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Serum Phosphate Levels (serum + phosphate_level)

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Medical Sciences	100%

Selected Abstracts

ORAL PHOSPHATE BINDERS FOR THE MANAGEMENT OF SERUM PHOSPHATE LEVELS IN DIALYSIS PATIENTS

JOURNAL OF RENAL CARE, Issue 2009
Ismail Mohammed MBBS, MRCP
SUMMARY Hyperphosphataemia is an inevitable consequence of end stage chronic kidney disease and is present in the majority of dialysis patients. Hyperphosphataemia is statistically associated with increased cardiovascular mortality among dialysis patients. Dietary restriction of phosphate and current dialysis modalities are not sufficiently effective to maintain serum phosphate levels within the recommended range so that the majority of dialysis patients require oral phosphate binders. However, benefits of achieving the recommended range have yet to be demonstrated prospectively. Unfortunately, conventional phosphate binders are not reliably effective and are associated with a range of limitations and side effects. Aluminium containing agents are highly efficient but no longer widely used because of well-established and proven toxicity. Calcium-based salts are inexpensive, effective and most widely used but there is now concern about their association with hypercalcaemia and vascular calcification. Sevelamer hydrochloride and lanthanum carbonate are non-aluminium, calcium-free phosphate binders. They are effective and reasonably well tolerated, but still do not control phosphate levels in all patients. Patient education programmes have been shown to be a useful and effective method of improving achievement of serum phosphate targets. [source]

Effect of Iron(III) Chitosan Intake on the Reduction of Serum Phosphorus in Rats

JOURNAL OF PHARMACY AND PHARMACOLOGY: AN INTERNATI ONAL JOURNAL OF PHARMACEUTICAL SCIENCE, Issue 7 2000
JOSEPH BAXTER
Because of the widespread use of aluminium- and calcium-containing phosphate binders for the control of hyperphosphataemia in patients with end-stage renal failure, an iron(III) chitosan complex was synthesised and fed to rats to measure its effect on serum phosphorus and calcium, intestinal phosphate binding and phosphate absorption. Thirty-six Wistar rats were randomly selected and distributed into a baseline group (n = 6), a control group (n = 8 (days 0,15), n = 8 (days 16,30)) and a treatment group (n = 8 (days 0,15), n = 8 (days 16,30)). The control groups ingested AIN-76 diet mix with a 1% w/w fibre content; however, the treatment groups had the fibre content completely substituted with iron(III) chitosan. The mean weights of the treated rats were slightly lower from 15 days (not significant); but overall, rat growth was not stunted in the treatment groups. The serum phosphorus levels of the treated group (n = 8) were significantly reduced after 15 days (P = 0.004; control: 5.7 ± 0.9 mg dL,1; treatment: 4.4±0.5 mg dL,1; 95% CI of difference: 0.5,2.2) and 30 days (P = 0.002; control: 5.5 ± 0.9 mg dL,1; treatment = 4.1 ± 0.6 mg dL,1; 95% CI of difference: 0.6,2.3) as compared with the respective control group. The serum calcium-phosphorus product was 62.0 ± 12.1 mg2 dL,2 for the control and 45.1 ± 6.6 mg2 dL,2 for the treatment group after 30 days (P = 0.004). The serum iron concentration of the treatment group did not differ from the baseline value after 15 and 30 days, but the treatment group was significantly higher than the control group (P < 0.05) after 30 days. The faeces phosphorus levels (mg day,1) were higher (P < 0.01) and its iron content was much higher (P < 0.01) for the treated group. The urine phosphorus (mg kg,1) was not significantly reduced for the treated group, but the mean was consistently less. The kidney and liver weights of both groups were similar, but the phosphorus content of the kidney (mg (g kidney),1) was higher for the treated group after 30 days (P = 0.041; control, 4.2 ± 1.2 mg g,1 vs treatment, 5.6 ± 1.4 mg g,1. Because iron(III) chitosan had a high phosphorus-binding capacity of 308 (mg P) per gram of Fe3+ for both the in-vitro (pH 7.5) and in-vivo studies, which is greater than nearly all commonly used phosphate binders, and a small net phosphorus absorption difference of 3.7 mg day,1, it is an efficient phosphate binder for lowering serum phosphate levels without increasing serum calcium levels. [source]

ORAL PHOSPHATE BINDERS FOR THE MANAGEMENT OF SERUM PHOSPHATE LEVELS IN DIALYSIS PATIENTS

Increased serum phosphate levels and calcium fluxes are seen in smaller individuals after a single dose of sodium phosphate colon cleansing solution: a pharmacokinetic analysis

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 11 2009
E. D. EHRENPREIS
Summary Background, Sodium phosphate containing colonoscopy preparations may cause electrolyte disturbances and calcium-phosphate nephropathy. Decreased body weight is an unexplored risk factor for complications with sodium phosphate ingestion. Aim, To perform a pharmacokinetic analysis of a single dose of Fleet Phospho-Soda in smaller and larger individuals. Methods, Seven subjects weighing <55 kg (Group I) and six weighing >100 kg (Group II) consumed 45 mL Fleet Phospho-Soda. Serum electrolytes were measured. Hydration was closely maintained by monitoring weight, fluid intake and total body water. Results, Marked increases in serum phosphate were seen in Group I compared to Group II. For example, mean serum phosphate at 120 min was 7.8 ± 0.5 mg/dL in Group I and 5.1 ± 0.8 mg/dL in Group II (P < 0.001). Normalized area under the phosphate vs. time curve for Group I was 1120 ± 190 mg/dL*min and 685 ± 136 mg/dL*min for Group II (P < 0.001). Twelve-hour urine calcium was lower in Group I (16.4 ± 7.6 mg) than in Group II (39.2 ± 7.8 mg, P < 0.001). Conclusions, Increased serum phosphate occurs in smaller individuals after ingestion of sodium phosphate preparations, even with strict attention to fluid intake. Smaller body weight poses a potential risk for calcium-phosphate nephropathy. [source]

Pre- and post-discharge feeding of very preterm infants: impact on growth and bone mineralization

CLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, Issue 4 2003
Sangita Kurl
Summary In this prospective study we examined (1) how the nutritional status of very preterm infants, judged by growth measures and biochemical values, evolved during the initial hospitalization; (2) the effect of feeding on growth after discharge from hospital; and (3) the risk factors associated with low lumbar bone mineral content (BMC) later in infancy. Sixty-four former preterm infants had their lumbar spine (L2,L4) BMC assessed by dual energy X-ray absorptiometry when they weighed between 5 and 7 kg. Predicted BMC values were calculated based on our previously reported reference lumbar BMC data. These values were used to convert the preterm infants' BMC values into percentages. The extremely preterm group (gestational age ,28 weeks) had significantly more respiratory morbidity and longer duration of hospital stay than the more mature infants. Both groups developed growth retardation and malnutrition during the hospital stay. Exclusive breastfeeding after discharge from hospital supported linear catch-up growth and weight gain but was associated with a 7·0 (1·2,41·7)-fold risk of having low BMC values. The other factors associated with the risk of having low BMC values later in infancy were low serum phosphate levels at 6 weeks, with a 7·8 (1·6,37·0)-fold risk, and male gender, with a 4·3 (1·2,16·1)-fold risk. Appropriately designed interventional studies are needed to improve the growth and nutrition of these infants during initial hospitalization. In order to improve the postdischarge nutrition, we suggest that the amount and duration of multicomponent human milk fortification should be studied further to provide individualized nutrition throughout the catch-up growth period until the end of the first year of life. [source]