S 20 CES Sanofi

Calcium consumption: yes with moderation                   

R. Guiberteau

Phosphorus Mission                                                             
F.  Quinio

Abstracts:

CKD-MBD in the calcium free era                                       

P. Hill

Chronic kidney disease (CKD), also known as chronic renal disease (CRD), is a progressive loss in renal function over time. The three most common causes of CKD are diabetes mellitus, hypertension, and glomerulonephritis. The presence of chronic kidney disease confers a markedly increased risk of cardiovascular disease, and people with CKD often have other risk factors for heart   disease. Treatments for CKD can help relieve symptoms, slow or prevent progression of the disease and reduce the risk of developing related problems. In this talk, the role of calcium and phosphate and metabolic bone disease associated with chronic kidney disease is discussed.

BIOGRAPHY OF THE SPEAKER

Calcium consumption: yes with moderation                   

R. Guiberteau

Calcium is an essential nutrient that plays a vital role in for example neuromuscular function, many enzyme-mediated processes, and blood clotting. Calcium is a mineral that builds and strengthens bones and is essentially found in milk and dairy products but also in many other foods at a lesser extent. The total body calcium content of an adult represents approximately 1kg Ca, of which over 99 per cent is within the bone, in form of hydroxyapatite crystals. In the blood, the circulating calcium levels are tightly regulated despite large variations in calcium intake and bone release. The parathyroid gland is the principal regulator, monitoring closely serum calcium levels and secreting parathyroid hormone when serum calcium falls. Serum calcium levels do not inform reliably about calcium needs. Calcium balances, that result of the amount of calcium ingested and absorbed minus the amount excreted provide such information and indicate whether the individuals are in neutral, positive or negative calcium balances. An important driver of the balance is the urinary calcium excretion. However, the capacity of the kidneys to adjust the excretion according to the absorption in order to maintain calcium homeostasis is lost prematurely when people reach Chronic Kidney Disease stage 3. At this stage and beyond, calcium supplements tend to induce a positive calcium balance that does not protect bone and do not reduce fracture risks but is associated with a dramatic increased risk of cardio vascular events. Therefore, by no doubt calcium is a key element of human physiology, but has to be consumed with moderation. More is not necessary better. Calcium supplements should be regarded as therapeutic agents especially in CKD and, as in all other such therapies, should require a careful analysis of risks and benefits before being prescribed.
 
BIOGRAPHY OF THE SPEAKER 

Phosphorus Mission                                                             
F.  Quinio

CKD is a complex condition at the cross roads of metabolic, bone and cardiovascular disorders which puts an important burden on dialysis patients and their caregivers who strive to help them live a normal life. Despite availability of cutting edge technologies and pharmacological treatments, many dialysis patients continue to suffer from uncontrolled biological and mineral parameters that have an impact on their lives, thus making therapeutic education and behavioural changes instrumental to achieve goals. Because of its widespread occurrence in many foods and not significantly removed during dialysis, excess phosphorus often poses important challenges to CKD patients. Phosphorus Mission is an interactive, application for mobile, tablets or notebooks which can be used by nurses during patient workshops to help them better understand their condition, the importance of healthy dietary choices and compliance to their prescribed treatments.  The fun user interface and quiz format encourages patient engagement which facilitates greater understanding and subsequent learning about healthy dietary habits in relation to their CKD condition. The Phosphorus Mission app can be used on a daily basis by both nurses and patients for making informative healthy dietary choices without the time consuming need for referencing tables or nutritional calculations. The patient can also use Phosphorus Mission at home, sharing their experiences and knowledge with other family members and care givers.  Based on gaming engagement, Phosphorus Mission is fun and simple to use by patients and people comfortable with technology.

 BIOGRAPHY OF THE SPEAKER