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Ageing and changes in phosphate transport: clinical implications.
No full textHyperphosphatemia is pivotal in some complications secondary to kidney dysfunction. Current guidelines suggest that hyperphosphatemia secondary to kidney dysfunction develops only when glomerular filtration rate is reduced well below the threshold of 60 ml/min. This paper deals with the relationship of age with serum phosphorus and with the possible influences of this relationship on hyperphosphatemia secondary to kidney dysfunction. A recent epidemiologic study shows that serum phosphorus decreases over time not only in pediatric age but also during adulthood. This decrease differs between men and women: continuous in men, but not in women, because of a transitory serum phosphorus increase during climacterics. Data show also that age-associated differences in serum phosphorus among adults are explained by differences in the maximal phosphorus reabsorption in the renal proximal tubule (TmP/GFR). Other studies suggest that the opposite influences on TmP/GFR of growth hormone (stimulation) and estrogen (inhibition) are the determinants of the age-associated changes in TmP/GFR and serum phosphorus. The decline of serum phosphorus with age leads to the hypothesis that, in the presence of a disorder inducing phosphorus retention, the prevalence of hyperphosphatemia should be higher in young adults than in the elderly because the healthy elderly have lower serum phosphorus. A large clinical study supports this hypothesis showing that hyperphosphatemia secondary to kidney dysfunction is approximately 4 times higher at age 65. Data suggest that the relation between kidney function and serum phosphorus should be reevaluated considering the possible confounding effect of age
IL CONTROLLO DEL RISCHIO ONCOGENO NEGLI AMBIENTI DI LAVORO. PROPOSTA DI UN PIANO DI SOLUZIONE
No full textFOLIA MEDIC
Protocollo di sorveglianza sanitaria dei lavoratori addetti ad attività di disinfezione e disinfestazione in un’ASL delle ragione Campania
No full textA population-based approach for the definition of chronic kidney disease: the CKD Prognosis Consortium
No full textIntroduction: The Kidney Disease: Improving Global
Outcomes (KDIGO) foundation promoted the establishment
of the Chronic Kidney Disease (CKD) Prognosis
Consortium to meta-analyze the association of
estimated glomerular filtration rate (eGFR) and albuminuria
with incidence of various outcomes in samples
of general populations from all over the world.
Methods: Variables in meta-analysis included eGFR
by the Modification of Diet in Renal Disease (MDRD)
Study equation, the urinary albumin to creatinine ratio
(uACR) as index of albuminuria, together with proteinuria
at dipstick urinalysis and classical markers of
cardiovascular risk. Overall, 105,872 participants had
uACR measurements, and 1,128,310 participants had
dipstick measurements.
Results: The association with mortality was continuous
over the whole range of uACR/proteinuria and Jshaped
for eGFR which was associated with an excess
risk for values <75 and ≥120 ml/min per 1.73 m2.
Results were similar for the association of eGFR or
uACR/proteinuria with renal failure. The associations
of eGFR and uACR/proteinuria with death or renal failure
were independent of each other. Findings were
consistent across population samples from North
America, Asia, Oceania and Europe, as well as in individuals
with age <65 years and individuals with age
≥65 years.
Conclusions: Data support the threshold of 60 ml/
min for CKD definition but suggest that eGFR in the
range 60-74 ml/min could represent the early stages of CKD. This first set of results of the CKD Prognosis
Consortium represents an important step in the evidence-
based definition of CKD. Conclusions should
be reevaluated with eGFR calculation by equations
less biased for normal-high eGFR
Phosphatemia and age: a neglected relation in medical practice.
No full textHyperphosphatemia is pivotal in some complications secondary to kidney dysfunction. Current guidelines suggest that hyperphosphatemia due to kidney dysfunction develops only when kidney function is reduced to 65 years. Data suggest that the relation between kidney function and phosphatemia should be re-evaluated considering possible confounding due to age
Protocollo di sorveglianza sanitaria dei lavoratori addetti ad attività di disinfezione e disinfestazione in un’ASL delle ragione Campania
No full text- …
