Poor kidney response to hormone may increase risks for kidney disease patients

Tests of resistance could help doctors monitor and treat patients

2013-03-22

(Press-News.org) Highlights Suboptimal kidney response to the hormone FGF-23 may put chronic kidney disease patients at increased risk of premature death and cardiovascular events. Resistance to the hormonal actions of FGF-23 in the kidney may identify novel aspects of kidney dysfunction.

60 million people globally have chronic kidney disease.

Washington, DC (March 21, 2013) — The kidneys' response to a particular hormone may affect kidney disease patients' heart health and longevity, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN). The findings may help doctors as they monitor and treat patients with kidney disease.

In patients with chronic kidney disease (CKD), blood levels of a hormone called fibroblast growth factor-23 (FGF-23) rise in parallel with declining kidney function, causing excess excretion of phosphorus in the urine. Also, FGF-23 has been consistently and strongly linked with heart disease and premature death, but the mechanisms behind these links are unclear.

Julie Dominguez, MD, Joachim Ix, MD (University of California San Diego, and Veterans Affairs San Diego Healthcare System) and their colleagues wondered whether the kidneys' response to the hormonal actions of FGF-23 may play a role. To investigate, they measured blood levels of FGF-23 and urine levels of phosphorus in 872 patients with CKD and cardiovascular disease.

Among the major findings: During an average 7.5 years of follow-up, there were 337 deaths and 199 cardiovascular events, such as heart attacks and strokes. Urinary phosphorus excretion significantly modified FGF-23's links with premature death and heart disease. Patients who had above-average FGF-23 but below-average urinary phosphorus had the highest risks of both premature death and cardiovascular events.

The findings reveal that associations of FGF-23 with premature death and cardiovascular events are stronger in people with lower urinary phosphorus independent of kidney function. In these individuals, the kidney's response to FGF-23 may be suboptimal.

"The relative resistance to the hormonal actions of FGF-23 in the kidney may identify novel aspects of kidney dysfunction, which may hold prognostic information for adverse health," said Dr. Ix. "Future studies are needed to determine the mechanisms of relative kidney resistance, and to determine their prognostic implications for other outcomes such as progression of kidney disease."

In an accompanying editorial, Ishir Bhan, MD, and Ravi Thadhani, MD (Massachusetts General Hospital) noted that the study prompts new questions to guide future studies into FGF-23 biology. "Perhaps the most important role of this study is to begin to shed some light on potential underlying mechanisms that might be at play in the complex relationship of FGF-23 and clinical effects, but many more questions are raised that this study is unable to answer," they wrote.

INFORMATION: Study co-authors include Michael Shlipak, MD and Mary Whooley, MD.

Disclosures: The authors reported no financial disclosures.

The article, entitled "Fractional Excretion of Phosphorus Modifies the Association Between FGF23 and Outcomes," will appear online at http://jasn.asnjournals.org/ on March 21, 2013, doi: 10.1681/2012090894.

The editorial, entitled "Fibroblast Growth Factor-23 and Outcomes: New Answers, New Questions," will appear online at http://jasn.asnjournals.org/ on March 21, 2013, doi: 10.1681/ASN.2013020169.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Founded in 1966, and with more than 13,500 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.

ELSE PRESS RELEASES FROM THIS DATE:

Healthy lifestyle linked with longer survival among kidney disease patients

2013-03-22

Highlights Among individuals with chronic kidney disease, adherence to a healthy lifestyle was associated with a greater likelihood of surviving over a 13-year period. The greatest survival benefits were related to nonsmoking. 60 million people globally have chronic kidney disease. Washington, DC (March 21, 2013) — Certain lifestyle factors—such as not smoking, getting regular physical activity, and avoiding a low body weight—may help prolong the lives of individuals with chronic kidney disease (CKD), according to a study appearing in an upcoming issue of the ...

Education for kidney failure patients may improve chances living donor transplantation

2013-03-22

Highlights In an analysis of 695 patients with kidney failure, Blacks had received less transplant education, were less knowledgeable about transplantation, and were less willing to pursue deceased or living donor transplantation than Whites. Patients who began a transplant evaluation process with a greater knowledge of transplantation and greater motivation to receive living donor transplants were ultimately more successful at receiving a living donor transplant. In 2010, a total of 28,662 kidney transplants took place in the U.S. Of those, only 6,809 were from ...

Technique could help designers predict how legged robots will move on granular surfaces

2013-03-22

VIDEO: Using a combination of theory and experiment, Georgia Tech researchers have developed a new approach for understanding and predicting how small legged robots -- and potentially also animals -- move... Click here for more information. Using a combination of theory and experiment, researchers have developed a new approach for understanding and predicting how small legged robots – and potentially also animals – move on and interact with complex granular materials such ...

Stem cells use signal orientation to guide division, Stanford study shows

2013-03-22

STANFORD, Calif. — Cells in the body need to be acutely aware of their surroundings. A signal from one direction may cause a cell to react in a very different way than if it had come from another direction. Unfortunately for researchers, such vital directional cues are lost when cells are removed from their natural environment to grow in an artificial broth of nutrients and growth factors. Now, researchers at the Stanford University School of Medicine and the Howard Hughes Medical Institute have devised a way to mimic in the laboratory the spatially oriented signaling ...

Study: Serious mental illness no barrier to weight loss success

2013-03-22

Through a program that teaches simple nutrition messages and involves both counseling and regular exercise classes, people with serious mental illness can make healthy behavioral changes and achieve significant weight loss, according to new Johns Hopkins research. These weight loss amounts were similar to those in other successful programs studied with subjects in the general population — studies that specifically excluded people with serious mental illnesses, the researchers say. Results of the new research, believed to be the first large study of its kind to involve ...

ASU Biodesign Institute scientists develop innovative twists to DNA nanotechnology

2013-03-22

VIDEO: This is an 11-by-11 gridiron structure (11 vertical helices by 11 horizontal helices) with 21 base pairs (bp) between junctions in both directions uses 5301 of 7249 nucleotides of the M13... Click here for more information. In a new discovery that represents a major step in solving a critical design challenge, Arizona State University Professor Hao Yan has led a research team to produce a wide variety of 2-D and 3-D structures that push the boundaries of the burgeoning ...

Road traffic pollution as serious as passive smoke in the development of childhood asthma

2013-03-22

New research conducted in 10 European cities has estimated that 14% of chronic childhood asthma is due to exposure to traffic pollution near busy roads. The results are comparable to the burden associated with passive smoking: the World Health Organization estimates that between 4% and 18% of asthma cases in children are linked to passive smoking. The findings, published online today (22 March 2013) ahead of print in the European Respiratory Journal, come as the European Commission has declared 2013 the 'Year of Air', which highlights the importance of clean air for ...

Acting out dreams linked to development of dementia, Mayo Clinic study finds

2013-03-22

SAN DIEGO — The strongest predictor of whether a man is developing dementia with Lewy bodies — the second most common form of dementia in the elderly — is whether he acts out his dreams while sleeping, Mayo Clinic researchers have discovered. Patients are five times more likely to have dementia with Lewy bodies if they experience a condition known as rapid eye movement (REM) sleep behavior disorder than if they have one of the risk factors now used to make a diagnosis, such as fluctuating cognition or hallucinations, the study found. The findings were being presented ...

Megavolcanoes tied to pre-dinosaur mass extinction

2013-03-22

Scientists examining evidence across the world from New Jersey to North Africa say they have linked the abrupt disappearance of half of earth's species 200 million years ago to a precisely dated set of gigantic volcanic eruptions. The eruptions may have caused climate changes so sudden that many creatures were unable to adapt—possibly on a pace similar to that of human-influenced climate warming today. The extinction opened the way for dinosaurs to evolve and dominate the planet for the next 135 million years, before they, too, were wiped out in a later planetary cataclysm ...

'Evolutionary glitch' possible cause of childhood ear infections

2013-03-22

Researchers at King's College London have uncovered how the human ear is formed, giving clues as to why children are susceptible to infections such as glue ear. The work was funded by the UK Medical Research Council and published today in the journal Science. It is estimated that one in five children around the age of two will be affected by glue ear, a build-up of fluid in the middle ear chamber. This part of the ear contains three tiny bones that carry sound vibrations from the eardrum to the inner ear. When fluid builds up in the chamber, this prevents the three ...

Poor kidney response to hormone may increase risks for kidney disease patients

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: