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Article ; Online: Persistent hyperparathyroidism in long-term kidney transplantation: time to consider a less aggressive approach.

Disthabanchong, Sinee

Current opinion in nephrology and hypertension

2022 Volume 32, Issue 1, Page(s) 20–26

Abstract: Purpose of review: Persistent hyperparathyroidism affects 50% of long-term kidney transplants with preserved allograft function. Timing, options and the optimal target for treatment remain unclear. Clinical practice guidelines recommend the same ... ...

Abstract	Purpose of review: Persistent hyperparathyroidism affects 50% of long-term kidney transplants with preserved allograft function. Timing, options and the optimal target for treatment remain unclear. Clinical practice guidelines recommend the same therapeutic approach as patients with chronic kidney disease. Recent findings: Mild to moderate elevation of parathyroid hormone (PTH) levels in long-term kidney transplants may not be associated with bone loss and fracture. Recent findings on bone biopsy revealed the lack of association between hypercalcaemic hyperparathyroidism with pathology of high bone turnover. Elevated PTH levels may be required to maintain normal bone volume. Nevertheless, several large observational studies have revealed the association between hypercalcemia and the elevation of PTH levels with unfavourable allograft and patient outcomes. Both calcimimetics and parathyroidectomy are effective in lowering serum calcium and PTH. A recent meta-analysis suggested parathyroidectomy may be performed safely after kidney transplantation without deterioration of allograft function. Summary: Treatment of persistent hyperparathyroidism is warranted in kidney transplants with hypercalcemia and markedly elevated PTH levels. A less aggressive approach should be applied to those with mild to moderate elevation. Whether treatments improve outcomes remain to be elucidated.
MeSH term(s)	Humans ; Kidney Transplantation/adverse effects ; Hypercalcemia/etiology ; Hyperparathyroidism/etiology ; Hyperparathyroidism/surgery ; Parathyroidectomy ; Parathyroid Hormone ; Calcium
Chemical Substances	Parathyroid Hormone ; Calcium (SY7Q814VUP)
Language	English
Publishing date	2022-10-11
Publishing country	England
Document type	Review ; Journal Article
ZDB-ID	1151092-4
ISSN	1473-6543 ; 1535-3842 ; 1062-4813 ; 1062-4821
ISSN (online)	1473-6543 ; 1535-3842
ISSN	1062-4813 ; 1062-4821
DOI	10.1097/MNH.0000000000000840
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Article ; Online: Role of Parathyroid Hormone and Parathyroid Hormone-Related Protein in Protein-Energy Malnutrition.

Srisuwarn, Praopilad / Disthabanchong, Sinee

Frontiers in bioscience (Landmark edition)

2023 Volume 28, Issue 8, Page(s) 167

Abstract: Parathyroid hormone (PTH) is an endocrine peptide found exclusively in the parathyroid glands, whereas parathyroid hormone-related protein (PTHrP) is expressed in a wide range of tissues and organs and exerts endocrine, paracrine, and autocrine actions. ... ...

Abstract	Parathyroid hormone (PTH) is an endocrine peptide found exclusively in the parathyroid glands, whereas parathyroid hormone-related protein (PTHrP) is expressed in a wide range of tissues and organs and exerts endocrine, paracrine, and autocrine actions. PTH and PTHrP have a similar homology, sharing the initial 13 amino acid residues at the N-terminus and binding to the same type 1 PTH receptor (PTH1R), which regulates calcium homeostasis. An abnormal increase in PTH production can occur in primary and secondary hyperparathyroidism, whereas PTHrP can be produced in large quantities by malignant cancer cells from solid organs. In addition to increased bone resorption and hypercalcemia, recent evidence suggests that excess PTH and PTHrP can result in protein-energy wasting, malnutrition, and cachexia. Through binding to PTH1R and activation of cyclic adenosine monophosphate (cAMP)-dependent protein kinase A in white adipose tissue, PTH and PTHrP can stimulate the expression of thermogenic genes causing adipose tissue browning. This change results in an increase in resting energy expenditure, loss of muscle and fat mass, and weight loss. These findings provide a mechanistic link for the long-established relationship between hyperparathyroidism and myopathy, as well as cancer and cachexia. The purpose of this review is to provide a summary of the emerging evidence from both experimental and clinical studies on the role of PTH and PTHrP in protein-energy malnutrition.
MeSH term(s)	Humans ; Adipose Tissue ; Cachexia ; Parathyroid Hormone ; Parathyroid Hormone-Related Protein/genetics ; Protein-Energy Malnutrition
Chemical Substances	Parathyroid Hormone ; Parathyroid Hormone-Related Protein ; PTHLH protein, human
Language	English
Publishing date	2023-09-04
Publishing country	Singapore
Document type	Journal Article ; Review
ZDB-ID	2704569-9
ISSN	2768-6698 ; 2768-6698
ISSN (online)	2768-6698
ISSN	2768-6698
DOI	10.31083/j.fbl2808167
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Article: Phosphate and Cardiovascular Disease beyond Chronic Kidney Disease and Vascular Calcification.

Disthabanchong, Sinee

International journal of nephrology

2018 Volume 2018, Page(s) 3162806

Abstract: Phosphate is essential for life but its accumulation can be detrimental. In end-stage renal disease, widespread vascular calcification occurs as a result of chronic phosphate load. The accumulation of phosphate is likely to occur long before the rise in ... ...

Abstract	Phosphate is essential for life but its accumulation can be detrimental. In end-stage renal disease, widespread vascular calcification occurs as a result of chronic phosphate load. The accumulation of phosphate is likely to occur long before the rise in serum phosphate above the normal range since several observational studies in both general population and early-stage CKD patients have identified the relationship between high-normal serum phosphate and adverse cardiovascular outcomes. Consumption of food high in phosphate increases both fasting and postprandial serum phosphate and habitual intake of high phosphate diet is associated with aging, cardiac hypertrophy, endothelial dysfunction, and subclinical atherosclerosis. The decline in renal function and dietary phosphate load can increase circulating fibroblast growth factor-23 (FGF-23) which may have a direct impact on cardiomyocytes. Increased FGF-23 levels in both CKD and general populations are associated with left ventricular hypertrophy, congestive heart failure, atrial fibrillation, and mortality. Increased extracellular phosphate directly affects endothelial cells causing cell apoptosis and vascular smooth muscle cells (VSMCs) causing transformation to osteogenic phenotype. Excess of calcium and phosphate in the circulation can promote the formation of protein-mineral complex called calciprotein particles (CPPs). In CKD, these CPPs contain less calcification inhibitors, induce inflammation, and promote VSMC calcification.
Language	English
Publishing date	2018-04-08
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2573904-9
ISSN	2090-2158 ; 2090-214X
ISSN (online)	2090-2158
ISSN	2090-214X
DOI	10.1155/2018/3162806
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Article ; Online: Incidence of

Srisuwarn, Praopilad / Sutharattanapong, Napun / Disthabanchong, Sinee / Kantachuvesiri, Surasak / Kitiyakara, Chagriya / Phakdeekitcharoen, Bunyong / Ingsathit, Atiporn / Sumethkul, Vasant

Transplant international : official journal of the European Society for Organ Transplantation

2024 Volume 37, Page(s) 11614

Abstract: Kidney transplant recipients (KTRs) are at increased risk of ... ...

Abstract	Kidney transplant recipients (KTRs) are at increased risk of developing
MeSH term(s)	Adult ; Humans ; Male ; Female ; Kidney Transplantation/adverse effects ; Thailand/epidemiology ; Incidence ; Retrospective Studies ; Population Control ; Neoplasms/epidemiology ; Neoplasms/etiology ; Skin Neoplasms/epidemiology ; Risk Factors ; Transplant Recipients
Language	English
Publishing date	2024-02-26
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	639435-8
ISSN	1432-2277 ; 0934-0874
ISSN (online)	1432-2277
ISSN	0934-0874
DOI	10.3389/ti.2024.11614
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Article: Improvement of nutritional status after parathyroidectomy in patients receiving maintenance hemodialysis.

Disthabanchong, Sinee / Saeseow, Sarunya / Khunapornphairote, Sirote / Suvikapakornkul, Ronnarat / Wasutit, Yodying / Tungkeeratichai, Jumroon

Frontiers in medicine

2023 Volume 10, Page(s) 1132566

Abstract: Aims/introduction: Parathyroidectomy is associated with improved survival in patients with end-stage kidney disease. Protein-energy wasting (PEW) is common in patients with kidney failure and predicts poor outcomes. Recent clinical trials have linked ... ...

Abstract	Aims/introduction: Parathyroidectomy is associated with improved survival in patients with end-stage kidney disease. Protein-energy wasting (PEW) is common in patients with kidney failure and predicts poor outcomes. Recent clinical trials have linked hyperparathyroidism to PEW. The present retrospective cohort study examined whether parathyroidectomy was associated with improvement in nutritional status in maintenance hemodialysis patients. Materials and methods: One hundred twenty-nine maintenance hemodialysis patients who had successful parathyroidectomy during 2012-2018 were identified (PTX group) and matched 1:1 to 479 patients with parathyroid hormone (PTH) levels ≤1,000 pg./mL (non-PTX control group) and 187 patients with PTH levels >1,000 pg./mL (pre-PTX control group) by propensity score. The matchings yielded 120 matched pairs from PTX and non-PTX groups (cohort 1) and 76 matched pairs from PTX and pre-PTX groups (cohort 2). Baseline and follow-up nutritional parameters associated with PEW were compared over the 12-month study period. Results: In cohort 1, substantially lower serum albumin and serum creatinine/body surface area (Cr/BSA) and higher proportions of patients with serum albumin ≤38 g/L (low albumin) and serum Cr/BSA ≤380 μmol/L/m Conclusion: Severe hyperparathyroidism was associated with nutritional impairment which improved considerably after parathyroidectomy.
Language	English
Publishing date	2023-07-06
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2023.1132566
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Article ; Online: Mechanisms of Vascular Calcification in Kidney Disease.

Disthabanchong, Sinee / Srisuwarn, Praopilad

Advances in chronic kidney disease

2019 Volume 26, Issue 6, Page(s) 417–426

Abstract: The increase in prevalence and severity of vascular calcification in chronic kidney disease is a result of complex interactions between changes in the vascular bed, mineral metabolites, and other uremic factors. Vascular calcification can occur in the ... ...

Abstract	The increase in prevalence and severity of vascular calcification in chronic kidney disease is a result of complex interactions between changes in the vascular bed, mineral metabolites, and other uremic factors. Vascular calcification can occur in the intima and the media of arterial wall. Under permissive conditions, vascular smooth muscle cells (VSMCs) can transform to osteoblast-like phenotype. The membrane-bound vesicles released from transformed VSMCs and the apoptotic bodies derived from dying VSMCs serve as nucleating structures for calcium crystal formation. Alterations in the quality and the quantity of endogenous calcification inhibitors also give rise to an environment that potentiates calcification.
MeSH term(s)	Animals ; Atherosclerosis/etiology ; Atherosclerosis/metabolism ; Calcium-Binding Proteins/metabolism ; Cell Transdifferentiation ; Endothelium/physiopathology ; Extracellular Matrix Proteins/metabolism ; Humans ; Magnesium/metabolism ; Myocytes, Smooth Muscle/physiology ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/metabolism ; Tunica Intima/pathology ; Vascular Calcification/etiology ; Vascular Calcification/metabolism ; alpha-2-HS-Glycoprotein/metabolism ; Matrix Gla Protein
Chemical Substances	Calcium-Binding Proteins ; Extracellular Matrix Proteins ; alpha-2-HS-Glycoprotein ; Magnesium (I38ZP9992A)
Language	English
Publishing date	2019-12-03
Publishing country	United States
Document type	Journal Article ; Review
ISSN	1548-5609 ; 1548-5595
ISSN (online)	1548-5609
ISSN	1548-5595
DOI	10.1053/j.ackd.2019.08.014
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Zs.A 4627: Show issues

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Article: Lowering vascular calcification burden in chronic kidney disease: Is it possible?

Disthabanchong, Sinee

World journal of nephrology

2013 Volume 2, Issue 3, Page(s) 49–55

Abstract: High prevalence of atherosclerosis and arterial calcification in chronic kidney disease is far beyond the explanation by common cardiovascular risk factors such as aging diabetes, hypertension and dyslipidemia. The magnitude of coronary artery ... ...

Abstract	High prevalence of atherosclerosis and arterial calcification in chronic kidney disease is far beyond the explanation by common cardiovascular risk factors such as aging diabetes, hypertension and dyslipidemia. The magnitude of coronary artery calcification is independently and inversely associated with renal function. In addition to cardiovascular risk factors, other chronic kidney disease-related risks such as phosphate retention, excess of calcium and prolonged dialysis vintage also contribute to the development of vascular calcification. Strategies to lower vascular calcification burden in chronic kidney disease population should include minimizing chronic kidney disease and atherosclerotic risk factors. Current therapies available are non-calcium containing phosphate binders, low dose active vitamin D and calcimimetic agent. The role of bisphosphonates in vascular calcification in chronic kidney disease population remains unclear. Preliminary data on sodium thiosulfate are promising, however, larger studies on efficacy and patient outcomes are necessary. Several large randomized controlled trials have confirmed the lack of benefit of statin in attenuating the progression of vascular calcification.
Language	English
Publishing date	2013-11-09
Publishing country	United States
Document type	Journal Article
ISSN	2220-6124
ISSN	2220-6124
DOI	10.5527/wjn.v2.i3.49
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Article ; Online: Improvement of nutritional status after parathyroidectomy in patients receiving maintenance hemodialysis

Sinee Disthabanchong / Sarunya Saeseow / Sirote Khunapornphairote / Ronnarat Suvikapakornkul / Yodying Wasutit / Jumroon Tungkeeratichai

Frontiers in Medicine, Vol

2023 Volume 10

Abstract: ... up nutritional parameters associated with PEW were compared over the 12-month study period.ResultsIn ...

Abstract	Aims/IntroductionParathyroidectomy is associated with improved survival in patients with end-stage kidney disease. Protein-energy wasting (PEW) is common in patients with kidney failure and predicts poor outcomes. Recent clinical trials have linked hyperparathyroidism to PEW. The present retrospective cohort study examined whether parathyroidectomy was associated with improvement in nutritional status in maintenance hemodialysis patients.Materials and methodsOne hundred twenty-nine maintenance hemodialysis patients who had successful parathyroidectomy during 2012–2018 were identified (PTX group) and matched 1:1 to 479 patients with parathyroid hormone (PTH) levels ≤1,000 pg./mL (non-PTX control group) and 187 patients with PTH levels >1,000 pg./mL (pre-PTX control group) by propensity score. The matchings yielded 120 matched pairs from PTX and non-PTX groups (cohort 1) and 76 matched pairs from PTX and pre-PTX groups (cohort 2). Baseline and follow-up nutritional parameters associated with PEW were compared over the 12-month study period.ResultsIn cohort 1, substantially lower serum albumin and serum creatinine/body surface area (Cr/BSA) and higher proportions of patients with serum albumin ≤38 g/L (low albumin) and serum Cr/BSA ≤380 μmol/L/m2 (low Cr/BSA) were observed in the PTX group. These parameters improved significantly after parathyroidectomy. Total lymphocyte count (TLC) was comparable at baseline but the percentage of patients with TLC <800 cells/mm3 (low TLC) decreased substantially after parathyroidectomy. At follow-up, serum albumin, serum Cr/BSA and proportions of patients with low albumin and Cr/BSA became comparable with the non-PTX control group. The percentage of patients with low TLC became lower in the PTX group. Mixed-models analysis confirmed significant differences in the changes in serum albumin, serum Cr/BSA, and proportions of patients with low albumin and TLC between the two groups. In cohort 2, nutritional parameters were comparable at baseline. At follow-up, serum Cr/BSA was ...
Keywords	hyperparathyoidism ; protein energy wasting ; dialysis ; parathyroidectomy ; sarcopenia ; hypoalbuminemia ; Medicine (General) ; R5-920
Subject code	610 ; 616
Language	English
Publishing date	2023-07-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
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Article: Vascular calcification in chronic kidney disease: Pathogenesis and clinical implication.

Disthabanchong, Sinee

World journal of nephrology

2013 Volume 1, Issue 2, Page(s) 43–53

Abstract: Cardiovascular disease is the leading cause of death among patients with chronic kidney disease (CKD). Vascular calcification (VC) is one of the independent risk factors associated with cardiovascular disease and cardiovascular mortality in both the ... ...

Abstract	Cardiovascular disease is the leading cause of death among patients with chronic kidney disease (CKD). Vascular calcification (VC) is one of the independent risk factors associated with cardiovascular disease and cardiovascular mortality in both the general population and CKD patients. Earlier evidence revealed substantially higher prevalence of VC in young adults on chronic hemodialysis compared to the general population in the same age range, indicating the influence of CKD-related risk factors on the development of VC. Pathogenesis of VC involves an active, highly organized cellular transformation of vascular smooth muscle cells to bone forming cells evidenced by the presence of bone matrix proteins in the calcified arterial wall. VC occurs in both the intima and the media of arterial wall with medial calcification being more prevalent in CKD. In addition to traditional cardiovascular risks, risk factors specific to CKD such as phosphate retention, excess of calcium, history of dialysis, active vitamin D therapy in high doses and deficiency of calcification inhibitors play important roles in promoting the development of VC. Non-contrast multi-slice computed tomography has often been used to detect coronary artery calcification. Simple plain radiographs of the lateral lumbar spine and pelvis can also detect VC in the abdominal aorta and femoral and iliac arteries. Currently, there is no specific therapy to reverse VC. Reduction of calcium load, lowering phosphate retention using non-calcium containing phosphate binders, and moderate doses of active vitamin D may attenuate progression. Parenteral sodium thiosulfate has also been shown to delay VC progression.
Language	English
Publishing date	2013-07-01
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2220-6124
ISSN	2220-6124
DOI	10.5527/wjn.v1.i2.43
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Article ; Online: Risk Factors of Renal Tubular Dysfunction in Thai People Living with HIV Receiving Tenofovir Disoproxil Fumarate.

Phuphuakrat, Angsana / Pasomsub, Ekawat / Chantratita, Wasun / Mahasirimongkol, Surakameth / Disthabanchong, Sinee / Sungkanuparph, Somnuek / Kiertiburanakul, Sasisopin

Journal of the International Association of Providers of AIDS Care

2022 Volume 21, Page(s) 23259582221134751

Abstract: Tenofovir disoproxil fumarate (TDF) associates with renal tubular dysfunction (RTD) in some people living with HIV (PLWH). We studied clinical and genetic factors associated with RTD in Thai PLWH receiving TDF. RTD was diagnosed in 13 of 65 (20%) ... ...

Abstract	Tenofovir disoproxil fumarate (TDF) associates with renal tubular dysfunction (RTD) in some people living with HIV (PLWH). We studied clinical and genetic factors associated with RTD in Thai PLWH receiving TDF. RTD was diagnosed in 13 of 65 (20%) patients. The median (interquartile range) age and CD4 cell counts were 43.8 (40.4-50.9) years and 554 (437-716) cells/mm
MeSH term(s)	Humans ; Tenofovir/adverse effects ; Anti-HIV Agents/adverse effects ; Thailand/epidemiology ; HIV Infections/drug therapy ; HIV Infections/complications ; Risk Factors
Chemical Substances	Tenofovir (99YXE507IL) ; Anti-HIV Agents
Language	English
Publishing date	2022-11-30
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2709037-1
ISSN	2325-9582 ; 2325-9574
ISSN (online)	2325-9582
ISSN	2325-9574
DOI	10.1177/23259582221134751
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