{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T12:32:15Z","timestamp":1723033935502},"reference-count":0,"publisher":"Ordem dos Medicos","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Med Port"],"abstract":"<jats:p>Introduction: A simple data filtering process together with some basic concepts of control theory applied to electronically stored\u00a0clinical data were used to identify some of the pathophysiological mechanisms underlying the perturbations of the calcium\/phosphorus\u00a0homeostasis in chronic kidney disease.Material and Methods: Retrospective data (a set per patient of serum single value concentrations of creatinine, calcium, phosphorus,\u00a0parathormone, 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D) from 2507 patients with stable chronic kidney disease not on renal\u00a0replacement therapy were studied. The variables were paired and subjected sequentially to a moving average and partioned into\u00a0frequency classes. The plots were interpreted using the concept of a feedback loop comprising two branches of opposite sign and of\u00a0set point of the loop. The set point for each pair of variables is displaced in the course of the disease and this displacement indicates\u00a0which of the two factors involved (the serum concentrations of calcium or parathormone, for example) is primarily affected.Results: This analysis showed that in the course of the development of chronic kidney disease the relationships between the observed\u00a0variables progressed following a monotonous, a biphasic or a triphasic pattern.Discussion: As chronic kidney disease progresses, calcium\/phosphorus metabolism regulation evolves through different phases. Later,\u00a0there is a progressive loss of the parathyroid gland sensitivity to the control by the serum concentrations of calcium and phosphorus.\u00a0The sensitivity to the inhibitory action of 1,25-dihydroxyvitamin D decreases monotonously but never releases the gland.Conclusion: The clinical data analysis used permits to illustrate the underlying pathophysiological mechanisms.<\/jats:p>","DOI":"10.20344\/amp.8040","type":"journal-article","created":{"date-parts":[[2017,7,1]],"date-time":"2017-07-01T13:17:57Z","timestamp":1498915077000},"page":"485-492","source":"Crossref","is-referenced-by-count":4,"title":["The Calcium\/Phosphorus Homeostasis in Chronic Kidney Disease: From Clinical Epidemiology to Pathophysiology"],"prefix":"10.20344","volume":"30","author":[{"given":"Ana","family":"Pires","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis","family":"Sobrinho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hugo Gil","family":"Ferreira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"8464","published-online":{"date-parts":[[2017,6,30]]},"container-title":["Acta M\u00e9dica Portuguesa"],"original-title":[],"link":[{"URL":"https:\/\/www.actamedicaportuguesa.com\/revista\/index.php\/amp\/article\/download\/8040\/5078","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.actamedicaportuguesa.com\/revista\/index.php\/amp\/article\/download\/8040\/5078","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,25]],"date-time":"2022-10-25T20:31:54Z","timestamp":1666729914000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.actamedicaportuguesa.com\/revista\/index.php\/amp\/article\/view\/8040"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6,30]]},"references-count":0,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2017,6,30]]}},"URL":"https:\/\/doi.org\/10.20344\/amp.8040","relation":{},"ISSN":["1646-0758","0870-399X"],"issn-type":[{"value":"1646-0758","type":"electronic"},{"value":"0870-399X","type":"print"}],"subject":[],"published":{"date-parts":[[2017,6,30]]}}}