer, and survival after cancer diagnosis. We excluded nonmelanoma skin cancer and patients with history of malignancy before transplantation., Results: We included 194 patients who received 206 PKTs (184 simultaneous PKTs and 22 pancreas after kidney transplants) with triple immunosuppressive therapy and basiliximab in more than 95%. The mean age at transplantation was 39 ± 7 years and 74% were male patients. Twelve patients developed malignancies (6.1%). Median time from transplant to NSOM was 6.6 (interquartile range [IQR] 0.2-11.7) years. The malignancies were 2 cecal appendix tumors, 2 hematologic tumors, 2 breast tumors, 1 melanoma, 1 native kidney tumor, 1 brain tumor, 1 bladder tumor, 1 prostate tumor, and 1 leiomyosarcoma. Thirty-five of the 194 patients of the whole cohort died throughout the follow-up, 4 of whom died after NSOM diagnosis (11.4%). Patient and grafts survivals were lower in recipients with tumor compared with recipients without tumor, but the difference was not statistically significant: renal graft survival was 80% vs 90% at 10 years (P = .86); and pancreatic graft survival was 45% vs 70% at 10 years (P = .15), respectively. The mean patient survival time from the diagnosis of cancer was 36.6 (IQR 18-54) months. Patient survival after NSOM diagnosis was 90% at 1 year and 50% at 5 years., Conclusion: The prevalence of NSOM in our PKT recipients is low, despite the scarce series of published data for comparison. Also hematologic tumors rate is very low, possibly influenced by age and type of induction., (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Published
- 2018
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18. Magnesium Replacement to Protect Cardiovascular and Kidney Damage? Lack of Prospective Clinical Trials.
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Muñoz-Castañeda JR, Pendón-Ruiz de Mier MV, Rodríguez M, and Rodríguez-Ortiz ME
- Subjects
- Animals, Apoptosis drug effects, Cardiovascular Diseases etiology, Cardiovascular Diseases metabolism, Cardiovascular Diseases pathology, Cardiovascular Diseases prevention & control, Cardiovascular System drug effects, Disease Progression, Drug Overdose, Enzyme Activation drug effects, Humans, Kidney drug effects, Magnesium blood, Magnesium pharmacology, Magnesium therapeutic use, Oxidative Stress drug effects, Protective Agents metabolism, Protective Agents pharmacology, Renal Insufficiency, Chronic complications, Renal Insufficiency, Chronic metabolism, Renal Insufficiency, Chronic pathology, Renal Insufficiency, Chronic prevention & control, Cardiovascular System metabolism, Kidney metabolism, Magnesium metabolism
- Abstract
Patients with advanced chronic kidney disease exhibit an increase in cardiovascular mortality. Recent works have shown that low levels of magnesium are associated with increased cardiovascular and all-cause mortality in hemodialysis patients. Epidemiological studies suggest an influence of low levels of magnesium on the occurrence of cardiovascular disease, which is also observed in the normal population. Magnesium is involved in critical cellular events such as apoptosis and oxidative stress. It also participates in a number of enzymatic reactions. In animal models of uremia, dietary supplementation of magnesium reduces vascular calcifications and mortality; in vitro, an increase of magnesium concentration decreases osteogenic transdifferentiation of vascular smooth muscle cells. Therefore, it may be appropriate to evaluate whether magnesium replacement should be administered in an attempt to reduce vascular damage and mortality in the uremic population In the present manuscript, we will review the magnesium homeostasis, the involvement of magnesium in enzymatic reactions, apoptosis and oxidative stress and the clinical association between magnesium and cardiovascular disease in the general population and in the context of chronic kidney disease. We will also analyze the role of magnesium on kidney function. Finally, the experimental evidence of the beneficial effects of magnesium replacement in chronic kidney disease will be thoroughly described., Competing Interests: The authors declare no conflict of interest.
- Published
- 2018
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19. Differential regulation of renal Klotho and FGFR1 in normal and uremic rats.
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Muñoz-Castañeda JR, Herencia C, Pendón-Ruiz de Mier MV, Rodriguez-Ortiz ME, Diaz-Tocados JM, Vergara N, Martínez-Moreno JM, Salmerón MD, Richards WG, Felsenfeld A, Kuro-O M, Almadén Y, and Rodríguez M
- Subjects
- Animals, Calcitriol pharmacology, Dietary Proteins administration & dosage, Dietary Proteins adverse effects, Fibroblast Growth Factor-23, Fibroblast Growth Factors administration & dosage, Fibroblast Growth Factors pharmacology, Glucuronidase genetics, HEK293 Cells, Humans, Klotho Proteins, Male, Phosphates pharmacology, Rats, Rats, Wistar, Receptor, Fibroblast Growth Factor, Type 1 genetics, Recombinant Proteins administration & dosage, Recombinant Proteins pharmacology, Wnt Signaling Pathway physiology, beta Catenin genetics, beta Catenin metabolism, Gene Expression Regulation physiology, Glucuronidase metabolism, Receptor, Fibroblast Growth Factor, Type 1 metabolism, Renal Insufficiency metabolism, Uremia metabolism
- Abstract
In renal failure, hyperphosphatemia occurs despite a marked elevation in serum fibroblast growth factor (FGF)-23. Abnormal regulation of the FGFR1-Klotho receptor complex may cause a resistance to the phosphaturic action of FGF23. The purpose of the present study was to investigate the regulation of renal Klotho and FGF receptor (FEFR)-1 in healthy and uremic rats induced by 5/6 nephrectomy. In normal rats, the infusion of rat recombinant FGF23 enhanced phosphaturia and increased renal FGFR1 expression; however, Klotho expression was reduced. Uremic rats on a high-phosphate (HP) diet presented hyperphosphatemia with marked elevation of FGF23 and an increased fractional excretion of phosphate (P) that was associated with a marked reduction of Klotho expression and an increase in FGFR1. After neutralization of FGF23 by anti-FGF23 administration, phosphaturia was still abundant, Klotho expression remained low, and the FGFR1 level was reduced. These results suggest that the expression of renal Klotho is modulated by phosphaturia, whereas the FGFR1 expression is regulated by FGF23. Calcitriol (CTR) administration prevented a decrease in renal Klotho expression. In HEK293 cells HP produced nuclear translocation of β-catenin, together with a reduction in Klotho. Wnt/β-catenin inhibition with Dkk-1 prevented the P-induced down-regulation of Klotho. The addition of CTR to HP medium was able to recover Klotho expression. In summary, high FGF23 levels increase FGFR1, whereas phosphaturia decreases Klotho expression through the activation of Wnt/β-catenin pathway.-Muñoz-Castañeda, J. R., Herencia, C., Pendón-Ruiz de Mier, M. V., Rodriguez-Ortiz, M. E., Diaz-Tocados, J. M., Vergara, N., Martínez-Moreno, J. M., Salmerón, M. D., Richards, W. G., Felsenfeld, A., Kuro-O, M., Almadén, Y., Rodríguez, M. Differential regulation of renal Klotho and FGFR1 in normal and uremic rats., (© FASEB.)
- Published
- 2017
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20. Graft Survival in Patients With Polycystic Kidney Disease With Nephrectomy of Native Kidney Pretransplant.
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García-Rubio JH, Carrasco Valiente J, Campos Hernández JP, Ruiz García J, Márquez López J, Regueiro López JC, Cano Castiñeira R, Pendón Ruiz de Mier MV, and Requena Tapia MJ
- Subjects
- Female, Humans, Male, Middle Aged, Retrospective Studies, Treatment Outcome, Graft Survival, Kidney Transplantation, Nephrectomy, Polycystic Kidney, Autosomal Dominant surgery
- Abstract
Introduction: Autosomal-dominant polycystic disease (ADPKD) represents 5%-10% of cases of end-stage renal failure. However, management of these patients in terms of whether or not to perform a transplant and optimal timing remains controversial. The objective of our analysis was to evaluate graft survival in patients with ADPKD in which we conduct pretransplant nephrectomy., Methods: This retrospective study including renal transplant patients secondary to ADPKD in our hospital between January 2000 and December 2012. Pretransplant native kidney nephrectomy was indicated in cases of need for space or repeated complications (cysts). We compared the initial function and graft survival between groups of transplanted based on whether nephrectomy had been performed or not., Results: Eighty-seven patients underwent a kidney transplant owing to ADPKD; 62% (n = 54) were male, with an average age of 55.22 years. Twenty-seven patients (30%) underwent nephrectomy native kidneys before transplantation. There were no serious postoperative complications. Patients who underwent nephrectomy (group 1) showed values of creatinine of 1.57 and 1.50 mg/dL at 3 and 6 months, respectively. In the no nephrectomy group, these values were 2.03 and 1.83 mg/dL, respectively. Graft survival after the first year was of 98% for group 1 and 95% for group 2. The 5-year implant survival was 95% and 80%, respectively., Conclusions: Native kidney nephrectomy before transplantation in ADPKD is safe in an experienced center, both in terms of surgery-related morbidity and mortality and graft survival and function., (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Published
- 2015
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21. Prospective study of the complications associated with percutaneous renal biopsy of native kidneys: experience in a centre.
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Pendón-Ruiz de Mier MV, Espinosa-Hernández M, Rodelo-Haad C, Esquivias-de Motta E, Gómez-Carrasco J, Ortega R, and Aljama P
- Subjects
- Adult, Aged, Aged, 80 and over, Biopsy, Needle adverse effects, Female, Humans, Male, Middle Aged, Postoperative Complications epidemiology, Postoperative Complications etiology, Prospective Studies, Kidney pathology
- Abstract
Background: Percutaneous renal biopsy (PRB) is a key invasive technique in the study of kidney disease and it is associated with considerable morbidity. Retrospective studies have shown minor complications in 10%-20% and major complications in 1.2%-6.6% of cases. However, this aspect has not been studied prospectively., Objective: The aim of our study was to prospectively assess complications related to PRB in the native kidney., Methods: From January 2009 to May 2013, we prospectively analysed PRB performed by nephrologists in native kidneys under ultrasound guidance. We analysed clinical and laboratory variables. We defined minor complications as the decrease in haemoglobin (Hb) of more than 1g/dL and major complications as the need for a transfusion or invasive technique., Results: 241 PRB were performed over this period. The mean patient age was 49 years (±17), the majority (56%) were male and 58.1% had high blood pressure. In 51% of cases, we carried out 2 punctures. There were minor complications in 46 patients (19.1%) and major complications in 9 patients (3.7%). In the univariate analysis, pre-PRB Hb was 10.3g/dL (±1.3) in patients with major complications and 12.3g/dL (±2.2) in the remaining patients (p=.003); in the multivariate analysis: OR 0.51, 95% CI (0.2-0.9), p<.05., Conclusions: PRB is a procedure that is not without risk, since minor complications occurred in 19.1% and major complications in 3.7% of cases. Pre-PRB Hb is an independent risk factor for the development of major complications.
- Published
- 2014
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22. Effectiveness of haemodiafiltration with ultrafiltrate regeneration in the reduction of light chains in multiple myeloma with renal failure.
- Author
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Pendón-Ruiz de Mier MV, Alvarez-Lara MA, Ojeda-López R, Martín-Malo A, Carracedo J, Caballero-Villarraso J, Alonso C, and Aljama P
- Subjects
- Acute Kidney Injury blood, Adsorption, Aged, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Boronic Acids administration & dosage, Bortezomib, Combined Modality Therapy, Cyclophosphamide administration & dosage, Dexamethasone administration & dosage, Female, Humans, Ion Exchange Resins, Male, Membranes, Artificial, Middle Aged, Multiple Myeloma blood, Multiple Myeloma drug therapy, Polymers, Pyrazines administration & dosage, Serum Albumin analysis, Thalidomide administration & dosage, Treatment Outcome, Acute Kidney Injury therapy, Hemodiafiltration methods, Immunoglobulin kappa-Chains blood, Immunoglobulin lambda-Chains blood, Multiple Myeloma complications, Myeloma Proteins analysis
- Abstract
Acute kidney failure in multiple myeloma (MM) occurs in 12%-20% of patients and is a poor prognostic factor for patient survival. Recent studies have shown that dialysis with a High-Cut-Off membrane (HCO) removes free light chains (FLC) effectively although with significant albumin loss. Other adsorption-based techniques, such as haemodiafiltration with ultrafiltrate regeneration by adsorption in resin (SUPRA-HFR), have not been studied. We present three cases of MM, all haemodialysis-dependent since diagnosis. Two cases were IgG kappa and one was IgA lambda. All patients were treated with chemotherapy and SUPRA-HFR. The aim of this study was to evaluate the effectiveness of SUPRA-HFR in the reduction of FLC and its effect on albumin. We collected blood samples pre- and post-dialysis, and ultrafiltrate (UF) samples pre- and post-resin 5 minutes into the session and 5 minutes from the end. The mean reduction rate of FLC in blood per session in the three patients was 53% and 63% (kappa) and 38% (lambda). In the UF, the mean FLC reduction rate was close to 99%, both at the start and at the end of dialysis, without the removal of albumin. With the results obtained we can conclude that this technique achieves an effective reduction of FLC, which is maintained throughout the session, without resin saturation and without albumin loss. Therefore, SUPRA-HFR is effective as an adjunctive therapy for MM.
- Published
- 2013
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23. Effectiveness of haemodiafiltration with ultrafiltrate regeneration in renal failure due to multiple myeloma.
- Author
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Pendón-Ruiz de Mier MV, Ojeda-López R, Alvarez de Lara-Sánchez MA, Martín-Malo A, and Aljama-García P
- Subjects
- Female, Humans, Middle Aged, Regeneration, Hemodiafiltration, Multiple Myeloma complications, Renal Insufficiency etiology, Renal Insufficiency therapy
- Published
- 2013
- Full Text
- View/download PDF
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