Cemented vertebra and adjacent vertebra refractured in a chronic kidney disease-mineral and bone disorder patient: A case report

BACKGROUND Although percutaneous vertebral augmentation(PVA)is a commonly used procedure for treating vertebral compression fracture(VCF),the risk of vertebral refracture should be considered.Chronic kidney disease-mineral and bone disorder(CKD-MBD)is a systemic disease of mineral and bone metabolism.It is associated with an increased risk of fracture.Few studies have reported the use of PVA in patients with CKD-MBD.We herein report a rare case wherein the cemented vertebra and the adjacent vertebra refractured simultaneously in a CKD-MBD patient after PVA.CASE SUMMARY A 74-year-old man suffered from low back pain after taking a fall about 3 wk ago.According to physical examination,imaging and laboratory findings,diagnoses of T12 VCF,CKD-MBD,and chronic kidney disease stage 5 were established.He then received percutaneous vertebroplasty at T12 vertebra.Fourteen weeks later,he presented with T12 and L1 vertebral refractures caused by lumbar sprain.Once again,he was given PVA which was optimized for the refractured vertebrae.Although the short-term postoperative effect was satisfactory,he reported chronic low back pain again at the 3-month follow-up.CONCLUSION It is necessary that patients with CKD-MBD who have received PVA are aware of the adverse effects of CKD-MBD.It may increase the risk of vertebral refracture.Furthermore,the PVA surgical technique needs to be optimized according to the condition of the patient.The medium-and long-term effects of PVA remain uncertain in patients with CKD-MBD.

Potential efficacy and mechanism of medicinal plants on chronic kidney disease-associated vascular calcification:a review

Vascular calcification is a crucial risk factor that affects the incidence and mortality of cardiovascular disease in chronic kidney disease patients.Modern medicine relies on calcium-phosphorus binding agents,calcium mimetics,active vitamin D,and hemodialysis to prevent and treat vascular calcification,however,their efficacy is unsatisfactory and adverse reactions often occur.Medical plant therapy can act as an integrative regulator in patients with chronic kidney disease-associated vascular calcification,which can significantly improve patients’symptoms,but its specific mechanism has not been fully elucidated yet.In this paper,we reviewed the domestic and international theoretical studies on the pathogenesis mechanism of chronic kidney disease-associated vascular calcification in recent years,summarized eight active ingredients of medicinal plants as well as four compound formulas for improving chronic kidney disease-associated vascular calcification,and explored the mechanism of action of herbal medicine,which will provide a new strategy for promoting the prevention and treatment of vascular calcification.

Unspecified live kidney donation by urological patients

BACKGROUND Individuals with benign kidney disorders undergoing nephrectomy have three possibilities:Autotransplantation,with a certain risk of complications,but without a clear benefit;discarding the kidney;or living kidney donation.AIM To investigate whether patients with benign kidney disorders and a medical indication for nephrectomy are suitable as unspecified live kidney donors.METHODS We searched all clinical data from 1994-2019 for unspecified donors and their transplant recipients(n=160).Nine of these 160 donors had pre-existing kidney disorders necessitating nephrectomy and had decided to donate their kidney anonymously after discussing the possibility of kidney donation.We studied the clinical course of these nine donating patients and their transplant recipients.RESULTS Seven of nine donating patients indicated unbearable loin pain as the main complaint,one donating patient refused ureterocutaneostomy and one had two aneurysms of the renal artery.Postoperatively,seven donating patients described absence of pain and one a significant reduction after the nephrectomy.The average 1-year creatinine level in the donating patients was 88μmol/L and after a median of 6.9 years the average creatinine level was 86.6μmol/L.In the transplant recipients,one major complication occurred which led to death and in one transplant recipient graft function failed to normalize at first but has been stable for nine years now.Currently,all transplant recipients are off dialysis.CONCLUSION Our data show that patients undergoing nephrectomy as part of treatment in selected kidney disorders can function as live kidney donors.

The Research Progression of Calcitonin for the Therapy of Renal Osteodystrophy

Calcitonin is a common medicine used in the treatment of osteoporosis,which could restrain the activity of osteoclasts,stop the loss of osteocalcin and reduce the transfer of osteocalcin.Calcitonin can also be used in the treatment of the pain-caused diseases which usually cause by hypercalcemia and others such like Paget's disease and bone tumors.As is approved by several clinic researches,calcitonin is powerful in adjusting the level of calcium,phosphorus and PTH during the treatment of renal osteodystrophy.In addition,it could improves the life quality of the patients who suffered from chronic kidney disease(CKD)and extending their life period.At present,several studies have shown us Calcitonin could be treated in renal osteodystrophy.However,the treatment experiences of Calcitonin are still lacking.Better understanding of the clinical evaluation for calcitonin in the treatment of renal osteodystrophy will hopefully help us to improve outcomes for these patients.