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Article ; Online: Experimental Models to Study Diabetes Mellitus and Its Complications: Limitations and New Opportunities.

Martín-Carro, Beatriz / Donate-Correa, Javier / Fernández-Villabrille, Sara / Martín-Vírgala, Julia / Panizo, Sara / Carrillo-López, Natalia / Martínez-Arias, Laura / Navarro-González, Juan F / Naves-Díaz, Manuel / Fernández-Martín, José L / Alonso-Montes, Cristina / Cannata-Andía, Jorge B

International journal of molecular sciences

2023 Volume 24, Issue 12

Abstract: Preclinical biomedical models are a fundamental tool to improve the knowledge and management of diseases, particularly in diabetes mellitus (DM) since, currently, the pathophysiological and molecular mechanisms involved in its development are not fully ... ...

Abstract	Preclinical biomedical models are a fundamental tool to improve the knowledge and management of diseases, particularly in diabetes mellitus (DM) since, currently, the pathophysiological and molecular mechanisms involved in its development are not fully clarified, and there is no treatment to cure DM. This review will focus on the features, advantages and limitations of some of the most used DM models in rats, such as the spontaneous models: Bio-Breeding Diabetes-Prone (BB-DP) and LEW.1AR1-
MeSH term(s)	Humans ; Rats ; Animals ; Disease Models, Animal ; Streptozocin ; Rats, Zucker ; Diabetes Mellitus, Type 1/complications ; Diabetes Mellitus, Type 2/complications
Chemical Substances	Streptozocin (5W494URQ81)
Language	English
Publishing date	2023-06-18
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms241210309
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Article ; Online: Phosphorus May Induce Phenotypic Transdifferentiation of Vascular Smooth Muscle Cells through the Reduction of microRNA-145.

Fernández-Villabrille, Sara / Martín-Carro, Beatriz / Martín-Vírgala, Julia / Alonso-Montes, Cristina / Fernández-Fernández, Alejandra / Martínez-Salgado, Carlos / Fernández-Martín, José L / Naves-Díaz, Manuel / Cannata-Andía, Jorge B / Carrillo-López, Natalia / Panizo, Sara

Nutrients

2023 Volume 15, Issue 13

Abstract: Phosphorus is a vital element for life found in most foods as a natural component, but it is also one of the most used preservatives added during food processing. High serum phosphorus contributes to develop vascular calcification in chronic kidney ... ...

Abstract	Phosphorus is a vital element for life found in most foods as a natural component, but it is also one of the most used preservatives added during food processing. High serum phosphorus contributes to develop vascular calcification in chronic kidney disease; however, it is not clear its effect in a population without kidney damage. The objective of this in vivo and in vitro study was to investigate the effect of high phosphorus exposure on the aortic and serum levels of miR-145 and its effect on vascular smooth muscle cell (VSMCs) changes towards less contractile phenotypes. The study was performed in aortas and serum from rats fed standard and high-phosphorus diets, and in VSMCs exposed to different concentrations of phosphorus. In addition, miR-145 silencing and overexpression experiments were carried out. In vivo results showed that in rats with normal renal function fed a high P diet, a significant increase in serum phosphorus was observed which was associated to a significant decrease in the aortic α-actin expression which paralleled the decrease in aortic and serum miR-145 levels, with no changes in the osteogenic markers. In vitro results using VSMCs corroborated the in vivo findings. High phosphorus first reduced miR-145, and afterwards α-actin expression. The miR-145 overexpression significantly increased α-actin expression and partially prevented the increase in calcium content. These results suggest that miR-145 could be an early biomarker of vascular calcification, which could give information about the initiation of the transdifferentiation process in VSMCs.
MeSH term(s)	Rats ; Animals ; Phosphorus/metabolism ; Muscle, Smooth, Vascular ; Actins/metabolism ; Cell Transdifferentiation ; MicroRNAs/genetics ; MicroRNAs/metabolism ; Phenotype ; Vascular Calcification/genetics ; Vascular Calcification/metabolism ; Myocytes, Smooth Muscle ; Cells, Cultured
Chemical Substances	Phosphorus (27YLU75U4W) ; Actins ; MicroRNAs ; MIRN145 microRNA, rat
Language	English
Publishing date	2023-06-27
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu15132918
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Article ; Online: Role of Klotho and AGE/RAGE-Wnt/β-Catenin Signalling Pathway on the Development of Cardiac and Renal Fibrosis in Diabetes.

Martín-Carro, Beatriz / Martín-Vírgala, Julia / Fernández-Villabrille, Sara / Fernández-Fernández, Alejandra / Pérez-Basterrechea, Marcos / Navarro-González, Juan F / Donate-Correa, Javier / Mora-Fernández, Carmen / Dusso, Adriana S / Carrillo-López, Natalia / Panizo, Sara / Naves-Díaz, Manuel / Fernández-Martín, José L / Cannata-Andía, Jorge B / Alonso-Montes, Cristina

International journal of molecular sciences

2023 Volume 24, Issue 6

Abstract: Fibrosis plays an important role in the pathogenesis of long-term diabetic complications and contributes to the development of cardiac and renal dysfunction. The aim of this experimental study, performed in a long-term rat model, which resembles type 1 ... ...

Abstract	Fibrosis plays an important role in the pathogenesis of long-term diabetic complications and contributes to the development of cardiac and renal dysfunction. The aim of this experimental study, performed in a long-term rat model, which resembles type 1 diabetes mellitus, was to investigate the role of soluble Klotho (sKlotho), advanced glycation end products (AGEs)/receptor for AGEs (RAGE), fibrotic Wnt/β-catenin pathway, and pro-fibrotic pathways in kidney and heart. Diabetes was induced by streptozotocin. Glycaemia was maintained by insulin administration for 24 weeks. Serum and urine sKlotho, AGEs, soluble RAGE (sRAGE) and biochemical markers were studied. The levels of Klotho, RAGEs, ADAM10, markers of fibrosis (collagen deposition, fibronectin, TGF-β1, and Wnt/β-catenin pathway), hypertrophy of the kidney and/or heart were analysed. At the end of study, diabetic rats showed higher levels of urinary sKlotho, AGEs and sRAGE and lower serum sKlotho compared with controls without differences in the renal Klotho expression. A significant positive correlation was found between urinary sKlotho and AGEs and urinary albumin/creatinine ratio (uACR). Fibrosis and RAGE levels were significantly higher in the heart without differences in the kidney of diabetic rats compared to controls. The results also suggest the increase in sKlotho and sRAGE excretion may be due to polyuria in the diabetic rats.
MeSH term(s)	Rats ; Animals ; Diabetes Mellitus, Experimental ; beta Catenin ; Kidney Diseases ; Receptor for Advanced Glycation End Products ; Fibrosis ; Glycation End Products, Advanced
Chemical Substances	beta Catenin ; Receptor for Advanced Glycation End Products ; Glycation End Products, Advanced
Language	English
Publishing date	2023-03-09
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms24065241
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Article ; Online: Fibrosis in Chronic Kidney Disease: Pathogenesis and Consequences.

Panizo, Sara / Martínez-Arias, Laura / Alonso-Montes, Cristina / Cannata, Pablo / Martín-Carro, Beatriz / Fernández-Martín, José L / Naves-Díaz, Manuel / Carrillo-López, Natalia / Cannata-Andía, Jorge B

International journal of molecular sciences

2021 Volume 22, Issue 1

Abstract: Fibrosis is a process characterized by an excessive accumulation of the extracellular matrix as a response to different types of tissue injuries, which leads to organ dysfunction. The process can be initiated by multiple and different stimuli and ... ...

Abstract	Fibrosis is a process characterized by an excessive accumulation of the extracellular matrix as a response to different types of tissue injuries, which leads to organ dysfunction. The process can be initiated by multiple and different stimuli and pathogenic factors which trigger the cascade of reparation converging in molecular signals responsible of initiating and driving fibrosis. Though fibrosis can play a defensive role, in several circumstances at a certain stage, it can progressively become an uncontrolled irreversible and self-maintained process, named pathological fibrosis. Several systems, molecules and responses involved in the pathogenesis of the pathological fibrosis of chronic kidney disease (CKD) will be discussed in this review, putting special attention on inflammation, renin-angiotensin system (RAS), parathyroid hormone (PTH), fibroblast growth factor 23 (FGF23), Klotho, microRNAs (miRs), and the vitamin D hormonal system. All of them are key factors of the core and regulatory pathways which drive fibrosis, having a great negative kidney and cardiac impact in CKD.
MeSH term(s)	Diabetes Mellitus/metabolism ; Disease Progression ; Female ; Fibroblast Growth Factor-23 ; Fibroblast Growth Factors/metabolism ; Fibrosis/metabolism ; Fibrosis/pathology ; Glucuronidase/metabolism ; Humans ; Inflammation/metabolism ; Klotho Proteins ; Male ; MicroRNAs/genetics ; MicroRNAs/metabolism ; Parathyroid Hormone/metabolism ; Phosphates/metabolism ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/metabolism ; Renal Insufficiency, Chronic/pathology ; Renin-Angiotensin System ; Vitamin D/metabolism
Chemical Substances	FGF23 protein, human ; MicroRNAs ; Parathyroid Hormone ; Phosphates ; Vitamin D (1406-16-2) ; Fibroblast Growth Factors (62031-54-3) ; Fibroblast Growth Factor-23 (7Q7P4S7RRE) ; Glucuronidase (EC 3.2.1.31) ; Klotho Proteins (EC 3.2.1.31)
Language	English
Publishing date	2021-01-02
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms22010408
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Article ; Online: Mineral and bone metabolism markers and mortality in diabetic patients on haemodialysis.

Martín-Carro, Beatriz / Navarro-González, Juan F / Ortiz, Alberto / Zoccali, Carmine / Floege, Jürgen / Ferreira, Manuel A / Gorriz-Teruel, José L / Carrillo-López, Natalia / Panizo, Sara / Locatelli, Francesco / Ketteler, Markus / London, Gerard M / Naves-Díaz, Manuel / Alonso-Montes, Cristina / Cannata-Andía, Jorge B / Fernández-Martín, José L

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

2023 Volume 38, Issue 11, Page(s) 2589–2597

Abstract: Background: Diabetic patients on haemodialysis have a higher risk of mortality than non-diabetic patients. The aim of this COSMOS (Current management of secondary hyperparathyroidism: a multicentre observational study) analysis was to assess whether ... ...

Abstract	Background: Diabetic patients on haemodialysis have a higher risk of mortality than non-diabetic patients. The aim of this COSMOS (Current management of secondary hyperparathyroidism: a multicentre observational study) analysis was to assess whether bone and mineral laboratory values [calcium, phosphorus and parathyroid hormone (PTH)] contribute to this risk. Methods: COSMOS is a multicentre, open-cohort, 3-year prospective study, which includes 6797 patients from 227 randomly selected dialysis centres in 20 European countries. The association between mortality and calcium, phosphate or PTH was assessed using Cox proportional hazard regression models using both penalized splines smoothing and categorization according to KDIGO guidelines. The effect modification of the association between the relative risk of mortality and serum calcium, phosphate or PTH by diabetes was assessed. Results: There was a statistically significant effect modification of the association between the relative risk of mortality and serum PTH by diabetes (P = .011). The slope of the curve of the association between increasing values of PTH and relative risk of mortality was steeper for diabetic compared with non-diabetic patients, mainly for high levels of PTH. In addition, high serum PTH (>9 times the normal values) was significantly associated with a higher relative risk of mortality in diabetic patients but not in non-diabetic patients [1.53 (95% confidence interval 1.07-2.19) and 1.17 (95% confidence interval 0.91-1.52)]. No significant effect modification of the association between the relative risk of mortality and serum calcium or phosphate by diabetes was found (P = .2 and P = .059, respectively). Conclusion: The results show a different association of PTH with the relative risk of mortality in diabetic and non-diabetic patients. These findings could have relevant implications for the diagnosis and treatment of chronic kidney disease-mineral and bone disorders.
MeSH term(s)	Humans ; Calcium ; Calcium, Dietary ; Diabetes Mellitus/etiology ; Minerals ; Parathyroid Hormone ; Phosphates ; Prospective Studies ; Renal Dialysis/adverse effects
Chemical Substances	Calcium (SY7Q814VUP) ; Calcium, Dietary ; Minerals ; Parathyroid Hormone ; Phosphates
Language	English
Publishing date	2023-06-23
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Observational Study
ZDB-ID	90594-x
ISSN	1460-2385 ; 0931-0509
ISSN (online)	1460-2385
ISSN	0931-0509
DOI	10.1093/ndt/gfad122
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Article ; Online: A single-oral bolus of 100,000 IU of cholecalciferol at hospital admission did not improve outcomes in the COVID-19 disease: the COVID-VIT-D-a randomised multicentre international clinical trial.

Cannata-Andía, Jorge B / Díaz-Sottolano, Augusto / Fernández, Pehuén / Palomo-Antequera, Carmen / Herrero-Puente, Pablo / Mouzo, Ricardo / Carrillo-López, Natalia / Panizo, Sara / Ibañez, Guillermo H / Cusumano, Carlos A / Ballarino, Carolina / Sánchez-Polo, Vicente / Pefaur-Penna, Jacqueline / Maderuelo-Riesco, Irene / Calviño-Varela, Jesús / Gómez, Mónica D / Gómez-Alonso, Carlos / Cunningham, John / Naves-Díaz, Manuel /

Douthat, Walter / Fernández-Martín, José L

BMC medicine

2022 Volume 20, Issue 1, Page(s) 83

Abstract: Background: Vitamin D status has been implicated in COVID-19 disease. The objective of the COVID-VIT-D trial was to investigate if an oral bolus of cholecalciferol (100,000 IU) administered at hospital admission influences the outcomes of moderate- ... ...

Abstract	Background: Vitamin D status has been implicated in COVID-19 disease. The objective of the COVID-VIT-D trial was to investigate if an oral bolus of cholecalciferol (100,000 IU) administered at hospital admission influences the outcomes of moderate-severe COVID-19 disease. In the same cohort, the association between baseline serum calcidiol levels with the same outcomes was also analysed. Methods: The COVID-VIT-D is a multicentre, international, randomised, open label, clinical trial conducted throughout 1 year. Patients older than 18 years with moderate-severe COVID-19 disease requiring hospitalisation were included. At admission, patients were randomised 1:1 to receive a single oral bolus of cholecalciferol (n=274) or nothing (n=269). Patients were followed from admission to discharge or death. Length of hospitalisation, admission to intensive care unit (ICU) and mortality were assessed. Results: In the randomised trial, comorbidities, biomarkers, symptoms and drugs used did not differ between groups. Median serum calcidiol in the cholecalciferol and control groups were 17.0 vs. 16.1 ng/mL at admission and 29.0 vs. 16.4 ng/mL at discharge, respectively. The median length of hospitalisation (10.0 [95%CI 9.0-10.5] vs. 9.5 [95%CI 9.0-10.5] days), admission to ICU (17.2% [95%CI 13.0-22.3] vs. 16.4% [95%CI 12.3-21.4]) and death rate (8.0% [95%CI 5.2-12.1] vs. 5.6% [95%CI 3.3-9.2]) did not differ between the cholecalciferol and control group. In the cohort analyses, the highest serum calcidiol category at admission (>25ng/mL) was associated with lower percentage of pulmonary involvement and better outcomes. Conclusions: The randomised clinical trial showed the administration of an oral bolus of 100,000 IU of cholecalciferol at hospital admission did not improve the outcomes of the COVID-19 disease. A cohort analysis showed that serum calcidiol at hospital admission was associated with outcomes. Trial registration: COVID-VIT-D trial was authorised by the Spanish Agency for Medicines and Health products (AEMPS) and registered in European Union Drug Regulating Authorities Clinical Trials (EudraCT 2020-002274-28) and in ClinicalTrials.gov ( NCT04552951 ).
MeSH term(s)	COVID-19 ; Cholecalciferol ; Double-Blind Method ; Hospitalization ; Hospitals ; Humans ; SARS-CoV-2 ; Treatment Outcome ; Vitamin D
Chemical Substances	Vitamin D (1406-16-2) ; Cholecalciferol (1C6V77QF41)
Language	English
Publishing date	2022-02-18
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2131669-7
ISSN	1741-7015 ; 1741-7015
ISSN (online)	1741-7015
ISSN	1741-7015
DOI	10.1186/s12916-022-02290-8
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Article ; Online: Cardiotrophin-1 opposes renal fibrosis in mice: Potential prevention of chronic kidney disease.

Perretta-Tejedor, Nuria / Muñoz-Félix, José M / Düwel, Annette / Quiros-Luis, Yaremi / Fernández-Martín, José L / Morales, Ana I / López-Hernández, Francisco J / López-Novoa, José M / Martínez-Salgado, Carlos

Acta physiologica (Oxford, England)

2019 Volume 226, Issue 2, Page(s) e13247

Abstract: Aim: Chronic kidney disease is characterized by tubulointerstitial fibrosis involving inflammation, tubular apoptosis, fibroblast proliferation and extracellular matrix accumulation. Cardiotrophin-1, a member of the interleukin-6 family of cytokines, ... ...

Abstract	Aim: Chronic kidney disease is characterized by tubulointerstitial fibrosis involving inflammation, tubular apoptosis, fibroblast proliferation and extracellular matrix accumulation. Cardiotrophin-1, a member of the interleukin-6 family of cytokines, protects several organs from damage by promoting survival and anti-inflammatory effects. However, whether cardiotrophin-1 participates in the response to chronic kidney injury leading to renal fibrosis is unknown. Methods: We hypothesized and assessed the potential role of cardiotrophin-1 in a mice model of tubulointerstitial fibrosis induced by unilateral ureteral obstruction (UUO). Results: Three days after UUO, obstructed kidneys from cardiotrophin-1 Conclusions: Cardiotrophin-1 participates in the endogenous response that opposes renal damage by counteracting the inflammatory, apoptotic and fibrotic processes. And exogenous cardiotrophin-1 is proposed as a candidate for the treatment and prevention of chronic renal fibrosis.
MeSH term(s)	Animals ; Cytokines/genetics ; Cytokines/metabolism ; Disease Models, Animal ; Fibrosis/metabolism ; Gene Expression Regulation/physiology ; Kidney/metabolism ; Mice, Knockout ; Renal Insufficiency, Chronic/genetics ; Renal Insufficiency, Chronic/metabolism ; Renal Insufficiency, Chronic/pathology ; Ureteral Obstruction/genetics ; Ureteral Obstruction/metabolism
Chemical Substances	Cytokines ; cardiotrophin 1 (AJ7U77BR8I)
Language	English
Publishing date	2019-01-18
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2218636-0
ISSN	1748-1716 ; 1748-1708
ISSN (online)	1748-1716
ISSN	1748-1708
DOI	10.1111/apha.13247
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Article ; Online: Mineral metabolism: Should cinacalcet be used in patients who are not on dialysis?

Cannata-Andía, Jorge B / Fernández-Martín, José L

Nature reviews. Nephrology

2009 Volume 5, Issue 6, Page(s) 307–308

Abstract: Cinacalcet is an effective treatment for secondary hyperparathyroidism in patients on dialysis. Until now, no randomized, placebo-controlled, long-term trial has tested this drug in individuals with chronic kidney disease who are not receiving dialysis. ...

Abstract	Cinacalcet is an effective treatment for secondary hyperparathyroidism in patients on dialysis. Until now, no randomized, placebo-controlled, long-term trial has tested this drug in individuals with chronic kidney disease who are not receiving dialysis.
MeSH term(s)	Cinacalcet ; Humans ; Hyperparathyroidism, Secondary/drug therapy ; Hyperparathyroidism, Secondary/etiology ; Hyperparathyroidism, Secondary/metabolism ; Hyperphosphatemia/drug therapy ; Hyperphosphatemia/etiology ; Hyperphosphatemia/metabolism ; Hypocalcemia/drug therapy ; Hypocalcemia/etiology ; Hypocalcemia/metabolism ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/metabolism ; Kidney Failure, Chronic/therapy ; Naphthalenes/therapeutic use ; Renal Dialysis
Chemical Substances	Naphthalenes ; Cinacalcet (UAZ6V7728S)
Language	English
Publishing date	2009-05-28
Publishing country	England
Document type	News ; Research Support, Non-U.S. Gov't
ZDB-ID	2490366-8
ISSN	1759-507X ; 1759-5061
ISSN (online)	1759-507X
ISSN	1759-5061
DOI	10.1038/nrneph.2009.54
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Article: Survival with low- and high-flux dialysis.

Sánchez-Álvarez, Emilio / Rodríguez-García, Minerva / Locatelli, Francesco / Zoccali, Carmine / Martín-Malo, Alejandro / Floege, Jürgen / Ketteler, Markus / London, Gerard / Górriz, José L / Rutkowski, Boleslaw / Ferreira, Anibal / Pavlovic, Drasko / Cannata-Andía, Jorge B / Fernández-Martín, José L

Clinical kidney journal

2020 Volume 14, Issue 8, Page(s) 1915–1923

Abstract: Background: Besides advances in haemodialysis (HD), mortality rates are still high. The effect of the different types of HD membranes on survival is still a controversial issue. The aim of this COSMOS (Current management Of Secondary hyperparathyroidism: ...

Abstract	Background: Besides advances in haemodialysis (HD), mortality rates are still high. The effect of the different types of HD membranes on survival is still a controversial issue. The aim of this COSMOS (Current management Of Secondary hyperparathyroidism: a Multicentre Observational Study) analysis was to survey, in HD patients, the relationship between the use of conventional low- or high-flux membranes and all-cause and cardiovascular mortality. Methods: COSMOS is a multicentre, open-cohort, 3-year prospective study, designed to evaluate mineral and bone disorders in the European HD population. The present analysis included 5138 HD patients from 20 European countries, 3502 randomly selected at baseline (68.2%), plus 1636 new patients with <1 year on HD (31.8%) recruited to replace patients who died, were transplanted, switched to peritoneal dialysis or lost to follow-up by other reasons. Cox-regression analysis with time-dependent variables, propensity score matching and the use of an instrumental variable (facility-level analysis) were used. Results: After adjustments using three different multivariate models, patients treated with high-flux membranes showed a lower all-cause and cardiovascular mortality risks {hazard ratio (HR) = 0.76 [95% confidence interval (CI) 0.61-0.96] and HR = 0.61 (95% CI 0.42-0.87), respectively}, that remained significant after matching by propensity score for all-cause mortality (HR = 0.69, 95% CI 0.52-0.93). However, a facility-level analysis showed no association between the case-mix-adjusted facility percentage of patients dialysed with high-flux membranes and all-cause and cardiovascular mortality. Conclusions: High-flux dialysis was associated with a lower relative risk of all-cause and cardiovascular mortality. However, dialysis facilities using these dialysis membranes to a greater extent did not show better survival.
Language	English
Publishing date	2020-12-26
Publishing country	England
Document type	Journal Article
ZDB-ID	2655800-2
ISSN	2048-8513 ; 2048-8505
ISSN (online)	2048-8513
ISSN	2048-8505
DOI	10.1093/ckj/sfaa233
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Article ; Online: Bone and mineral metabolism at 55 haemodialysis centres in Lima.

Méndez-Chacón, Pedro / Riccobelli, Nicolás / Dionisi, María P / Sánchez-Álvarez, Emilio / Bardales-Viguria, Fernando / Méndez-Chacón Rodríguez, Carla / Cannata-Andía, Jorge B / Fernández-Martín, José L

Nefrologia

2018 Volume 38, Issue 3, Page(s) 279–285

Abstract: Background: Mineral and bone metabolism disorders are common complications in haemodialysis patients that present significant geographical variability.: Objectives: The objective of this study was to assess these disorders for the first time in ... ...

Title translation	Influencia de la sobrecarga de calcio sobre el metabolismo óseo y mineral en 55 centros de hemodiálisis de Lima.
Abstract	Background: Mineral and bone metabolism disorders are common complications in haemodialysis patients that present significant geographical variability. Objectives: The objective of this study was to assess these disorders for the first time in haemodialysis patients from Peru. Methods: The study included 1551 haemodialysis patients from 55 centres affiliated with the Social Health System of Peru in the city of Lima. Demographic data, comorbidities, treatments and biochemical parameters were collected from each patient. Serum calcium, phosphorus and PTH levels were categorised according to the recommended ranges in the KDOQI and KDIGO guidelines. Results: The mean age of the patients was 59.5±15.6 years, with a mean time on haemodialysis of 58.0±54.2 months. All patients were dialysed with a calcium concentration in the dialysis fluid of 3.5 mEq/l and 68.9% of patients were prescribed phosphate-binding agents (98.4% of them calcium carbonate). A high percentage of patients showed serum calcium above, and serum phosphorus below, the recommended ranges in the KDOQI guidelines (32.8% and 37.3%, respectively). More than half of the patients had serum PTH values below the recommended ranges of both the KDOQI and KDIGO guidelines (56.4% and 51.6%, respectively). Conclusions: Patients included in this study were younger than those from other studies and showed both hypophosphataemia and suppressed PTH, probably due to an excessive calcium overload through dialysis fluid and the use of calcium-containing phosphate binding agents.
MeSH term(s)	Ambulatory Care Facilities ; Bone and Bones/metabolism ; Calcium/metabolism ; Chronic Kidney Disease-Mineral and Bone Disorder/metabolism ; Chronic Kidney Disease-Mineral and Bone Disorder/therapy ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Peru ; Phosphorus/metabolism ; Renal Dialysis ; Urban Health
Chemical Substances	Phosphorus (27YLU75U4W) ; Calcium (SY7Q814VUP)
Language	Spanish
Publishing date	2018-05-02
Document type	Journal Article ; Multicenter Study ; Observational Study
ZDB-ID	2837917-2
ISSN	2013-2514 ; 2013-2514
ISSN (online)	2013-2514
ISSN	2013-2514
DOI	10.1016/j.nefro.2017.09.011
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