Bone & Mineral Metabolism

ASN Names Next Editor-in-Chief of CJASN

ASN has named Rajnish Mehrotra, MD, FASN, as CJASN Editor-in-Chief effective January 1, 2017. He will serve a six-year term.

Communities at ASN

ASN Communities offer multiple opportunities to connect with colleagues working in the areas that interest you most. Check out this rapidly growing and dynamic ASN initiative here.

Surgery Is Better than Bisphosphonates for Preventing Fractures in Patients with Hyperparathyroidism

Among 6272 people diagnosed with hyperparathyroidism between 1995 and 2010, there were 56 hip fractures per 1000 people after 10 years among those not treated for hyperparathyroidism. Among those who had parathyroid surgery, there were just 20 fractures per 1000 people. Surprisingly, the hip fracture rate was highest among those taking bisphosphonates, at 86 fractures per 1000 patients. Similar results were seen for bone fractures of all types.

Women with Kidney Stones May Be at Increased Risk of Coronary Heart Disease

In a recent literature search and meta-analysis, a history of kidney stones was associated with a 43% increased risk of coronary heart disease in women. An association was not significant in males. The North American Journal of Medical Sciences analysis included 7 populations from 4 cohort studies and 1 cross-sectional study.

Infected Kidney Stones Linked with Increased Risk of Sepsis after Removal

After adjustments, positive stone culture was independently associated with a 6.9 times increased likelihood of postoperative sepsis after stone percutaneous nephrolithotomy in a recent study. Postoperative sepsis occurred in 31% of the 45 patients who had a positive stone culture vs. 5.9% of the 161 patients who had a sterile stone culture. Among the patients with positive cultures, Enterococcus species (29.4%) and Escherichia coli (21.6%) were the most prevalent gram positive and gram negative bacteria, respectively.

Potassium Salts May Provide Important Benefits for Bone Health

A meta-analysis of 14 studies confirms that supplementation with alkaline potassium salts (bicarbonate and citrate) leads to significant reductions in urinary calcium and acid excretion, as well as decreased bone resorption. This means that excess acid is neutralized and bone mineral is preserved. The Osteoporosis International findings suggest that eating more fruits and vegetables, which are rich in potassium salts, could be a way to improve bone strength and prevent osteoporosis.

High Serum Calcium Linked with Increased Risk of Premature Death in Dialysis Patients

Among 129,076 patients on hemodialysis or peritoneal dialysis who were treated between 2001 and 2006, uncorrected serum calcium levels <8.5 or ≥10.2 mg/dL were linked with an increased risk of premature death, regardless of dialysis modality. Albumin-corrected calcium ≥10.2 mg/dL and serum phosphorus ≥6.4 mg/dL were also associated with increased risk of premature death in the JASN study.

Calcium and Phosphorus Regulatory Hormones Tied to Kidney Stone Incidence

A study of men in the Health Professionals Follow-Up Study who were free of nephrolithiasis at blood draw revealed higher plasma 1,25-dihydroxyvitamin D, even in ranges considered normal, was associated with higher risk of symptomatic kidney stones over 12 years. After adjusting for BMI, diet, plasma factors, and other covariates, men in the highest quartile of plasma 1,25-dihydroxyvitamin D had a 73% increased risk of incident symptomatic kidney stones compared with men in the lowest quartile. Higher fibroblast growth factor 23 was also associated with increased risk.

Magnesium May Benefit Dialysis Patients with Hyperphosphatemia

In a recent study of data from 142,069 hemodialysis patients in Japan, an increase in serum phosphate levels over 1 year elevated the risk of cardiovascular mortality in patients with low serum magnesium levels (<2.7 mg/dL) as well as in those with intermediate serum levels (2.7 to 3.0 mg/dL). However, no significant risk was observed in patients with magnesium levels ≥3.1 mg/dL. Among patients with serum phosphate levels ≥6.0 mg/dL, the cardiovascular mortality risk significantly decreased with increasing serum magnesium levels.

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