Loss of Metacarpal and Iliac Bone in Chronic Renal Failure: Influence of Haemodialysis, Parathyroid Activity, Type of Renal Disease, Physical Activity and Heparin Consumption

1979 ◽  
Vol 56 (4) ◽  
pp. 317-324 ◽  
Author(s):  
R. G. Henderson ◽  
R. G. G. Russell ◽  
M. J. Earnshaw ◽  
J. G. G. Ledingham ◽  
D. O. Oliver ◽  
...  
Keyword(s):  
Physical Activity ◽  
Renal Failure ◽  
Chronic Renal Failure ◽  
Bone Loss ◽  
Renal Disease ◽  
Dietary Calcium Intake ◽  
Bone Area ◽  
Maintenance Haemodialysis ◽  
Bone Biopsies ◽  
The Mean

1. Bone loss was assessed by measurement of cortical thickness of metacarpal bone by X-ray and of trabecular bone area in serial bone biopsies in 49 patients with chronic renal failure, six before and 45 during maintenance haemodialysis treatment. 2. Metacarpal cortical measurements (MCM) were very reproducible (coefficient of variation 1·95%), whereas bone area measurements by histology showed great variability. There was no correlation between rates of change of MCM and bone area over the same period, although both tended to fall with time. 3. The mean annual rate of bone loss measured by MCM for patients on dialysis was 2·08 ± 0·32 mm/year (mean ±1 sem) and this rate was not significantly different from the mean rate of loss of 2·49 ± 0·78 mm/year for the six patients who were not on maintenance haemodialysis. 61% of all patients showed a significant decrease during the period of study (1–6 years), but none had symptoms attributable to bone loss. 4. The loss tended to be greatest in women over the age of 40 years. The initial amount of bone and the rate of loss measured by MCM or bone histology were not influenced significantly by the presence or absence of histological or radiological evidence of parathyroid overactivity or of osteomalacia, nor by differences in the causes of renal disease. 5. Loss of metacarpal cortical bone correlated with heparin consumption during haemodialysis in men but not in women. The amount of bone and its rate of loss was not influenced by the presence of an arteriovenous shunt in one arm compared with the other. In neither sex did bone loss correlate with physical activity. 6. A relative deficiency of calcium due to a low dietary calcium intake and intestinal malabsorption of calcium, together with a dialysate calcium of only 1·5 mmol/l, may be more important causes of bone loss in patients in this study.

Increased lysine transport capacity in erythrocytes from patients with chronic renal failure

1989 ◽  
Vol 76 (4) ◽  
pp. 419-422 ◽  
Author(s):  
F. C. Fervenza ◽  
C. M. Harvey ◽  
B. M. Hendry ◽  
J. C. Ellory
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Diffusion Constant ◽  
Linear Component ◽  
Transport Capacity ◽  
Mean Values ◽  
Maintenance Haemodialysis ◽  
Apparent Diffusion ◽  
Intracellular Amino Acids ◽  
The Mean

1. The initial rate of l-lysine influx into erythrocytes from 13 patients with chronic renal failure has been measured using 14C-labelled lysine. Ten patients were on maintenance haemodialysis and three had never been dialysed. The results are compared with data obtained from 12 normal individuals. 2. The rate of lysine influx into washed cells from buffered saline containing 0.02–0.5 mmol of l-lysine/l has been calculated. The results can be fitted with a model in which influx has a single saturable component obeying Michaelis–Menten kinetics, and a linear non-saturable component. 3. In uraemic erythrocytes the saturable component had a mean Vmax. of 0.762 mmol h−1 litre−1 of cells (n = 13, sem 0.072) and a mean Km of 68.2 μmol/l (sem 5.7). These values in normal erythrocytes were 0.566 mmol h−1 litre−1 of cells (n = 12, sem 0.033) and 70.5 μmol/l (sem 4.1), respectively. The mean apparent diffusion constant (KD) for the linear component of influx was 0.224 h−1 (sem 0.039) in uraemic cells and 0.178 h−1 (sem 0.028) in normals. 4. The 35% increase in mean Vmax. seen in uraemic erythrocytes was statistically significant (P = 0.02). A similar increase in Vmax. in uraemic cells compared with controls was seen in erythrocytes which were studied in zero-trans conditions after depletion of intracellular amino acids. The mean values of Km and KD were not significantly different in uraemia. The origins of this increased membrane transport capacity for lysine in uraemia are discussed.

Abnormal erythrocyte choline transport in patients with chronic renal failure

1991 ◽  
Vol 80 (2) ◽  
pp. 137-141 ◽  
Author(s):  
F. C. Fervenza ◽  
D. Meredith ◽  
J. C. Ellory ◽  
B. M. Hendry
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Chronic Renal Failure ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Normal Subjects ◽  
Choline Transport ◽  
Maintenance Haemodialysis ◽  
Control Subjects ◽  
Transplant Patients ◽  
The Mean

1. Erythrocyte choline transport has been studied in nine patients on maintenance haemodialysis for chronic renal failure, six patients on continuous ambulatory peritoneal dialysis, 31 patients with renal transplants and in nine normal control subjects. 2. The mean maximum rate of choline influx (Vmax., measured at an extracellular choline concentration of 250 μmol/l) was 66.7 (sd 14.1) μmol h−1 l−1 cells in patients on haemodialysis, 87.8 (sd 18.5) μmol h−1 l−1 cells in patients on continuous ambulatory peritoneal dialysis and 30.5 (sd 4.9) μmol h−1 l−1 cells in control subjects. The increase in choline flux in patients on haemodialysis and patients on continuous ambulatory peritoneal dialysis compared with control subjects was highly significant (P < 0.001). 3. Renal transplant patients showed variable values for the Vmax. of choline influx (range 17.7-71.7 μmol h−1 l−1 cells). The values showed a signifcant negative correlation with creatinine clearance and this correlation correctly extrapolated to the maximum choline flux in normal subjects and in patients on dialysis. 4. The kinetics of choline transport have been studied in erythrocytes of patients on haemodialysis and control subjects in ‘zero-trans’ conditions after depletion of intracellular choline. The mean Vmax. in these conditions was 38.4 (sd 4.6) μmol h−1 l−1 cells in patients on haemodialysis compared with 14.2 (sd 3.7) μmol h−1 l−1 cells in control subjects. The mean Km under ‘zero-trans’ conditions was 19.4 (sd 2.4) μmol/l in patients on haemodialysis and 7.4 (sd 1.4) μmol/l in control subjects. These differences were significant (P < 0.001).

RELATIONSHIP BETWEEN CARDIOVASCULAR DISEASES AND ANATOMOSIS OF ARTERIOVENOUS FISTULAR IN PATIENTS WITH REGULARLY HEMODIALYSIS

2017 ◽  
pp. 88-92
Author(s):  
Van Hien Pham ◽  
Huu Vu Quang Nguyen ◽  
Tam Vo
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Renal Failure ◽  
Chronic Renal Failure ◽  
Cardiovascular Diseases ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Negative Correlation ◽  
Mean Value ◽  
The Mean

Background: Cardiovascular diseases are the leading cause of death in patients with chronic renal failure. When a patient undergoes dialysis, making AVF or AVG causes cardiovascular events. Understanding the relationship between complications: hypertension, heart failure, AVF or AVG (formation time, position, diameter) helps us monitor, detect, prevent and treatment of complications to limit the risk of death in patients with dialysis. Objective: Relationship between cardiovascular diseases and anatomosis of arteriovenous fistular in patients with regularly hemodialysis at Cho Ray Hospital. Methods: A cross-sectional study was conducted at Cho Ray Hospital from 2015 to 2016. The survey some cardiovascular diseases are done by clinical examination, tests for diagnostic imaging such as X-ray, electrocardiogram and echocardiogram: heart and diameter of anastomosis AVF, AVG. Results: The study population included 303 patients with chronic renal failure who were dialysis. Of which, patients aged 25-45 accounted for the highest proportion (43.9%). The proportion of male and female patients was similar (48.5% and 51.5% respectively). The mean value of systolic blood pressure on patients made AVF, AVG less than 12 months is higher than patients made AVF, AVG over 12 months, and there is negative correlation (r = -0.43) between AVF, AVG and systolic blood pressure (p <0.05). The mean value of diastolic blood pressure on patients made AVF, AVG less than 12 months is lower than patients made AVF, AVG over 12 months, and and there is positive correlation (r = -0.43) between AVF, AVG and diastolic blood pressure (p <0.05) (p <0.05). The prevalence of patients with heart failure made AVF, AVG over 12 months is higher than that of the under 12 months group, there is a negative correlation (r = - 0.43) between AVF, AVG diameter and EF index (p <0.05). Conclusion: It is important to note the diameter of anastomosis AVF, AVG in patients with chronic renal failure dialysis to limit cardiovascular complications, especially heart failure. Key words: Chronic kidney disease, hemodialysis.

Oral and Maxillofacial Manifestations of Mineral and Bone Disorders Associated with Chronic Renal Failure

2017 ◽  
Vol 68 (6) ◽  
pp. 1325-1328
Author(s):  
Andrada Raluca Doscas ◽  
Mihail Balan ◽  
Mihai Liviu Ciofu ◽  
Doriana Agop Forna ◽  
Marius Cristian Martu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Renal Function ◽  
Chronic Renal Failure ◽  
Health Concern ◽  
Oral Manifestations ◽  
End Stage Renal Failure ◽  
Brown Tumors ◽  
The Mean ◽  
End Stage

Chronic kidney disease (CKD) is a multifactorial syndrome and a global health concern. As renal function declines, there is a progressive deterioration of mineral homeostasis. Starting from stage 3 of CKD oral manifestations of mineral disorders can occasionally appear and become more frequent and evident in stage 5. We retrospectively analysed 43 patients diagnosed with end stage renal failure undergoing dialysis, hospitalized in our clinic for different oral and maxillofacial pathologies. The mean dialysis period was 5.43 years. Radiographic alterations afecting the jaws were found in all patients. The most common feature was partial or total loss of lamina dura, followed by alterations of the bony trabeculae. 9 patients presented brown tumors which are considered the final stage of secondary hyperparathyroidism associated with renal failure.

Neuropeptide Y as a plasma marker for phaeochromocytoma, ganglioneuroblastoma and neuroblastoma

1992 ◽  
Vol 83 (2) ◽  
pp. 205-211 ◽  
Author(s):  
Toraichi Mouri ◽  
Masahiko Sone ◽  
Kazuhiro Takahashi ◽  
Keiichi Itoi ◽  
Kazuhito Totsune ◽  
...  
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Neuropeptide Y ◽  
Healthy Adult ◽  
Plasma Samples ◽  
Normal Range ◽  
Maintenance Haemodialysis ◽  
Upper Limits ◽  
Highly Sensitive ◽  
Plasma Marker

1. We investigated the usefulness of neuropeptide Y as a plasma marker for phaeochromocytoma, ganglioneuroblastoma and neuroblastoma using a simple and highly sensitive r.i.a. for human neuropeptide Y. 2. Plasma immunoreactive neuropeptide Y concentrations were measured without extraction in plasma samples (100 μl) from patients with various diseases. 3. The plasma immunoreactive neuropeptide Y concentration in patients with phaeochromocytoma (172.3 ± 132.4 pmol/l, mean ± sd, n = 23) was significantly higher than that in healthy adult subjects (40.1 ± 10.1 pmol/l, n = 40, P<0.0001). The plasma immunoreactive neuropeptide Y concentrations in patients with ganglioneuroblastoma (590.7 ± 563.6 pmol/l, n = 6) and patients with neuroblastoma (566.9 ± 524.4 pmol/l, n = 15) were significantly higher than those in control children (1–9 years old, 82.2 ± 39.9 pmol/l, n = 72, P<0.0001). 4. The plasma immunoreactive neuropeptide Y concentration in patients with essential hypertension (34.0 ± 3.7 pmol/l, n = 18) was within the normal range, but in patients with chronic renal failure undergoing maintenance haemodialysis (192.1 ± 68.0 pmol/l, n = 25) and in non-dialysed patients with chronic renal failure (85.1 ± 23.1 pmol/l, n = 7) it was significantly higher than that in healthy adult subjects (P<0.0001). 5. Eighty-seven per cent of the patients with phaeochromocytoma, 67% of the patients with ganglioneuroblastoma and 80% of the patients with neuroblastoma showed plasma immunoreactive neuropeptide Y concentrations higher than the upper limits in the control subjects [62 pmol/l (adult) and 160 pmol/l (children)]. 6. These results suggest that neuropeptide Y is a useful plasma marker for these tumours in addition to other factors unless the patients have renal failure.

Stable Strontium Absorption as a Measure of Intestinal Calcium Absorption: Comparison with the Double-Radiotracer Calcium Absorption Test

1994 ◽  
Vol 87 (3) ◽  
pp. 363-368 ◽  
Author(s):  
Aubrey Blumsohn ◽  
Brian Morris ◽  
Richard Eastell
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Time Course ◽  
Calcium Absorption ◽  
Quadratic Term ◽  
The Mean ◽  
Stable Strontium ◽  
The Relationship ◽  
Dual Tracer ◽  
Fractional Absorption

1. Stable strontium (Sr) has been proposed as an alternative to calcium (Ca) isotopes for the measurement of intestinal Ca absorption. The aim of this study was to compare the time course and fractional absorption of Ca and Sr, when both are measured using dual-tracer techniques. 2. 45Ca and Sr absorption tests were carried out on consecutive days in patients with osteoporosis (n = 10) or chronic renal failure (n = 7). Both tests were repeated in four patients with chronic renal failure after treatment with calcitriol (1 μg daily for 10 days). 3. The time course of Ca absorption was determined using the 85Sr (intravenous)/45Ca (oral) dual-tracer technique, and the time course of Sr absorption using 85Sr (intravenous)/stable Sr (oral). Oral tracers were administered on consecutive days with a test meal containing 5.3 mmol of Ca and 2.5 mmol of either stable Sr or Ca carrier. The fractional absorption of 45Ca and Sr at 6 h (FA360) and the absorption rate as a function of time were calculated by deconvolution. 4. The mean FA360 for Sr (20.2%) was lower than the mean FA360 for 45Ca (37.8%, P < 0.001, paired t-test), but the time course of Sr absorption was similar to that of Ca. There was a significant correlation between the FA360 for 45Ca and Sr, although the relationship was improved by including a quadratic term (R2 = 0.89, P < 0.001, significance of quadratic term, P < 0.05). After 1,25-dihydroxyvitamin D treatment, the FA360 of stable Sr increased 4.29-fold, whereas the FA360 of 45Ca increased only 2.4-fold. 5. Although the fractional absorption of Sr determined by dual-tracer deconvolution was the best predictor of FA360 for 45Ca, little was lost by confining the analysis to a single serum Sr measurement taken 3 h or more after oral administration. 6. We conclude that Sr absorption is qualitatively similar to that of Ca, although absorption of Sr is much lower than that of Ca. Furthermore, the relationship does not appear to be linear. Stable Sr may be useful in place of Ca isotopes in the routine clinical evaluation of Ca absorption.

Recent Advances in the Management of the Infant, Child, and Adolescent With Chronic Renal Failure

1990 ◽  
Vol 11 (9) ◽  
pp. 277-282
Author(s):  
Richard N. Fine
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Quarter Century ◽  
Irreversible Reduction ◽  
Age Limits ◽  
Stage Renal Disease ◽  
End Stage

The prognosis of the infant, child, or adolescent with chronic renal failure, defined as an irreversible reduction in glomerular filtration rate, has improved during the past quarter century because of the use of dialysis and renal transplantation. These have prolonged lives in previously fatal situations. Because the potential not only to sustain life but also to effect full rehabilitation exists with the introduction of these treatments, it is now imperative that the multisystem consequences of uremia be either minimized or totally avoided in the pediatric patient with chronic renal failure. The role of the pediatrician in managing the infant, child, or adolescent with chronic renal failure should be directed toward minimizing the potentially devastating consequences of uremia so that the patient is in optimal clinical condition when end stage renal disease occurs. INCIDENCE It is difficult to know the incidence and prevalence of chronic renal failure and end stage renal disease in children. Surveys in Europe and North America have been conducted to obtain precise information regarding these issues; not only have the definitions included in these surveys differed, but the upper and lower age limits defining pediatric patients have not been uniform. The available data suggest a prevalence of chronic renal failure of 18.5 per 1 million child population and an incidence of end stage renal disease of from 3 to 6 children per 1 million total population.

Haemodialysis

2010 ◽  
pp. 3930-3943
Author(s):  
Ken Farrington ◽  
Roger Greenwood
Keyword(s):  
Renal Failure ◽  
Renal Disease ◽  
Clinical Outcomes ◽  
Successful Treatment ◽  
Endstage Renal Disease ◽  
Maintenance Haemodialysis ◽  
The Past ◽  
Anaemia Management ◽  
Developed World

Over the past four decades, maintenance haemodialysis has proved to be a highly successful treatment for patients with endstage renal disease. In the developed world, the haemodialysis population continues to increase and is becoming more elderly and dependent. However, despite considerable advances in haemodialysis technology and other significant improvements, such as those in renal anaemia management, the long-term clinical outcomes for patients remain much less good than those of other people with comparable characteristics but without renal failure....

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