Document Detail

Phosphate salivary secretion in hemodialysis patients: implications for the treatment of hyperphosphatemia.
MedLine Citation:
PMID:  17220638     Owner:  NLM     Status:  MEDLINE    
BACKGROUND/AIMS: Hyperphosphatemia is recognized as contributing to the increased risk of cardiac death in end-stage renal disease (ESRD) and hemodialysis (HD) patients. Currently available pharmacologic treatment for hyperphosphatemia is based on phosphate binders but, despite treatment, only half of the patients fall within the range for serum phosphorus of the K/DOQI guidelines. Therefore, there is a need to identify other therapeutic approaches in order to reduce serum phosphate. Salivary fluid contains phosphate which, if related to the daily salivary secretion (1,000-1,880 ml), may raise interest in order to identify further additive approaches to phosphorus removal in uremic patients, while data about salivary phosphate secretion in ESRD patients are controversial. METHODS: This study evaluates salivary phosphate secretion in 68 HD patients compared with 30 healthy subjects. Saxon's test confirmed normal salivary function in patients and controls. Salivary calcium and serum phosphate, calcium and PTH were also measured. RESULTS: HD patients had significantly higher salivary phosphorus levels compared with healthy controls: 30.35 (26.5-34.6) vs. 12.1 (10.58-14.73) mg/dl (p < 0.0001), and this significantly correlated (p < 0.0001) with serum phosphorus. Multiple regression analysis confirmed serum phosphorus as the only predictor (p < 0.0001) of salivary phosphorus. CONCLUSIONS: Given the functional secretive similarity between salivary glands and the kidneys, this increased salivary phosphate secretion might be interpreted as being compensatory in the presence of renal failure. Absorption of the increased salivary phosphate secretion, however, may worsen hyperphosphatemia; therefore, the binding of salivary phosphate might be considered as a further therapeutic approach to hyperphosphatemia in ESRD.
Vincenzo Savica; Lorenzo A Calò; Renato Caldarera; Adelaide Cavaleri; Antonio Granata; Domenico Santoro; Rodolfo Savica; Ugo Muraca; Agostino Mallamace; Guido Bellinghieri
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Publication Detail:
Type:  Journal Article     Date:  2007-01-12
Journal Detail:
Title:  Nephron. Physiology     Volume:  105     ISSN:  1660-2137     ISO Abbreviation:  Nephron Physiol     Publication Date:  2007  
Date Detail:
Created Date:  2007-02-07     Completed Date:  2007-02-28     Revised Date:  2008-04-08    
Medline Journal Info:
Nlm Unique ID:  101159772     Medline TA:  Nephron Physiol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  p52-5     Citation Subset:  IM    
Copyright Information:
Copyright 2007 S. Karger AG, Basel.
Department of Nephrology, University of Messina, Messina, Italy.
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MeSH Terms
Kidney Failure, Chronic / complications,  metabolism*,  rehabilitation*
Middle Aged
Phosphates / analysis*
Phosphorus Metabolism Disorders / etiology,  metabolism*,  therapy*
Renal Dialysis*
Saliva / chemistry*
Reg. No./Substance:

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