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1. Interdisziplinäre Interaktion bei vaskulärer Erkrankung des Auges, Diabetes und diabetischer Retinopathie

Author

W. Kleophas and F. Dellanna

Subjects
Pediatrics, medicine.medical_specialty, business.industry, Disease, Diabetic retinopathy, Early Therapy, medicine.disease, Diabetic foot, Diabetic nephropathy, Ophthalmology, Blood pressure, Diabetes mellitus, Medicine, Microalbuminuria, business
Abstract

The incidence of diabetes mellitus type 2 is greatly increasing worldwide. An early therapy with intensified control of diabetes and blood pressure is especially important to avoid delayed complications. In addition to diabetic foot syndrome, diabetic retinopathy and diabetic nephropathy still represent commonly occurring problems. Despite improvements in the quality of care, the targets of the St. Vincent Declaration have still not yet been achieved. Diabetic retinopathy and diabetic nephropathy show parallels in the course of the disease and in the pathological anatomical alterations which have led to the inauguration of a diabetic renal-retinal syndrome. The ophthalmological assessment of the retina was previously considered to be a diagnostic aid for assessment of diabetic nephropathy; however, nowadays a simple estimation of the glomerular filtration rate using the modification of diet in renal disease (MDRD) formula and determination of microalbuminuria can in contrast give ophthalmologists an early indication of the possible presence of microangiopathic alterations.

Published
2014
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2. Anaemia in CKD 5D

Author

A. Mikhail, M. Kaplan, I. Macdougall, R. J. Schmidt, A. Rastogi, W. Wang, S. Tong, M. Mayo, N. Oestreicher, B. Schiller, J. M. Green, R. Verma, K. Leu, R. B. Mortensen, P. R. Young, P. Schatz, D. M. Wojchowski, Y. Shimonaka, Y. Sasaki, K. Yorozu, M. N. Sasaki, K. Ikuta, Y. Kohgo, Y. M. Omori, M. Hiramatsu, N. Momoki, Y. Kakio, N. Shibuto, H. Takeuchi, M. Fukumoto, K. Maruyama, Y. Matsuo, Y. Omori, B. M. Robinson, M. Larkina, D. A. Goodkin, Y. Li, F. Locatelli, J. Nolen, W. Kleophas, R. L. Pisoni, S. Sibbel, S. Brunelli, M. Krishnan, M. Horie, E. Hasegawa, K.-i. Minoshima, C. Ambrus, L. Kerkovits, J. Szegedi, A. Benke, E. Toth, L. Nagy, B. Borbas, A. Rozinka, J. Nemeth, G. Varga, I. Kulcsar, L. Gergely, S. Szakony, I. Kiss, K. Danielson, A. R. Qureshi, O. Heimburger, P. Stenvinkel, B. Lindholm, B. Hylander-Rossner, G. Germanis, M. Hansson, S. Beshara, P. Barany, J.-M. Dueymes, A. Kolko, C. Couchoud, C. Combe, A. Covic, D. Goldsmith, P. Zaoui, L. Gesualdo, G. London, F. Dellanna, J. Mann, M. Turner, M. Muenzberg, K. MacDonald, K. Denhaerynck, I. Abraham, M. B. Sanchez, R. C. Casero, R. V. Ortiz, I. G. Carmelo, S. C. Munoz, E. R. Gomez, C. S. Rodriguez, T. Kuji, T. Fujikawa, M. Kakimoto-Shino, K. Shibata, Y. Toya, S. Umemura, N. Topuzovic, I. Mihaljevic, V. Rupcic, G. Sterner, N. Clyne, J. Toblli, F. Di Gennaro, M. Chmielewski, P. Jagodzinski, M. Lichodziejewska-Niemierko, B. Rutkowski, K. Takasawa, C. Takaeda, H. Ueda, M. Higuchi, T. Maeda, N. Tomosugi, T. F. Moghazy, M. Jakic, L. Zibar, G. Romei Longhena, W. Beck, A. Liebchen, U. Teatini, J. B. Rottembourg, A. Guerin, M. Diaconita, A. Dansaert, K. Koike, K. Fukami, K. Shimamatsu, A. Kawaguchi, and S. Okuda

Subjects
Transplantation, medicine.medical_specialty, Nephrology, business.industry, Internal medicine, medicine, business
Published
2013
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3. Anaemia in CKD 1-5

Author

M. Hirata, Y. Tashiro, K. Aizawa, K. Endo, K. Serizawa, K. Yogo, A. Cases, J. Portoles, J. Calls, A. Martinez-Castelao, M. A. Munar, A. Segarra, E. Samouilidou, K. Pantelias, D. Petras, T. Mpakirtzi, C. Pipili, G. Chatzivasileiou, K. Vasiliou, E. Denda, E. Grapsa, H. Tzanatos, S. Shoji, M. Inaba, N. Tomosugi, S. Okuno, M. Ichii, T. Yamakawa, S. Kurihara, L. Barsan, A. Stanciu, S. Stancu, C. Capusa, L. Bratescu, G. Mircescu, K.-L. Kuo, S.-C. Hung, T.-S. Lee, D.-C. Tarng, I. Nistor, A. Covic, D. Goldsmith, P. Garrido, J. Fernandes, S. Ribeiro, H. Vala, B. Parada, R. Alves, L. Belo, E. Costa, A. Santos-Silva, F. Reis, K. Abdulnabi, A. Ullah, A. Abdulateef, M. Howse, A. Khalil, B. Fouqueray, M. Hoffmann, J. Addison, N. Manamley, D. Stamopoulos, N. Mpakirtzi, N. Afentakis, K.- H. Yu, J. Chou, S. Klaus, M. Schaddelee, M. Kashiwa, A. Takada, T. Neff, J. Galle, K. Claes, S. Di Giulio, A. Guerin, H. Herlitz, I. Kiss, G. Wirnsberger, M. Froissart, C. Winearls, A. Martinez Castelao, A. Cases Amenos, A. Torre Carballada, F. J. Torralba Iranzo, J. M. Bronsoms Artero, D. Toran Monserrat, M. Valles Prats, J. L. Merino, B. Espejo, B. Bueno, Y. Amezquita, V. Paraiso, Z. Kiss, L. Kerkovits, C. Ambrus, I. Kulcsar, J. Szegedi, A. Benke, B. Borbas, S. Ferenczi, M. Hengsperger, S. Kazup, L. Nagy, J. Nemeth, A. Rozinka, T. Szabo, T. Szelestei, E. Toth, G. Varga, G. Wagner, G. Zakar, L. Gergely, K. Exarchou, N. Tanahill, A. Anthoney, S. Ahmed, R. Oprican, M. Lipan, B. Chirculescu, S. Roger, R. Malecki, M. Farouk, F. Dellanna, M. Thomas, M. Touam, F. Chantrel, M. Bouiller, J.-M. Hurot, T. Raphael, A. Testa, S. Veillon, B. Vendrely, Z. Masoumi, P. Ahmadpoor, S. M. H. Ghaderian, M. Nafar, S. Samavat, F. Samadian, F. Poorrezagholi, M. Shahidi, E. Riccio, B. Visciano, I. Capuano, A. Memoli, G. Mozzillo, B. Memoli, and A. Pisani

Subjects
Transplantation, medicine.medical_specialty, Nephrology, business.industry, Internal medicine, Medicine, business
Published
2013
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4. Bestimmung der glomerulären Filtrationsrate bei chronischer Niereninsuffizienz

Author

F. Dellanna

Subjects
Nephrology, Gynecology, medicine.medical_specialty, Transplant surgery, Cystatin C, biology, business.industry, Internal medicine, medicine, biology.protein, Renal function, business
Abstract

Die Naherungsformeln, insbesondere die CKD-EPI- und MDRD-Formel, stellen eine wichtige Bereicherung in der Diagnostik der Nierenfunktion dar, da sie sensitiver sind als die isolierte Serumkreatininmessung. In einer kurzlich publizierten Metaanalyse schnitt die CKD-EPI-Formel hinsichtlich der Risikoeinschatzung fur kardiovaskulare Endpunkte und das Erreichen der terminalen Niereninsuffizienz im Vergleich besser ab als die MDRD-Formel. Beide Formeln haben jedoch ihre Limitationen und tendieren zur Unterschatzung der wahren Nierenfunktion und zur Ungenauigkeit mit Abweichungen von mehr als 30% gegenuber Referenzmethoden. In besonderen klinischen Situationen sind daher die endogene Kreatinin-Clearance und die Cystatin-C-Messung indizierte Untersuchungsmethoden. Fur die prognostische Einschatzung sind neben dem CKD („chronic kidney disease“)-Stadium weitere Parameter heranzuziehen.

Published
2012
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5. Renal anaemia - CKD 5D

Author

K. Takasawa, C. Takaeda, M. Higuchi, T. Maeda, N. Tomosugi, N. Ueda, Y. Sasaki, M. Ikezoe, M. Hagiwara, S. Furuhata, M. Murakami, Y. Shimonaka, S. Yamazaki, S. Hamahata, M. Oue, T. Kuragano, M. Furuta, M. Yahiro, A. Kida, Y. Otaki, Y. Hasuike, H. Nonoguchi, T. Nakanishi, P. Sarafidis, A. Rumjon, D. Ackland, H. Maclaughlin, S. S. Bansal, I. C. Macdougall, V. Panichi, A. Rosati, E. Malagnino, R. Giusti, A. Casani, G. Betti, P. Conti, G. Bernabini, C. Gabrielli, D. Caiani, A. Scatena, M. Migliori, F. Pizzarelli, E. Mitsopoulos, M. Tsiatsiou, I. Minasidis, V. Kousoula, E. Intzevidou, P. Passadakis, V. Vargemezis, D. Tsakiris, S. W. Lines, A. M. Carter, E. J. Dunn, M. J. Wright, R. Aoyagi, T. Miura, L. De Paola, G. Lombardi, G. Coppolino, L. Lombardi, H. Fukumoto, S. Kaibe, M. Tokuyama, M. Hiwasa, T. Miyamoto, H. Ohue, A. Matsumoto, K. Toyoda, J. Rottembourg, C. Emery, A. Lafuma, J. Wernli, L. Zakin, L. Mahi, D. Borzych-Duzalka, Y. Bilginer, L. Pape, I. S. Ha, M. Bak, A. Chua, L. Rees, S. Pesle, F. Cano, A. Urzykowska, S. Emre, J. Russcasso, V. Ramela, N. Printza, C. White, D. Kuzmanovska, V. Andrea, D. Muller-Wiefel, B. Warady, F. Schaefer, J. H. Chung, M. K. Park, H. L. Kim, B. C. Shin, T. Fujikawa, T. Kuji, M. Kakimoto, K. Shibata, H. Satta, M. Nishihara, S. Kawata, N. Koguchi, Y. Toya, S. Umemura, V. David, G. Michel, H. Maxime, L. Paul, K. Sebastien, V. Francois, V. Kuntsevich, Y. Dou, S. Thijssen, N. W. Levin, P. Kotanko, B. S. Kim, W. D. Park, H. C. Song, H. G. Kim, Y.-O. Kim, K. Woodburn, K.-L. Fong, Y. Moriya, Y. Tagawa, F. Kanda, N. Morita, G. London, P. Zaoui, A. Covic, F. Dellanna, D. Goldsmith, L. Gesualdo, J. Mann, C. Combe, M. Turner, M. Meunzberg, K. Macdonald, I. Abraham, A. Guerin, M. Diaconita, R. Apruzzese, A. Kruse, G. Ouellet, C. Bond, D. Jensen, S. Wang, E. Pham, J. Rubin, M. Sika, R. Niecestro, S. Sloneker, P. Strzemienski, E. Solon, D. Stamopoulos, N. Mpakirtzi, E. Grapsa, B. Gogola, E. Manios, N. Afentakis, and J. Ewer

Subjects
Transplantation, medicine.medical_specialty, Nephrology, business.industry, Internal medicine, medicine, Renal anaemia, business
Published
2012
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6. The PRIMAVERA study protocol design: Evaluating the effect of continuous erythropoiesis receptor activator (C.E.R.A.) on renal function in non-anemic patients with chronic kidney disease

Author

Martina Koch, Ingeborg A. Hauser, J. Seufert, Oliver Witzke, Danilo Fliser, and F. Dellanna

Subjects
medicine.medical_specialty, medicine.drug_class, Medizin, Urology, Renal function, Polyethylene Glycols, End stage renal disease, chemistry.chemical_compound, Internal medicine, medicine, Humans, Erythropoiesis, Pharmacology (medical), Erythropoietin, Kidney transplantation, Randomized Controlled Trials as Topic, Creatinine, business.industry, Anemia, General Medicine, medicine.disease, Interim analysis, Erythropoiesis-stimulating agent, Continuous erythropoietin receptor activator, Treatment Outcome, Endocrinology, chemistry, Kidney Failure, Chronic, business, Glomerular Filtration Rate, Kidney disease
Abstract

Erythropoiesis stimulating agents (ESA) are widely used for hemoglobin correction in patients suffering from renal anemia. However, their beneficial non-hematopoietic effects on renal deterioration have not been adequately assessed. The Primavera study is the first prospective, controlled trial to assess whether ESA treatment could ameliorate progression of chronic kidney disease (CKD) in non-anemic patients. Primavera is a single-blind, 24-month trial in which patients are randomized to placebo or to C.E.R.A., a continuous erythropoietin receptor activator. Patients with type 2 diabetes or who have undergone kidney transplantation are eligible to enter the study if they have CKD stage III (estimated GFR [eGFR] 30–59 mL/min/1.73 m 2 ), urinary albumin to creatinine ratio (UACR) ≥ 50 g/g and ≤ 1500 g/g, or total urine protein ≥ 50 mg/24 h and ≤ 1500 mg/24 h, and hemoglobin 11–14 g/dL. The primary efficacy endpoint is the change in eGFR from baseline to month 24. Secondary efficacy endpoints are the changes in UACR, serum cystatin C and serum creatinine from baseline. Safety endpoints include adverse events and discontinuation due to pre-specified adverse events. An interim analysis will be performed after all patients have completed the first year. The planned sample size is 400 patients (200 type 2 diabetics, 200 transplant recipients) conferring 90% power to detect a prespecified significant difference of 1.5 mL/min/1.73 m 2 in the annual reduction in eGFR between treatment groups. The results of Primavera are expected in 2013.

Published
2011
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7. Dosing strategies for conversion of haemodialysis patients from short-acting erythropoiesis stimulating agents to once-monthly C.E.R.A.: experience from the MIRACEL study

Author

F. Bozkurt, R. E. Winkler, N. Bockreiss, V. Schettler, Danilo Fliser, F. Dellanna, and S. Graf

Subjects
medicine.medical_specialty, Darbepoetin alfa, business.industry, medicine.medical_treatment, Epoetin alfa, General Medicine, medicine.disease, Gastroenterology, Continuous erythropoietin receptor activator, Surgery, Concomitant, Internal medicine, medicine, Coagulopathy, Hemodialysis, Dosing, Adverse effect, business, medicine.drug
Abstract

SUMMARY Aims: To analyse the impact of dosing decisions for continuous erythropoietin receptor activator (C.E.R.A.), a continuous erythropoietin receptor activator. Methods: This was a prospective, multicentre, single-arm study in haemodialysis patients receiving epoetin alfa ⁄beta or darbepoetin alfa. After a 2-month screening phase, patients were converted to monthly C.E.R.A. using pre-filled syringes during a 5-month titration phase and a 2-month evaluation phase. Results: Four hundred and twenty-four eligible patients were converted to C.E.R.A. Mean Hb were 11.7 ± 0.7, 11.7 ± 0.8 and 11.5 ± 0.8 g ⁄dl during screening, titration and evaluation, respectively. C.E.R.A. starting dose was 125 l g( n = 311) or 200 lg (n = 106), with corresponding final doses of 129 ± 61 lg and 203 ± 58 lg. The mean number of C.E.R.A. dose decreases and increases were 0.9 ± 1.0 and 1.1 ± 1.0 per patient, respectively. Hb rarely exceeded 12.5 g ⁄dl after a C.E.R.A. dose increase (< 8%) and remained ‡ 11 g ⁄dl after a dose reduction on approximately three-quarters of occasions. Among the 53 occasions where Hb decreased ‡ 2g ⁄dl between two consecutive visits, the previous dose had been withheld (n = 9), concomitant blood loss, coagulopathy or infection was present (n = 13), or iron parameters were low (n = 17). There were 104 adverse events ⁄month during screening, and 45 ⁄month during the titration ⁄evaluation phases. Serious adverse events occurred in 18.0 and 21.0 patients ⁄month during the screening and titration ⁄evaluation phases, respectively. Conclusion: Switching haemodialysis patients from shorter-acting ESA to once-monthly C.E.R.A. using pre-filled syringes is straightforward, and Hb levels remain stable. Starting dose recommendations and dose changes correlated well with the clinical setting. Collateral factors such as infection or aggravating concomitant medical conditions should be taken into account. What’s known Fewer than half of all dialysis patients maintain target haemoglobin levels over a 6-month period despite widespread use of erythropoeisis stimulating agents (ESA), partly due to haemoglobin cycling in response to short, intermittent bursts of erythropoietic activity following short-acting ESA administration. C.E.R.A., a continuous erythropoietin receptor activator, offers oncemonthly dosing without compromising haemoglobin control in maintenance dialysis patients compared with other ESAs.

Published
2010
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8. Efficacy of cinacalcet administered with the first meal after dialysis: the SENSOR Study

Author

P M Jehle, M C Sánchez González, D Sanz, V Zani, C Asensio, F Dellanna, J Bover, D Carter, P Gross, and Roland M. Schaefer

Subjects
Male, Nephrology, medicine.medical_specialty, Cinacalcet, Nausea, Calcimimetic, medicine.medical_treatment, Administration, Oral, Naphthalenes, Gastroenterology, Renal Dialysis, Internal medicine, medicine, Humans, Dialysis, Hyperparathyroidism, business.industry, General Medicine, Middle Aged, medicine.disease, Treatment Outcome, Endocrinology, Parathyroid Hormone, Vomiting, Kidney Failure, Chronic, Female, Hyperparathyroidism, Secondary, Secondary hyperparathyroidism, medicine.symptom, business, medicine.drug
Abstract

Background: Cinacalcet, a novel calcimimetic, simultaneously lowers parathyroid hormone (PTH), phosphorus (P), calcium (Ca) and Ca x P in patients who are on dialysis with secondary hyperparathyroidism (sHPT) associated with CKD. Previous studies have required cinacalcct to be administered during the dialysis session and at the same time on non-dialysis days. The aim of the SENSOR study was to demonstrate that cinacalcet given in a more clinically practical manner with the first major meal after dialysis is noninferior to cinacalcet given with food during the dialysis session. Methods: In this open-label study dialysis patients with poorly controlled sHPT (intact PTH (iPTH) > 300 pg/ml) were randomized to receive cinacalcet either daily with their post-dialysis meal (n = 337) or with food during the dialysis session (n = 336). The primary endpoint was the proportions of patients with mean iPTH ≤ 300 pg/ml (≤ 31.8 pmol/l) at Weeks 11 and 13 of a 21 -week treatment period. Secondary endpoints included the proportion of patients with Ca x P < 55 mg 2 /dl 2 (< 4.44 mmol 2 /l 2 ) at Weeks 11 and 13 and patients who discontinued the study due to nausea or vomiting. Results: Comparable proportions of patients in the cinacalcet "during dialysis" and "post-dialysis meal" groups had a mean iPTH ≤ 300 pg/ml (54 vs. 57%, respectively, 95% confidence interval (CI) difference -4, +10%) and Ca x P < 55 mg 2 /dl 2 (78 vs. 73%, respectively, 95% Cl difference - 11, +2%) at Weeks 11 and 13. The groups were also comparable at Week 21. Cinacalcet was well tolerated, with < 3% of patients in both groups discontinuing due to nausea or vomiting. A combined post-hoc analysis of both groups showed the incidence of nausea and vomiting was lower if cinacalcet was administered during the evening. Conclusions: Administering cinacalcet with the first main meal after dialysis was as effective as administration with food during the dialysis session. Cinacalcet was well tolerated. The incidence of gastrointestinal adverse events appeared to be lower when cinacalcet was administered in the evening.

Published
2008
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9. The effects of cinacalcet in older and younger patients on hemodialysis: The evaluation of cinacalcet HCL therapy to lower cardiovascular events (EVOLVE) trial

Author

P. Ryckelynck, Y. Woredekal, T. Gehr, Marian Klinger, J. Passauer, K. Liss, E. Del Valle, B. Linares, Ferdinando Avella, Stolear Jc, S. Tolkan, O. Hermida, V. Wizemann, Ricardo Correa-Rotter, J. Santos, Gert Mayer, Michael Anger, B. Pellegrino, B. Wikström, A. Ståhl, H. Al-Bander, Pedro Alejandro Gordan, Philip A. Kalra, E. Galindo-Ramos, Carmine Zoccali, G. Dolson, M. Eigner, Sanjay Dalal, G. Touchard, J Peeters, G. Da Roza, Shannon Murphy, R. Errico, M. Lonergan, A. Andrusev, H. Boulechfar, P. Zaoui, Michael Suranyi, de Francisco Martín de Francisco, S. Jacobson, B. Gupta, C. Stafford, J. Picollo de Oliveira, Ilka Regina Souza de Oliveira, F. Dumler, J. Martinez Saye, E. de Almeida Romão, Emmanuel A. Burdmann, C. Vermeij, N. Kumar, E. Shahmir, J. Stratton, R. Schmidt, Mario Cozzolino, Lars Christian Rump, Rainer Oberbauer, J. Kumar, M. Saklayen, Brian Hutchison, C. Denu-Ciocca, L. Weiss, E. Friedman, L. Renders, K. Gurevich, L. Brandi, W. Shapiro, Kym M. Bannister, K. Berta, Muhammad M. Yaqoob, C. Lok, A. Pedrosa, Rosa M.A. Moysés, K. Bhandari, J. Arrieta, T. Crouch, Brigitte Maes, G. Wong, Myriam González, Matthew R. P. Davies, R. Gonzalez, Geoffrey A. Block, T. Nammour, T. Youell, J. Ramirez, S. Tobe, N. Ramirez, T. Bochicchio-Ricardelli, J. Cangiano-Rivera, D. Streja, J. Endsley, K. Ang, R. Patak, J. Cheng, T. Rogers, Alberto Albertazzi, H. Holzer, G. Choukroun, Jose A.L. Arruda, Philippe Rieu, P. Simon, Stephen Z. Fadem, Jared G. Sugihara, H. Alfred, Bruce F. Culleton, G. Frascà, Giovanni Pertosa, W. Van Kuijk, H. Beresan, Samuel S. Blumenthal, Piergiorgio Messa, H. Baer, Michael C. Braun, B. Rutkowski, W. Riegel, M. Komandenko, V. Ermolenko, Martin Wilkie, N. Muirhead, Peter G. Kerr, D. Rattensberger, J. Sabto, Anjay Rastogi, L. Lef, M. El Shahawy, D. Tharpe, A. Smirnov, J. Pons, F. García, F. Zantvoort, A. Lionet, J. Topf, Marcia R. Silver, Reinhard Kramar, E. Moriero, A. Rekhi, S. Roe, P. Batista, E. Kolmakova, F. Rahim, M. Ostrowski, Janice P. Lea, Patrizia Ondei, C. Martinez, J. Donck, Nicole Lopez, F. Schena, Allen R. Nissenson, Alex P.S. Disney, R. Valtuille, C. Najun Zarazaga, M. Fraenkel, Pieter Evenepoel, R. Cottiero, S. Di Giulio, V. Gura, S. Karunakaran, P. Nader, F. Saldanha Thome, Walter Douthat, A. Fekete, L. Arbeit, W. Sulowicz, I. Marin, Charles R.V. Tomson, Andrzej Wiecek, Luis A. Juncos, G. Mingardi, P. Light, Max Dratwa, H. Reichel, R. Raja, U. Ranjit, G. Sterner, E. Coll Piera, P. Pai, Robert J. Walker, R. Bregman, E. Hübel, M. Timofeev, T. Szabo, A. Elli, N. Padmanabhan, N. Garrote, M. Mysliwiec, David C. Wheeler, J. Cruz-Valdez, R. Klauser, Maree-Ross Smith, Antonio Carlos Carvalho, A. Losito, M. Durlik, G. Petraglia, Gianni Cappelli, Y. Lien, M. Chaffin, N. García, R. Halligan, Glenn M. Chertow, M. Bastos, P. Smak Gregoor, S. Ong, M. Belledonne, Fredric O. Finkelstein, J. Martínez García, R. Pecoits Filho, M. Klingberg, B. Carvalho, S. Noble, T. Plumb, A. Chew Wong, Michael Roppolo, U. Neyer, S. Ahmad, J. Mackie, R. Minasian, M. Verrelli, A. Abukurah, M. Laski, P. Brunet, Madeleine V. Pahl, Daniel Zehnder, E. Alas, Muralidhar Acharya, G. Rudolf, G. Zakar, M. Reddy, R. Specter, G. Grandaliano, I. Kulcsar, A. Amatya, Eugenie Pedagogos, O. Ayodeji, G. Jensen, S. Diamond, Xavier Warling, P. Teredesai, M. Mathew, M. Haque, M. Solis, E. Andrés Ribes, M.A. van den Dorpel, Akhtar Ashfaq, Christian Rabbat, David G. Warnock, M. Sebastian Diaz, C. Mousson, R. Darwish, M. Sperto Baptista, N. Salgado, E. Alvarez Sandoval, M. Vasilevsky, P. Chidester, D. Polack, Simon J. Davies, G. Brosnahan, A. Agarwal, Chaim Charytan, T. Hannedouche, M. Gross, I. Arias, G. James, Jürgen Floege, Tom Dejagere, Patrick S. Parfrey, S. Cournoyer, T. Cavalieri, Gérard M. London, K. Gandhi, A. Kshirsagar, O. Khrustalev, J. Zacharias, Michel Dhaene, Jennifer Tuazon, W. Weise, J. Guzman-Rivera, HS Brink, Alastair J. Hutchison, P. D. Cunha, Robyn G Langham, S. Soman, J. Goldman, S. Kazup Erdelyine, A. Widerhorn, M. Henriquez, N. Hunt, W. Hoerl, O. Arkossy, J. Szegedi, R. Dhingra, M. Fernandez Lucas, Jesus Navarro, A. Kark, Andrey Gurevich, Cynthia J. Brown, Rajnish Mehrotra, L. Kleinman, S. Ferenczi, Loreto Gesualdo, V. Schwenger, M. Ramirez, N. Mittman, Ana María Cusumano, K. Marczewski, Moustafa Moustafa, Sônia M. H. A. Araújo, E. Ladanyi, M. Auricchio, Maurice Laville, P. Urena Torres, C. Gallart, A. Israelit, V. Altobelli, E. Hagen, S. Nosrati, John P. Middleton, Kant Ks, F. Al-Saghir, S. Steinberg, S. Neiva Coelho, Botond Csiky, Philip G Zager, M. Sekkarie, Vanda Jorgetti, Domingos O. d'Avila, Carol A. Pollock, L. Lai, B. von Albertini, Beckie Michael, U. Kunzendorf, N. Frischmuth, A. Durrbach, L. Vasconcellos, Raymond Vanholder, M. Dickenmann, B. Schiller-Moran, Steven D. Soroka, J. Rubin, O. Balkarova, S. Morse, M. Teixeira Araújo, D. Perlin, M. Khan, C. Hura, Dagmar-C. Fischer, D. Machado, Seamas C. Donnelly, D. Sapir, V. Lorica, L. Deboni, M. Jose, M. Galicia, K. Bidas, David Spiegel, David Goldsmith, Peter F Mount, A. Strokov, L. Yu, J. Pitone, Biagio Ricciardi, Alastair Gillies, M. Moyses Neto, Piergiorgio Bolasco, V. Anashkin, John R. Sedor, M. Lee, E.M. Jones, M. Culpepper, G. London, D. Joly, N. Khadikova, Charles A. Herzog, P. Meier, M. Farina, Dana V. Rizk, William M. McClellan, M. Cook, Bastian Dehmel, Patrizia Ferrari, F. Almeida, V. Pogue, R. McCrary, F. Macario, J. Golden, E. Wijeyesinghe, Tilman B. Drüeke, E. Osanloo, M. Muszytowski, F. Arif, Giuseppe Villa, M. Torres Zamora, Steven Zeig, N. Thompson, A. Jamal, C. Sholer, P. Stroumza, D. Reddan, Arun Gupta, J. Montenegro, T. DelGiorno, D. Eadington, G. Shostka, Michel Jadoul, A. Weigert, Sergio Stefoni, P. Dreyer, Carmel M. Hawley, J. Cardeal da Costa, M. Switalski, G. Talaulikar, A. Felsenfeld, J. MacLaurin, T. Herman, N. Pritchard, M. Michaud, K.-U. Eckardt, R. Romero, G. Volgina, Fred E. Husserl, J. Soler Amigó, David S. Goldfarb, A. Matalon, M. D. Torres, P. Sampaio Lacativa, L. Major, U. Lund, A. Lafalla, S. Sarkar, Jennifer M. MacRae, J. Lobo, Liudmila Rozhinskaya, Johann Braun, H. Daugaard, S. Khokhar, S. Rubinstein, D. Bhatia, G. Timokhovskaya, T. Wooldridge, A. Voßkühler, Nelson Kopyt, Pablo E. Pergola, Michel Burnier, L. Samuels, J. Alcázar de La Ossa, J. Billiouw, R. Liebl, P. Sidhu, S. Menahem, P. Montambault, E. Schwertfeger, K. Staroselsky, J. Kovarik, S. Horn, N. Tareen, Simon D. Roger, Francesco Locatelli, Kenneth W. Mahaffey, J Vanwalleghem, Robert I. Lynn, M. Prados, K. Kapatkin, N. Peñalba, Kailash Jindal, M. Stegman, R. Stahl, Joseph A. Eustace, S. Desmeules, A. Hazzan, D. Scott, B. Taparia, G. Keightley, P. Jensen, V. Ortalda, K. McConnell, Alejandro Martin-Malo, Margaret M. Williams, Stuart M. Sprague, S. Chow, Diego Brancaccio, Yumi Kubo, P. Dykes, E. de Francesco Daher, C. Erley, Joanna Matuszkiewicz-Rowińska, T. Minga, I. Dasgupta, Galen S. Wagner, N. Marchetta, R. Rigolosi, P. Raguram, P. Lang, P. Cambier-Dwelschauwers, A. Tsang, M. Schonefeld, W. Bentkowski, Z. Sharon, Daniel Batlle, James T. McCarthy, M. Vital Flores, M. Rambausek, A. Zemtchenkov, Fabio Malberti, V. Thakur, O. Domashenko, D. Wheeler, J. Capelli, Bernard Jones, D. Uehlinger, K. Olgaard, K. Lhotta, M. Bernardo, S. Goldberger, Alison Thomas, E. Dunnigan, A. Ksiazek, A. Assefi, C. Poole, G. Rosa Diez, G. Newman, J. Cotton, C. Combe, B. Murthyr, Sharon M. Moe, H. Neumayer, J. Mittleman, Robert G. Fassett, W. Cleveland, F. van der Sande, C. Vela, H. Fessi, J. Robertson, Giuseppe Cannella, Bryan N. Becker, João M. Frazão, V. Shilo, M. Rano, J. De Meester, R. Fiedler, J. Floege, B. Murray, Giovambattista Capasso, F. Dellanna, J. Luiz Gross, K. Tucker, C. Santiago, Paul J. Martin, M. Nowicki, L. Friedman, William G. Goodman, G. Diez, Markus Ketteler, S. Arfeen, I. Mezei, J. Ortiz, Elizabeth E. Brown, Deborah Zimmerman, Aleix Cases, M. El Khatib, Martine Leblanc, R. Daelemans, K. Malireddi, C. Rikker, R. Gladish, F. Aranda Verástegui, R. Kopelman, B. Borbas, J. Buerkert, K. Ntoso, J. Peña, V. Garcia, C. West, M. Azer, J. Kwan, J. Sterrett, P. Swift, A. Raff, R. Kohli, S. Lew, Steven J. Rosansky, H. Graf, K. Bouman, F. Skinner, C. Tielemans, S. Ferreira Filho, Jocemir Ronaldo Lugon, M. Weinberg, Parfrey, P. S., Drueke, T. B., Block, G. A., Correa-Rotter, R., Floege, J., Herzog, C. A., London, G. M., Mahaffey, K. W., Moe, S. M., Wheeler, D. C., Kubo, Y., Dehmel, B., Goodman, W. G., Chertow, G. M., Santos, J., Najun Zarazaga, C., Marin, I., Garrote, N., Cusumano, A., Penalba, N., Del Valle, E., Juncos, L., Martinez Saye, J., Lef, L., Altobelli, V., Petraglia, G., Rosa Diez, G., Douthat, W., Lobo, J., Gallart, C., Lafalla, A., Diez, G., Linares, B., Lopez, N., Ramirez, N., Gonzalez, R., Valtuille, R., Beresan, H., Hermida, O., Rudolf, G., Marchetta, N., Rano, M., Ramirez, M., Garcia, N., Gillies, A., Jones, B., Pedagogos, E., Walker, R., Talaulikar, G., Bannister, K., Suranyi, M., Kark, A., Roger, S., Kerr, P., Disney, A., Mount, P., Fraenkel, M., Mathew, M., Fassett, R., Jose, M., Hawley, C., Lonergan, M., Mackie, J., Ferrari, P., Menahem, S., Sabto, J., Hutchison, B., Langham, R., Pollock, C., Holzer, H., Oberbauer, R., Arias, I., Graf, H., Mayer, G., Lhotta, K., Neyer, U., Klauser, R., Hoerl, W., Horn, S., Kovarik, J., Kramar, R., Eigner, M., Dhaene, M., Billiouw, J., De Meester, J., Warling, X., Cambier-Dwelschauwers, P., Evenepoel, P., Daelemans, R., Dratwa, M., Maes, B., Stolear, J., Dejagere, T., Vanwalleghem, J., Bouman, K., Jadoul, M., Peeters, J., Vanholder, R., Tielemans, C., Donck, J., Almeida, F., Picollo de Oliveira, J., Burdmann, E., Garcia, V., Saldanha Thome, F., Deboni, L., Bregman, R., Lugon, J., Araujo, S., Ferreira Filho, S., de Francesco Daher, E., Sperto Baptista, M., Carvalho, A., D'Avila, D., Moyses Neto, M., Yu, L., Bastos, M., Sampaio Lacativa, P., Jorgetti, V., de Almeida Romao, E., Cardeal da Costa, J., Pecoits Filho, R., Gordan, P., Salgado, N., Teixeira Araujo, M., Neiva Coelho, S., Oliveira, I., Moyses, R., Vasconcellos, L., Batista, P., Luiz Gross, J., Pedrosa, A., Cournoyer, S., Leblanc, M., Chow, S., Karunakaran, S., Wong, G., Tobe, S., Desmeules, S., Zimmerman, D., Murphy, S., Montambault, P., Donnelly, S., Macrae, J., Culleton, B., Soroka, S., Rabbat, C., Jindal, K., Vasilevsky, M., Michaud, M., Wijeyesinghe, E., Zacharias, J., Lok, C., Muirhead, N., Verrelli, M., Da Roza, G., Sapir, D., Olgaard, K., Daugaard, H., Brandi, L., Jensen, P., Boulechfar, H., Ang, K., Simon, P., Rieu, P., Brunet, P., Touchard, G., London, G., Urena Torres, P., Combe, C., Durrbach, A., Ortiz, J., Hannedouche, T., Vela, C., Lionet, A., Ryckelynck, P., Zaoui, P., Choukroun, G., Fessi, H., Lang, P., Stroumza, P., Joly, D., Mousson, C., Laville, M., Dellanna, F., Erley, C., Braun, J., Rambausek, M., Riegel, W., Klingberg, M., Schwertfeger, E., Wizemann, V., Eckardt, K., Reichel, H., Passauer, J., Hubel, E., Frischmuth, N., Liebl, R., Fiedler, R., Schwenger, V., Vosskuhler, A., Kunzendorf, U., Renders, L., Rattensberger, D., Rump, L., Ketteler, M., Neumayer, H., Zantvoort, F., Stahl, R., Ladanyi, E., Kulcsar, I., Mezei, I., Csiky, B., Rikker, C., Arkossy, O., Berta, K., Szegedi, J., Major, L., Ferenczi, S., Fekete, A., Szabo, T., Zakar, G., Wagner, G., Kazup Erdelyine, S., Borbas, B., Eustace, J., Reddan, D., Capasso, G., Locatelli, F., Villa, G., Cozzolino, M., Brancaccio, D., Messa, P., Bolasco, P., Ricciardi, B., Malberti, F., Moriero, E., Cannella, G., Ortalda, V., Stefoni, S., Frasca, G., Cappelli, G., Albertazzi, A., Zoccali, C., Farina, M., Elli, A., Avella, F., Ondei, P., Mingardi, G., Errico, R., Losito, A., Di Giulio, S., Pertosa, G., Schena, F., Grandaliano, G., Gesualdo, L., Auricchio, M., Bochicchio-Ricardelli, T., Aranda Verastegui, F., Pena, J., Chew Wong, A., Cruz-Valdez, J., Torres Zamora, M., Solis, M., Sebastian Diaz, M., Vital Flores, M., Alvarez Sandoval, E., van den Dorpel, M., Brink, H., Van Kuijk, W., Vermeij, C., Smak Gregoor, P., Hagen, E., van der Sande, F., Klinger, M., Nowicki, M., Muszytowski, M., Bidas, K., Bentkowski, W., Wiecek, A., Ksiazek, A., Marczewski, K., Ostrowski, M., Switalski, M., Sulowicz, W., Matuszkiewicz-Rowinska, J., Mysliwiec, M., Durlik, M., Rutkowski, B., Macario, F., Carvalho, B., Frazao, J., Machado, D., Weigert, A., Andrusev, A., Khrustalev, O., Zemtchenkov, A., Gurevich, K., Staroselsky, K., Khadikova, N., Rozhinskaya, L., Timokhovskaya, G., Strokov, A., Balkarova, O., Ermolenko, V., Kolmakova, E., Komandenko, M., Timofeev, M., Shilo, V., Shostka, G., Smirnov, A., Anashkin, V., Volgina, G., Domashenko, O., Gurevich, A., Perlin, D., Martinez Garcia, J., Andres Ribes, E., Coll Piera, E., Fernandez Lucas, M., Galicia, M., Prados, M., Gonzalez, M., Romero, R., Martin de Francisco, A., Montenegro, J., Santiago, C., Garcia, F., Alcazar de La Ossa, J., Arrieta, J., Pons, J., Martin-Malo, A., Soler Amigo, J., Cases, A., Sterner, G., Jensen, G., Wikstrom, B., Jacobson, S., Lund, U., Weiss, L., Stahl, A., von Albertini, B., Burnier, M., Meier, P., Martin, P., Uehlinger, D., Dickenmann, M., Yaqoob, M., Zehnder, D., Kalra, P., Padmanabhan, N., Roe, S., Eadington, D., Pritchard, N., Hutchison, A., Davies, S., Wilkie, M., Davies, M., Pai, P., Swift, P., Kwan, J., Goldsmith, D., Tomson, C., Stratton, J., Dasgupta, I., Sarkar, S., Moustafa, M., Gandhi, K., Jamal, A., Galindo-Ramos, E., Tuazon, J., Batlle, D., Tucker, K., Schiller-Moran, B., Assefi, A., Martinez, C., Samuels, L., Goldman, J., Cangiano-Rivera, J., Darwish, R., Lee, M., Topf, J., Kapatkin, K., Baer, H., Kopelman, R., Acharya, M., Tharpe, D., Bernardo, M., Nader, P., Guzman-Rivera, J., Pergola, P., Sekkarie, M., Alas, E., Zager, P., Liss, K., Navarro, J., Roppolo, M., Denu-Ciocca, C., Kshirsagar, A., El Khatib, M., Kant, K., Scott, D., Murthyr, B., Finkelstein, F., Keightley, G., Mccrary, R., Pitone, J., Cavalieri, T., Tsang, A., Pellegrino, B., Schmidt, R., Ahmad, S., Brown, C., Friedman, E., Mittman, N., Fadem, S., Shapiro, W., Reddy, M., Goldberger, S., Woredekal, Y., Agarwal, A., Anger, M., Haque, M., Chidester, P., Kohli, R., Rubinstein, S., Newman, G., Gladish, R., Ayodeji, O., Soman, S., Sprague, S., Hunt, N., Gehr, T., Rizk, D., Warnock, D., Polack, D., Pahl, M., Fischer, D., Dreyer, P., James, G., Husserl, F., Rogers, T., Raff, A., Sedor, J., Silver, M., Smith, M., Steinberg, S., Delgiorno, T., Jones, E., Cunha, P. D., Cheng, J., Pogue, V., Blumenthal, S., Brown, E., Charytan, C., Buerkert, J., Cook, M., Felsenfeld, A., Tareen, N., Gupta, A., Herman, T., Diamond, S., Hura, C., Laski, M., Maclaurin, J., Plumb, T., Brosnahan, G., Kumar, J., Henriquez, M., Poole, C., Osanloo, E., Matalon, A., Sholer, C., Arfeen, S., Azer, M., Belledonne, M., Gross, M., Dunnigan, E., Mcconnell, K., Becker, B., Skinner, F., Rigolosi, R., Spiegel, D., Stegman, M., Patak, R., Streja, D., Ranjit, U., Youell, T., Wooldridge, T., Stafford, C., Cottiero, R., Weinberg, M., Schonefeld, M., Shahmir, E., Hazzan, A., Ashfaq, A., Bhandari, K., Cleveland, W., Culpepper, M., Golden, J., Lai, L., Lien, Y., Lorica, V., Robertson, J., Malireddi, K., Morse, S., Thakur, V., Israelit, A., Raguram, P., Alfred, H., Weise, W., Al-Saghir, F., El Shahawy, M., Rastogi, A., Nissenson, A., Kopyt, N., Lynn, R., Lea, J., Mcclellan, W., Teredesai, P., Ong, S., Tolkan, S., Sugihara, J., Minga, T., Mehrotra, R., Minasian, R., Bhatia, D., Specter, R., Capelli, J., Sidhu, P., Dalal, S., Dykes, P., Khan, M., Rahim, F., Saklayen, M., Thomas, A., Michael, B., Torres, M., Al-Bander, H., Murray, B., Abukurah, A., Gupta, B., Nosrati, S., Raja, R., Zeig, S., Braun, M., Amatya, A., Endsley, J., Sharon, Z., Dolson, G., Dumler, F., Ntoso, K., Rosansky, S., Kumar, N., Gura, V., Thompson, N., Goldfarb, D., Halligan, R., Middleton, J., Widerhorn, A., Arbeit, L., Arruda, J., Crouch, T., Friedman, L., Khokhar, S., Mittleman, J., Light, P., Taparia, B., West, C., Cotton, J., Dhingra, R., Kleinman, L., Arif, F., Lew, S., Nammour, T., Sterrett, J., Williams, M., Ramirez, J., Rubin, J., Mccarthy, J., Noble, S., Chaffin, M., and Rekhi, A.

Subjects
Parathyroidectomy, Adult, Male, medicine.medical_specialty, Cinacalcet, Epidemiology, medicine.medical_treatment, Calcimimetic Agents, Critical Care and Intensive Care Medicine, Lower risk, Severity of Illness Index, CKD, cardiovascular disease, hemodialysis, hyperparathyroidism, mineral metabolism, Age Factors, Aged, Aged, 80 and over, Cardiovascular Diseases, Cinacalcet Hydrochloride, Female, Humans, Hyperparathyroidism, Secondary, Kidney Failure, Chronic, Kidney Transplantation, Middle Aged, Renal Dialysis, Nephrology, Transplantation, Internal medicine, medicine, Intensive care medicine, Hyperparathyroidism, business.industry, Original Articles, medicine.disease, Secondary hyperparathyroidism, Hemodialysis, business, medicine.drug
Abstract

Background andobjectivesThecalcimimeticcinacalcet reduced therisk of death or cardiovascular (CV) events in older, but not younger, patients with moderate to severe secondary hyperparathyroidism (HPT) who were receiving hemodialysis. To determine whether the lower risk in younger patients might be due to lower baseline CV risk and more frequent use of cointerventions that reduce parathyroid hormone (kidney transplantation, parathyroidectomy, and commercial cinacalcet use), this study examined the effects of cinacalcet in older ($65 years, n=1005) and younger (,65 years, n=2878) patients. Design, setting, participants, & measurements Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events (EVOLVE) was a global, multicenter, randomized placebo-controlled trial in 3883 prevalent patients on hemodialysis, whose outcomes included death, major CV events, and development of severe unremitting HPT. The age subgroup analysis was prespecified. ResultsOlderpatients hadhigher baselineprevalenceof diabetesmellitusandCV comorbidity. Annualizedrates of kidney transplantation and parathyroidectomy were .3-fold higher in younger relative to older patients and were more frequent in patients randomized to placebo. In older patients, the adjusted relative hazard (95% confidence interval) for the primary composite (CV) end point (cinacalcet versus placebo) was 0.70 (0.60 to 0.81); in younger patients, the relative hazard was 0.97 (0.86 to 1.09). Corresponding adjusted relative hazards for mortality were 0.68 (0.51 to 0.81) and 0.99 (0.86 to 1.13). Reduction in the risk of severe unremitting HPT was similar in both groups. Conclusions In the EVOLVE trial, cinacalcet decreased the risk of death and of major CV events in older, but not younger, patients with moderate to severe HPT who were receiving hemodialysis. Effect modification by age may be partly explained by differences in underlying CV risk and differential application of cointerventions that reduce parathyroid hormone. Clin J Am Soc Nephrol 10: ccc–ccc, 2015. doi: 10.2215/CJN.07730814

Published
2015

10. Evaluation of maintenance of stable haemoglobin levels in haemodialysis patients converting from epoetin or darbepoetin to monthly intravenous C.E.R.A.: the MIRACEL study

Author

D, Fliser, W, Kleophas, F, Dellanna, F, Dellana, R E, Winkler, W, Backs, U, Kraatz, W, Fassbinder, V, Wizemann, and G, Strack

Subjects
Nephrology, medicine.medical_specialty, education.field_of_study, business.industry, Population, Haemoglobin levels, General Medicine, Recombinant Proteins, Continuous erythropoietin receptor activator, Surgery, Epoetin Alfa, Hemoglobins, Renal Dialysis, Internal medicine, medicine, Humans, Darbepoetin alfa, Kidney Diseases, Dosing, Trial registration, education, business, Erythropoietin
Abstract

C.E.R.A., a continuous erythropoietin receptor activator, offers once-monthly dosing without compromising haemoglobin control. This study was undertaken to examine whether monthly C.E.R.A. using pre-filled syringes maintains stable haemoglobin levels when administered according to local clinical judgement.MIRACEL was a prospective, open-label, single-arm, multicentre study performed at 90 nephrology centres in Germany. After a 2-month screening phase, haemodialysis patients receiving epoetin or darbepoetin were converted to monthly intravenous C.E.R.A., with a 5-month titration phase followed by a 2-month evaluation phase.Clinicaltrials.gov: NCT00413894 RESULTS: Of 661 patients screened, 424 (64.1%) started C.E.R.A. therapy (previous treatment: 72.2% epoetin, 27.8% darbepoetin); 416 were eligible for inclusion in the intent-to-treat population. A mean of two C.E.R.A. dose changes were required during the 7-month treatment period. The primary efficacy variable, haemoglobin within 11-12.5 g/dL or 10-13 g/dL during the evaluation phase, was achieved in 109 (30.8%) and 265 (74.9%) of the 354 evaluable patients, respectively, with no differences observed between patients formerly receiving epoetin or darbepoetin or different dosing frequencies. During the screening, titration and evaluation phases, mean haemoglobin was 11.7 +/- 0.7 g/dL, 11.6 +/- 0.9 g/dL and 11.4 +/- 1.0 g/dL, respectively, and 90.6% (377/416), 70.4% (293/416) and 82.9% (345/416) of patients exhibitedor = 1 g/dL change from phase-specific individual means. C.E.R.A. was well-tolerated with a safety profile similar to that reported in phase III studies.In this single-arm, open-label, multicentre study, conversion of a large population of haemodialysis patients from epoetin or darbepoetin to monthly C.E.R.A. administration using pre-filled syringes was shown to be practical, convenient and offer good control of haemoglobin levels, regardless of the previous type of therapy or dosing frequency.

Published
2010

11. Rechtsseitiger Gesichtstumor bei einem 39-jährigen Hämodialysepatienten

Author

W. Kleophas, G.R. Hetzel, A. Westhoff, W. Kösters, and F. Dellanna

Subjects
Gynecology, medicine.medical_specialty, Transplant surgery, Nephrology, business.industry, medicine, business
Abstract

Ein brauner Tumor stellt eine gutartige Resorptionsgeschwulst des Knochens bei Osteodystrophia fibrosa cystica dar. Die braune Farbe ist durch Hamosiderinablagerungen bedingt. Die Osteodystrophia fibrosa cystica ist die charakteristische Knochenmanifestation des Hyperparathyreoidismus. Wahrend vor 50 Jahren noch etwa 10–25% der Patienten ein solches Krankheitsbild aufwiesen, ist es heute durch die besseren Therapiemoglichkeiten des Hyperparathyreoidismus selten zu sehen [1]. Einzelne Falle im Gesichtsbereich wurden bei unerkanntem primarem Hyperparathyreoidismus beschrieben [1, 2]. Das pathognomonische Zeichen bei der Histologie ist eine Vermehrung der Riesenosteoklasten und ein Ersatz der normalen Zellen und Markelemente durch fibroses Gewebe [3]. Radiologisch nachweisbare Veranderungen sind typischerweise auch Resorptionen der Endphalangen und ein Aufweichen der Kortikalisausenlinie der Fingerknochen (subperiostaler Knochenabbau). Ublicherweise zeigen eine Reihe von Markern einen gesteigerten Knochenumbau an.

Published
2008
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12. Internal filtration--advantage in haemodialysis?

Author

C. A. Baldamus, F. Dellanna, and A. Wuepper

Subjects
Adult, Male, Metabolic Clearance Rate, Hydrostatic pressure, Ultrafiltration, Dialysate flow, law.invention, chemistry.chemical_compound, law, Renal Dialysis, Medicine, Humans, Filtration, Aged, Transplantation, Creatinine, Chromatography, business.industry, Blood flow, Middle Aged, Membrane, chemistry, Biochemistry, Nephrology, Urea, Female, business, beta 2-Microglobulin
Abstract

Internal filtration is defined as the total water flux across the membrane within the closed blood and dialysate compartment of a dialyser. The aim of our study was to increase convection by increasing the amount of internal filtration and to study the effect on elimination of high and low molecular weight uraemic toxins during regular haemodialysis. Three high-flux polysulfone dialysers with identical type of membrane (Fresenius Sps600) and same number of fibres but with different inner diameters () and therefore different surface areas [] (175 microns [0.55 m2], 200 microns [0.65 m2] and 250 microns [0.79 m2]) were tested in routine haemodialysis sessions (10 patients). At a blood flow of 250 ml/min and a dialysate flow of 500 ml/min hydrostatic pressures at dialysate-in/outlet (PD(in), PD(out) and blood-in/outlet (PBin, PBout), mTMP, clearances (Cl) and mass balances of creatinine, urea, phosphate and beta-2-microglobulin (beta 2-M) at 30 and 180 min were measured at net ultrafiltration rate of 0 ml/min. Clearances of all three dialysers were matched for small toxins (urea: 180 +/- 4.83 ml/min). The 175 microns diameter dialyser achieved a significantly better removal of beta 2M (Cl beta 2-M 57.4 +/- 9.43 ml/min) than the two other filters (200 microns: 29.9 +/- 8.4 ml/min; 250 microns: 11.1 +/- 6.79 ml/min) although the surface area of the 175 microns filter was smallest. Hydrostatic pressure analysis revealed that at the same median transmembrane pressures (mTMP) internal filtration increased with decreasing inner fibre diameter. Longitudinal flow resistance and thereby local transmembrane pressure difference increased with narrowing the inner fibre diameter.

Published
1996

13. Bone disease in CKD 1-5

Author

M. I. Yilmaz, A. Sonmez, M. Saglam, H. Yaman, S. Kilic, T. Eyileten, K. Caglar, Y. Oguz, A. Vuaral, M. Yenicesu, F. Mallamaci, C. Zoccali, S. Mazzaferro, M. Pasquali, S. Rotondi, L. Tartaglione, G. Pirro, M. L. Muci, C. Conte, G. Mandanici, A. Frasheri, F. Pugliese, H. Fehmi, Y. Long, K. Kono, H. Fujii, K. Nakai, S. Goto, J. Shite, K.-i. Hirata, M. Fukagawa, S. Nishi, J. R. Wu-Wong, M. Nakane, Y.-w. Chen, P. Nikolopoulos, A. Vlachopanou, C. Giannaki, V. Siapera, V. Papachristopoulos, C. Gouva, V. Sakhuja, P. Dheerendra, V. Jha, M. Rathi, H. S. Kohli, D. Hadjiyannakos, S. Trompouki, V. Filiopoulos, M. Sonikian, I. Karatzas, K. Panagiotopoulos, D. Vlassopoulos, H. Taskapan, O. Baysal, D. Karahan, O. Ulutas, G. Mircescu, C. Capusa, S. Stancu, M. Badulescu, L. Barsan, N. Dorobantu, D. Maria, E. Mota, I. Yildiz, Y. Sagliker, O. Demirhan, V. Acharya, L. Zhang, O. Golea, A. Sabry, D. Ookalkar, D. Radulescu, L. Garneata, H. Ben Maiz, C. Hsu Chen, J. Prado Rome, M. Benzegoutta, N. Paylar, K. Eyuboglu, E. Karatepe, M. Esenturk, O. Yavascan, S. M. Adam, I. Emir, A. Grzegorzevska, E. Tunc, F. Ocal, E. Usta, V. Shilo, M. M. Mazdeh, R. C. Francesco, N. Levin-Iaina, J. Malyszko, P. Kozminski, E. Koc-Zorawska, M. Mysliwiec, M. Lipan, H. Reichel, J. Ringel, C. Guggenberger, F. Dellanna, C. Teixeira, E. Almeida, M. Raimundo, F. Neves, A. Santana, A. Fortes, F. Abreu, C. Pinto Abreu, Z. El Bouazzaoui, A. Cortesao Costa, E. Nogueira, A. Gomes da Costa, E. ElShafey, A. Alsahow, K. Saran, M. Attia, L. Di Lullo, A. Gorini, A. Cecilia, C. Comegna, C. Galderisi, G. R. Iannacci, M. Vitale, P. Polito, I. Kyritsis, M.-E. Roumelioti, I. Agroyannis, S. Vrachnis, V. Kapelleris, O. Fituri, G. Ismail, A. Donia, S. Sezer, S. Karakan, B. Atesagaoglu, E. Tutal, N. Ozdemir Acar, S. Ozturk, S. Uzun, A. H. Kaya, M. Gursu, B. Kaya, A. Sarbay Kemik, Z. Aydin, S. Karadag, H. Feyizoglu, R. Kazancioglu, and I. Vlad

Subjects
Transplantation, medicine.medical_specialty, Bone disease, Nephrology, business.industry, Internal medicine, medicine, business, medicine.disease
Published
2011
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