BackgroundHigh serum phosphate and fibroblast growth factor-23 (FGF-23) levels are well-recognized independent risk factors of mortality and morbidity in patients with chronic kidney diseases (CKDs). Sevelamer, as a phosphate chelating agent, reduces serum phosphate and FGF-23 levels produced by bone osteocytes. This study aimed to determine the best dose at which sevelamer could successfully reduce serum phosphate and FGF-23 levels in rat models of adenine-induced CKD.MethodsCKD was induced using adenine. Healthy and CKD-induced rats were divided into 6 groups as follows: healthy controls; CKD controls; rats treated with 1%, 2%, and 3% sevelamer for CKDs; and healthy rats administered 3% sevelamer. Biochemical factors and serum FGF-23 levels were measured using spectrophotometry and enzyme-linked immunosorbent assay methods.ResultsSerum phosphate levels were best decreased in rats receiving 3% sevelamer in their diet (5.91±1.48 mg/dL vs. 8.09±1.70 mg/dL, P<0.05) compared with the CKD control rats. A dose-dependent decrease in serum FGF-23 levels was observed, and the most significant results were obtained in rats receiving 3% sevelamer compared with the CKD control rats (142.60±83.95 pg/mL vs. 297.15±131.10 pg/mL, P<0.01).ConclusionsHigher sevelamer doses significantly reduced serum phosphate and FGF-23 levels in adenine-induced CKD rats.

BackgroundIn recent years, stents are increasingly used in variety of coronary lesions. Ostial lesion of left anterior descending coronary artery (LAD) however remains a challenge area because of the invariable involvement of distal left main coronary artery (LMCA). This study was designed to evaluate the clinical and angiographic outcomes of everolimus-eluting stent (EES) implantation for ostial LAD.MethodsEESs were implanted in 45 consecutive patients with ostial LAD stenoses. For complete lesion coverage, stent positing was extended into the distal LMCA in 6 patients (13.3%) with intermediated LMCA narrowing. We assess MACE during one-year follow-up.ResultsIn-hospital success rate was 100%; neither cardiac death nor stent thrombosis in our patients, but two patients had myocardial infarction in non-related coronary artery during follow-up. Two patients had angiographic restenosis and underwent TLR. The cumulative MACE-free survival rate was 95.6% at one year.ConclusionEES was in ostial LAD lesions with complete lesion coverage achieving high procedural success rate and acceptable clinical outcomes during one-year follow-up period.

Conventional repair of pararenal aortic aneurysms has been a technically challenging operation, with a significant morbidity rate of 28-35%. Endovascular stent grafting requires satisfactory landing zones for stent graft anchoring. Therefore, pararenal abdominal aortic aneurysms are usually contraindicated for this procedure because of difficulties associated with proximal graft fixation. In this case, we attempted to use a new strategy with an implanted atrial septal defect (ASD) Amplatzer device across the neck of the aneurysm. However, one month after this procedure the patient was referred to the hospital due to significant compression of the right inferior vena cava (IVC). Conclusion. In patients with an atrial septal defect and abdominal pain due to an aneurysm, implantation of an Amplatzer device across the aneurysm neck, may be beneficial.