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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
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Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
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Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
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Kidney Disease Progression Does Not Decrease Intestinal Phosphorus Absorption in a Rat Model of Chronic Kidney

Colby J Vorland1, Annabel Biruete2, Pamela J Lachcik1

  • 1Department of Nutrition Science, Purdue University, West Lafayette, IN, USA.

Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research
|October 17, 2019
PubMed
Summary

Chronic kidney disease (CKD) in rats did not reduce intestinal phosphorus absorption, despite lower vitamin D levels. Phosphorus balance remained negative as kidney function declined, highlighting CKD-MBD complexities.

Keywords:
ANIMAL MODELSDISORDERS OF CALCIUM/PHOSPHATE METABOLISMGENETIC ANIMAL MODELSNUTRITIONPTH/VIT D/FGF23

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Area of Science:

  • Nephrology
  • Mineral Metabolism
  • Gastroenterology

Background:

  • Chronic kidney disease-mineral bone disorder (CKD-MBD) affects phosphorus balance.
  • The Cy/+ rat is a progressive model for studying CKD-MBD.
  • Intestinal phosphorus absorption in CKD is not fully understood.

Purpose of the Study:

  • To investigate the impact of progressive kidney disease on intestinal phosphorus absorption and whole-body phosphorus balance in Cy/+ rats.
  • To compare phosphorus absorption and balance between CKD rats and normal littermates at different disease stages.

Main Methods:

  • Used 48 Cy/+ (CKD) and 48 normal littermate (NL) rats at 20 and 30 weeks.
  • Measured intestinal phosphorus absorption using an in situ jejunal ligated loop method with 33P.
  • Assessed whole-body phosphorus balance through metabolic studies.

Main Results:

  • CKD rats showed slightly higher sodium-dependent phosphorus absorption, which decreased with age.
  • Intestinal phosphorus absorption in situ was not reduced in CKD rats, contrasting with lower plasma 1,25-dihydroxyvitamin D.
  • Phosphorus balance was negative in CKD rats and worsened with disease progression.

Conclusions:

  • Intestinal phosphorus absorption, assessed in situ, does not decrease with CKD progression despite reduced vitamin D.
  • Findings challenge the physiological relevance of some in vitro studies on phosphorus transport in CKD.
  • Phosphorus balance remains impaired in progressive CKD, underscoring the need for effective management strategies.