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Urinary Tract Calculi III: Medical Management01:30

Urinary Tract Calculi III: Medical Management

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The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
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Urinary Tract Calculi IV: Nutrition Therapy and Prevention01:27

Urinary Tract Calculi IV: Nutrition Therapy and Prevention

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Management of renal calculi focuses on effective strategies like tailored nutrition and hydration therapy. Adjusting diet and fluid intake reduces stone formation and recurrence, making these interventions simple yet powerful in kidney stone prevention and management.Understanding Kidney StonesKidney stones form when calcium, oxalate, uric acid, and cystine concentrate and crystallize in urine. Factors contributing to their formation include genetic predisposition, certain medical conditions,...
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Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

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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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Treatment for Pulmonary Arterial Hypertension: Phosphodiesterase Inhibitors01:28

Treatment for Pulmonary Arterial Hypertension: Phosphodiesterase Inhibitors

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Phosphodiesterase 5 (PDE5) inhibitors are potent enzymes that function to hydrolyze cyclic nucleotides to their corresponding 5' monophosphates. Their unique biochemical properties have been applied in treating Pulmonary Arterial Hypertension (PAH).
Among the PDE5 inhibitors, sildenafil (Revatio) stands out as a competitive and selective inhibitor. It operates by elevating cellular levels of cGMP and augmenting signaling through the cGMP-PKG pathway, promoting vasodilation. Upon oral...
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Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers01:26

Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers

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Receptor tyrosine kinase inhibitors (TKIs) and calcium channel blockers (CCBs) are two critical categories of drugs employed in the treatment of pulmonary artery hypertension (PAH). PAH is a disease that causes high blood pressure in the pulmonary arteries, resulting in chest pain, fatigue, and shortness of breath.
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
240
Roles of Electrolytes: Calcium and Phosphate01:27

Roles of Electrolytes: Calcium and Phosphate

413
Calcium and phosphate are essential electrolytes in the human body, with calcium being the most abundant mineral. Around 99% of the body's calcium is stored in the skeleton and teeth, forming a crystal lattice of mineral salts in combination with phosphates. Calcium plays crucial roles in various bodily functions such as blood clotting, neurotransmitter release, muscle tone maintenance, and nervous and muscle tissue excitability.
The calcium concentration in blood plasma is primarily...
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Related Experiment Video

Updated: Aug 30, 2025

Optimized Procedure for Determining the Adsorption of Phosphonates onto Granular Ferric Hydroxide using a Miniaturized Phosphorus Determination Method
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Phosphate Frustration: Treatment Options to Complement Current Therapies.

Pablo E Pergola1

  • 1Renal Associates, PA, San Antonio, TX 78212, USA.

International Journal of Nephrology
|September 1, 2022
PubMed
Summary

Hyperphosphatemia is common in chronic kidney disease (CKD) patients on dialysis. New therapies like tenapanor are needed as current treatments often fail to achieve target phosphate levels.

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Area of Science:

  • Nephrology
  • Internal Medicine
  • Pharmacology

Background:

  • Hyperphosphatemia is prevalent in advanced chronic kidney disease (CKD), linked to adverse clinical outcomes.
  • Current guidelines recommend normalizing phosphate levels in CKD patients.
  • Despite dietary restrictions, dialysis, and phosphate binders, many CKD patients on dialysis fail to reach serum phosphate <5.5 mg/dL.

Purpose of the Study:

  • To highlight the challenges in achieving target phosphate levels in CKD patients on dialysis.
  • To introduce tenapanor as a potential therapeutic innovation for managing hyperphosphatemia.

Main Methods:

  • A chart audit assessed phosphate binder efficacy in CKD patients on dialysis.
  • Review of clinical trial data for tenapanor, a novel phosphate absorption inhibitor.

Main Results:

  • A chart audit revealed 74-86% of patients on dialysis and phosphate binders could not consistently achieve serum phosphate ≤5.5 mg/dL over 6 months.
  • Evidence suggests serum phosphate <4.5 mg/dL is associated with better survival and cardiovascular outcomes.
  • Current therapies are insufficient to achieve and maintain target phosphate levels for most patients.

Conclusions:

  • Achieving target phosphate levels remains a significant challenge for CKD patients on dialysis.
  • Phosphate binders have limited efficacy due to high dietary phosphate intake.
  • Tenapanor offers a promising therapeutic option to complement existing treatments for hyperphosphatemia in CKD.