Showing papers by "Tilman B. Drüeke published in 2005"
TL;DR: In subjects on dialysis with secondary HPT, cinacalcet facilitates achievement of the K/DOQI-recommended targets for PTH, calcium, phosphorus, and Ca x P.
317 citations
TL;DR: The oral administration of lanthanum carbonate to normal rats leads to a more than 10-fold increase of tissue La content in at least some organs, including the liver, lung, and kidney, which is further enhanced by the uremic state.
164 citations
TL;DR: Sevelamer delays not only vascular calcification but also atherosclerotic lesion progression in uremic apolipoprotein E–deficient mice, opening the possibility of a cholesterol-independent action of sevelamer on atheroma formation via effects on mineral metabolism, oxidative stress, or both.
Abstract: Background— The novel phosphate binder sevelamer has been shown to prevent the progression of aortic and coronary calcification in uremic patients. Whether it also decreases the progression of athe...
143 citations
TL;DR: Short-term oral vitamin C supplementation did not modify well-defined oxidative/antioxidative stress and inflammation markers in HD patients, and whether a higher oral dose or the intravenous route can modify these markers remains to be determined.
Abstract: Background. There is increasing evidence for the presence of oxidative stress and vitamin C deficiency in dialysis patients. Limited data, however, are available regarding the effects of vitamin C supplementation on oxidative stress and inflammation markers in such patients. Methods. We ran a prospective, randomized, openlabel trial to assess the effects of oral vitamin C supplementation (250 mg three times per week) for 2 months on well-defined oxidative and inflammatory markers in 33 chronic haemodialysis (HD) patients. Results. Normalization of plasma total vitamin C and ascorbate levels by oral vitamin C supplementation did not modify plasma levels of carbonyls, C-reactive protein and albumin, or erythrocyte concentrations of reduced and oxidized glutathione. Conclusion. Short-term oral vitamin C supplementation did not modify well-defined oxidative/antioxidative stress and inflammation markers in HD patients. Whether a higher oral dose or the intravenous route can modify these markers remains to be determined.
106 citations
TL;DR: Dietary salt restriction accelerated atherosclerotic lesion formation in apoE(-/-) mice through a mechanism that is probably related to ANG-II formation, and whether these findings are relevant to human cardiovascular disease remains to be evaluated.
38 citations
TL;DR: The development of vitamin D analogs with less side effects than with calcitriol is of major theoretical interest, but practical evidence is still needed to be convinced that this goal can be achieved in chronic kidney disease patients.
Abstract: Purpose of review It is possible to control the secondary hyperparathyroidism and osteitis fibrosa of patients with chronic kidney disease by calcitriol when given early and in appropriate doses. However, this control is often achieved at the price of unacceptably high plasma calcium and phosphorus levels, the induction of adynamic bone disease, and soft tissue calcification. To avoid these side effects, so-called ‘nonhypercalcemic’ vitamin D analogs have been developed. Their possible advantages and their precise place in the treatment and prevention of secondary hyperparathyroidism remain a matter of debate. Recent findings A large US multicenter study showed that the administration of the vitamin D analog paricalcitol to hemodialysis patients, as compared with calcitriol, was associated with better survival. In a subsequent large US multicenter study paricalcitol-treated hemodialysis patients experienced fewer hospitalizations and hospital days compared with calcitriol-treated patients. In a third, smaller study from Japan, regular alfacalcidol users among hemodialysis patients had better cardiovascular survival than nonusers. Finally, in a recent historical control study the mortality of a large hemodialysis patient cohort was analyzed as a function of previous vitamin D treatment. Patients on active vitamin D compounds at any time had a 2-year survival advantage over vitamin D-naive patients. It must be pointed out, however, that all four studies were retrospective in nature. Summary The development of vitamin D analogs with less side effects than with calcitriol is of major theoretical interest. Practically speaking, however, we still need to be convinced that this goal can be achieved in chronic kidney disease patients.
28 citations
TL;DR: The advent of a new class of therapeutic agents, the calcimimetics, will allow an easier control of already established parathyroid overfunction, as has been demonstrated in several phase II studies and one phase III study with cinacalcet.
Abstract: Currently available options for the treatment of hyperparathyroidism secondary to chronic renal failure do not allow the achievement of target values for plasma calcium, phosphorus, and parathyroid hormone in the majority of patients with chronic kidney disease (CKD) stage 5. This is particularly true for CKD patients who have been referred to nephrologists late in the course of their disease and in whom prevention has not been possible. The advent of a new class of therapeutic agents, the calcimimetics, will allow an easier control of already established parathyroid overfunction, as has been demonstrated in several phase II studies and one phase III study with cinacalcet. Future studies will show whether an earlier start of treatment in patients with CKD stage 2, 3, and 4 allows the prevention of secondary hyperparathyroidism. Since all available experience has been gathered in adult patients it is also necessary to test the efficacy and safety of the calcimimetics in children with CKD.
15 citations
TL;DR: Anemia is associated with poor cardiovascular and global outcome in patients with chronic kidney disease (CKD) and the correction of anemia requires epoetin in most instances.
Abstract: Anemia is associated with poor cardiovascular and global outcome in patients with chronic kidney disease (CKD) ([1][1]). The correction of anemia requires epoetin in most instances. This in turn generally requires intravenous iron supplementation to avoid iron-deficiency and to achieve optimal
14 citations
TL;DR: To the Editor: In a recent issue of Kidney International, Szczech et al1 indicated that in the cinacalcet phase III studies "management of phosphorus binders and vitamin D sterols were left to the clinical discretion of the site investigators in each of these trials," and in this context, the doses of phosphate binder or vitamin D analogs were not significantly different during the study and between study groups.
12 citations
TL;DR: Medical research can be seriously compromised by the selective publication of clinical trial results and it is imperative that information regarding clinical trials be available to the general public.
Abstract: Medical research can be seriously compromised by the selective publication of clinical trial results. Therefore, it is imperative that information regarding clinical trials be available to the general public.
We require, as a condition of consideration for publication, registration in a public
4 citations
TL;DR: Medical research can be seriously compromised by the selective publication of clinical trial results, so it is imperative that information regarding clinical trials should be available to the general public.