Effect of serum phosphate on parathyroid hormone secretion during hemodialysis

Effect of serum phosphate on parathyroid hormone secretion during hemodialysis.BackgroundRecent studies have demonstrated that a high concentration of phosphate directly stimulates parathyroid hormone (PTH) secretion. High serum levels of phosphate are usually observed in patients with end-stage renal disease. The aim of the present study was to evaluate whether serum phosphate concentration had an acute effect on PTH secretion in hemodialysis patients. The levels of serum phosphate were manipulated during the hemodialysis session by using a phosphate free dialysate or a dialysate with a high content of phosphate.MethodsTen stable hemodialysis patients with PTH values above 300 pg/ml were included in the study. A PTH-calcium curve was obtained during both high phosphate and phosphate free hemodialysis.ResultsThe serum phosphate concentration remained high (2.17 ± 0.18mM) throughout the high phosphate hemodialysis and decreased progressively to normal levels (1.02 ± 0.06mM) during the phosphate free hemodialysis. The serum PTH levels at maximal inhibition by hypercalcemia (minimal PTH) were greater during the high phosphate than the phosphate free hemodialysis (413 ± 79 vs. 318 ± 76 pg/ml, P < 0.003). In all patients the values of minimum PTH were greater during the high phosphorus than the phosphorus free hemodialysis. The values of maximally stimulated PTH during hypocalcemia and the set point of the PTH-calcium curve were similar during the high phosphate and the phosphate free hemodialysis.ConclusionThe maintenance of high serum phosphorus levels during hemodialysis prevented, in part, the inhibition of PTH secretion by calcium, which strongly suggests that in hemodialysis patients high serum phosphate contributes directly to the elevation of PTH levels despite normal or high serum calcium concentration

Evaluation of calcium acetate/magnesium carbonate as a phosphate binder compared with sevelamer hydrochloride in haemodialysis patients: a controlled randomized study (CALMAG study) assessing efficacy and tolerability

Background. Phosphate binders are required to control serum phosphorus in dialysis patients. A phosphate binder combining calcium and magnesium offers an interesting therapeutic option

Riociguat treatment in patients with chronic thromboembolic pulmonary hypertension: Final safety data from the EXPERT registry

Objective: The soluble guanylate cyclase stimulator riociguat is approved for the treatment of adult patients with pulmonary arterial hypertension (PAH) and inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH) following Phase

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International audienceThe scope of the use of proton pump inhibitors (PPIs) in hemodialysis patients is really worrying because of its widespread use, often in the absence of medical supervision and its implications have potential adverse effects

Hemoglobin Variability in Nondialysis Chronic Kidney Disease: Examining the Association with Mortality

Background and objectives: Anemia and hemoglobin (Hb) variability are associated with mortality in hemodialysis patients who are on erythropoiesis-stimulating agents (ESA). Our aim was to describe the degree of Hb variability present in nondialysis patients with chronic kidney disease (CKD), including those who were not receiving ESA, and to investigate the association between Hb variability and mortality

Study of Bc+→χcπ+B_c^+ \rightarrow \chi_c \pi^+ decays

International audienceA study of $B_c^+ \rightarrow \chi_c \pi^+$ decays is reported using proton-proton collision data, collected with the LHCb detector at centre-of-mass energies of 7, 8, and 13 TeV, corresponding to an integrated luminosity of 9fb$^{-1}$. The decay $B_c^+ \rightarrow \chi_{c2} \pi^+$ is observed for the first time, with a significance exceeding seven standard deviations. The relative branching fraction with respect to the $B_c^+ \rightarrow J/\psi \pi^+$ decay is measured to be $$\frac{\mathcal{B}_{B_c^+ \rightarrow \chi_{c2} \pi^+}} {\mathcal{B}_{B_c^+ \rightarrow J/\psi \pi^+}} = 0.37 \pm 0.06 \pm 0.02 \pm 0.01 ,$$ where the first uncertainty is statistical, the second is systematic, and the third is due to the knowledge of the $\chi_c \rightarrow J/\psi \gamma$ branching fraction. No significant $B_c^+ \rightarrow \chi_{c1} \pi^+$ signal is observed and an upper limit for the relative branching fraction for the $B_c^+ \rightarrow \chi_{c1} \pi^+$ and $B_c^+ \rightarrow \chi_{c2} \pi^+$ decays of $$\frac{\mathcal{B}_{B_c^+ \rightarrow \chi_{c1} \pi^+}} {\mathcal{B}_{B_c^+ \rightarrow \chi_{c2} \pi^+}} < 0.49$$ is set at the 90% confidence level

Measurements of the branching fraction ratio B(ϕ→μ+μ−)/B(ϕ→e+e−)\cal{B}(\phi \to \mu^+\mu^-)/\cal{B}(\phi \to e^+e^-) with charm meson decays

International audienceMeasurements of the branching fraction ratio ${\cal{B}(\phi \to \mu^+ \mu^-)/\cal{B}(\phi\to e^+e^-)}$ with ${D_{s}^{+} \to \pi^{+} \phi}$ and ${D^{+} \to \pi^{+} \phi}$ decays, denoted $R^{s}_{\phi \pi}$ and $R^{d}_{\phi \pi}$, are presented. The analysis is performed using a dataset corresponding to an integrated luminosity of 5.4$\,\rm{fb}^{-1}$ of $pp$ collision data collected with the LHCb experiment. The branching fractions are normalised with respect to the ${B^{+} \to K^{+} J/\psi(\to e^+e^-)}$ and ${B^{+} \to K^{+} J/\psi(\to \mu^+\mu^-)}$ decay modes. The combination of the results yields $$R_{\phi \pi} = 1.022 \pm 0.012 \,({\rm stat}) \, \pm 0.048 \,({\rm syst}).$$ The result is compatible with previous measurements of the $\phi \to \ell^{+}\ell^{-}$ branching fractions and predictions based on the Standard Model