Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:3.1.3.1 (alkaline phosphatase)
 47,916 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A study has been made of possible interrelationships between circulating vitamin A concentration and indicators of altered calcium homeostasis in 31 patients with stable chronic renal failure. Plasma retinol concentrations were high, possibly as a result of increased retinol-binding-protein concentrations secondary to renal failure. There was no correlation between retinol concentration and any other measurement, including vitamin A intake. However, there were significant correlations between plasma parathyroid hormone and calcium, phosphate, alkaline phosphatase, urea, and creatinine concentrations; and those patients with radiological sub-periosteal erosions tended to have the highest concentrations of circulating parathyroid hormone. Our data give no support to the contention that vitamin A status has any bearing on the progression and severity of the hyperparathyroid bone disease of renal failure.
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PMID:Relationship between vitamin A and bone disease in chronic renal failure. 653 95

In 46 patients with primary hyperparathyroidism, in 21 non-dialysed patients with advanced renal failure, and in 52 patients on hemodialysis, a significant positive correlation was found between bone isoenzyme of serum alkaline phosphatase and plasma tartrate resistant acid phosphatase. In primary hyperparathyroidism, a significant positive correlation was found between the radiological degree of osteodystrophy and the biochemical parameters of bone remodelling. After removal of the parathyroid adenoma, only the tartrate-resistant acid phosphatase decreased to normal limits. Plasma tartrate resistant acid phosphatase was most significantly influenced by serum immunoreactive parathyroid hormone levels. In chronic renal failure, bone isoenzyme of serum alkaline phosphatase was most significantly influenced by serum immunoreactive parathyroid hormone levels, by hypocalcemia and by duration of hemodialysis. The results confirm that in hyperparathyroidism the extent of the whole-body rates of bone resorption and formation are approximately equal. The biochemical parameters can be used for serial assessment of the course of the disease but are not specific for diagnosis.
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PMID:Relationship of plasma tartrate resistant acid phosphatase to the bone isoenzyme of serum alkaline phosphatase in hyperparathyroidism. 662 82

The influence of aluminium in dialysate on the effects of 1 alpha (OH)3 on hemodialyzed hypocalcemic patients with end-stage renal failure, was studied during a 24- to 42-month period. 51 hypocalcemic patients were divided into two groups; group 1 consisted of 28 patients who were dialyzed using dialysate prepared from reverse osmosed water; the 23 patients in group 2 used dialysate prepared from softened water. Aluminium concentration in the dialysate used for group 1 was less than the detectable limit (10 micrograms/l) in twelve times determinations, while that for group 2 was 23.1 +/- 9.2 micrograms/l (mean +/- SD, n = 14). By the administration of 1 alpha (OH)D3, the serum concentration of calcium was increased, and that of iPTH and alkaline phosphatase activity was decreased in both groups. Subperiosteal resorption of the finger bone, evaluated by Jensen's criteria, was significantly improved in group 1, while there was no improvement in group 2. Serum aluminium concentration in the patients of group 1 and group 2 were 46.6 +/- 6.3 and 84.7 +/- 13.9 micrograms/l, respectively, and the concentration of the latter was significantly higher than that of the former (p less than 0.01). It was also shown that there is a positive correlation between the extent of subperiosteal resorption and the concentration of aluminum in serum. Serum aluminium concentration and bone aluminium content were increased according to the duration of hemodialysis in the patients who were dialyzed using dialysate from softened water, while there was no correlation between the duration of hemodialysis and serum aluminium concentration for the patients of group 1.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Influence of aluminium on the effect of 1 alpha (OH)D3 on renal osteodystrophy. 663 56

The case records of 327 patients who underwent bone biopsy in late or terminal renal failure, before any form of dialysis or transplantation, were examined for clues to the aetiology of renal osteomalacia and its manifestations. Fifty four per cent of the biopsies showed pure osteitis fibrosa, 34 per cent osteomalacia with osteitis fibrosa and 12 per cent showed neither abnormality. Osteomalacia was strongly associated with chronic pyelonephritis and obstructive uropathy as primary renal disease. In two matched groups of 100 each, and within the major primary diseases, it was associated with acidosis, hypocalcaemia and normophosphataemia (as opposed to hyperphosphataemia). There was no association with known length or uraemia and only a weak and inconsistent relationship with severity of uraemia. In the few patients studied, there was no relationship between osteomalacia and serum 25-hydroxycholecalciferol level. In contrast to the state of patients treated by haemodialysis, osteomalacia in this undialysed group was manifested by a higher level of serum alkaline phosphatase than pure osteitis fibrosa, serum iPTH did not differ between the groups, there was no predominance of symptoms in one group, other than proximal myopathy which had a weak association with osteomalacia, and Looser zones were more common than complete fractures. Our study shows that osteomalacia has different manifestations, and probably different causes, before and after the start of haemodialysis. These two stages of renal failure should be clearly distinguished in reports of renal bone disease.
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PMID:Osteomalacia in patients with chronic renal failure before dialysis or transplantation. 664 48

Parathyroidectomy was performed during a 5-year period in 11 of 196 patients undergoing maintenance dialysis for renal failure. Characteristics of the series were relatively long periods of dialysis, severe symptomatic bone disease, hypercalcemia, increased alkaline phosphatase, greatly raised serum levels of immunoreactive parathyroid hormone and X-ray changes appearing as abnormal bone structure, metastatic calcifications and pathologic fractures. Most of the operations consisted of total parathyroidectomy alone or accompanied by autotransplantation of parathyroid tissue. Subjective and objective improvement followed the operation in most cases, and the outlined indications thus appeared to be adequate. However, only a minority of the patients became symptom-free, and current methods of treating autonomic hyperparathyroidism in patients on regular dialysis must be regarded as suboptimal. The relative indications for the 2 types of operations are discussed. Total parathyroidectomy may be an acceptable operation for patients of this category.
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PMID:Parathyroidectomy for hyperparathyroidism in maintenance dialysis patients. 664 83

The activity of intestinal isoenzyme of serum alkaline phosphatase was evaluated in 21 non-dialyzed patients with advanced renal failure and in 52 patients on regular hemodialysis. In patients without hepatopathy, a significant inverse correlation was found between the enzyme activity and serum calcium levels. Hepatopathy was the most significant variable influencing the enzyme activity in patients on dialysis. Secondary hyperparathyroidism and a decreased rate in enzyme elimination should be assessed for the above-normal activities of intestinal ALP in serum in chronic renal failure.
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PMID:Metabolic implications in the elevation of serum activity of intestinal alkaline phosphatase in chronic renal failure. 672 22

An 82-year-old woman with essential mixed cryoglobulinemia type II (IgM K IgG) presented with moderate renal failure and nephritic syndrome. Mesangiocapillary glomerulonephritis with mesangial and subendothelial granular deposits containing IgG, IgM, and C3 in conjunction with small-vessel vasculitis was seen on renal biopsy. Renal symptomatology preceded by a period of 10 months the development of leg ulcers and purpura. The onset of the skin lesions was accompanied by an acute decline of renal function and an increase in liver alkaline phosphatase. Plasmapheresis with a 50% plasma exchange each week over 12 weeks led to improvement in renal function, healing of leg ulcerations, disappearance of purpura, and a return to the baseline of alkaline phosphatase in association with the disappearance of circulating cryoglobulins.
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PMID:Plasmapheresis as sole therapy in a patient with essential mixed cryoglobulinemia. 674 40

Twenty-three patients with end-stage renal failure on maintenance haemodialysis were treated with 1,25-dihydroxy vitamin D3 or 24-25-dihydroxy vitamin D3 for 3-32 months (total 232 patient months). Treatment with 1,25-dihydroxy vitamin D3 was marked by symptomatic, biochemical and histological improvements in the majority of patients. In contrast, treatment with 24,25-dihydroxy vitamin D3 produced no biochemical or histological improvements and such patients developed severe symptomatic bone disease. Successful renal transplantation resulted in rapid improvement in symptoms, biochemistry and bone histology in nine of 10 patients irrespective of whether prior treatment was with 1,25-dihydroxy vitamin D3, 24,25-dihydroxy vitamin D3 or both. During treatment with 1,25-dihydroxy vitamin D3 progressive reduction in dosage was required in the majority of patients because of hypercalcaemia, which was rapidly corrected by stopping treatment for a few days. Hypercalcaemia did not occur until serum alkaline phosphatase (AP) and amino terminal parathyroid hormone (N-PTH) had fallen towards normal. Treatment failure was uncommon in 1,25-dihydroxy vitamin D3-treated patients and was characterized by the early development of hypercalcaemia. Addition of 24,25-dihydroxy vitamin D3 in such patients rendered the hypercalcaemia more manageable but did not lead to any further improvement in biochemistry or bone histology. Treatment with 24,25-dihydroxy vitamin D3 was accompanied by the development of severe symptomatic bone disease in the majority of patients and a characteristic pattern of biochemical abnormalities with hypocalcaemia and rises in AP and N-PTH. Substitution of 1,25-dihydroxy vitamin D3 treatment for 24,25-dihydroxy vitamin D3 in these patients resulted in prompt improvement in clinical, biochemical and histological abnormalities. Successful renal transplantation was accompanied by rapid resolution of clinical, biochemical and histological features of renal osteodystrophy irrespective of whether previous treatment was with 1,25-dihydroxy vitamin D3 or 24,25-dihydroxy vitamin D3. Hypophosphataemia was common in the early months after renal transplantation without evidence of continuing hyperparathyroidism. The studies have confirmed that 1,25-dihydroxy vitamin D3 is effective in controlling clinical, biochemical and histological features of renal osteodystrophy while 24,25-dihydroxy vitamin D3 did not have a useful therapeutic effect in the dose used.
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PMID:Long-term effects of 1,25-dihydroxy vitamin D3 and 24,25-dihydroxy vitamin D3 in renal osteodystrophy. 676 Feb 36

A newly recognized clinical and morphologic pattern of acute alcoholic liver disease is described. Twenty-one patients, having the hepatic morphologic features of alcoholic foamy degeneration, were retrospectively analyzed. All patients had a significant history of chronic alcoholism. Jaundice and hepatomegaly were usually present. Hepatic encephalopathy, ascites, bleeding esophageal varices, or functional renal failure occurred in less than 10%. Usually this was the first episode of decompensation. Laboratory studies revealed a pattern of very transiently marked elevation of serum aminotransferase and more prolonged elevation of alkaline phosphatase activity and bilirubin levels. In the majority of cases, leukocytosis was absent, and serum cholesterol was elevated. The laboratory profile differed significantly from that of acute sclerosing hyaline necrosis. Serologic markers of acute viral hepatitis A and B were absent. Needle biopsy specimens of the liver revealed intact lobular architecture except for 1 case of cirrhosis. The perivenular hepatocytes revealed foamy fatty change characterized by striking cell swelling with massive accumulation of microvesicular fat, bile pigment deposition in the cytoplasm, and no displacement of the nucleus to the periphery of the cell. Megamitochondria were frequently identified. Multiple foci of hepatocyte dropout without significant parenchymal neutrophilic exudation and delicate intrasinusoidal collagen fibers were present in the perivenular area. Macrovesicular fatty change coexisted to a variable degree. The affected hepatocytes had extensive disorganization of the organelles by electron microscopy and decreased or absent functional activity by enzyme histochemical staining. These changes appear to be a purely degenerative process without inflammatory reaction. All patients in the present series showed a rapid recovery upon abstaining from alcohol.
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PMID:Alcoholic foamy degeneration--a pattern of acute alcoholic injury of the liver. 682 80

Serum sulfate concentrations may reach five to ten times normal in renal failure patients dialyzed on a sorbent cartridge system, and these patients have elevated alkaline phosphatase levels suggesting an increased incidence of renal oseodystrophy. We studied the effect of adding sulfate on ionized calcium (Ca2+) in human serum in vitro and in rat serum in vivo. K2SO4 or Na2SO4:NaCl mixtures were added to aliquots of serum from normal subjects to reproduce the observed biologic range of sulfate concentrations up to 10 mmol. Serum Ca2+ concentration was found to decrease linearly as serum sulfate concentration increased, for each subject. The weighted mean slope estimates of the effect of sulfate on ionized calcium in two experiments were -.0197 and -.0181. Rats were infused through the inferior vena cava with 2 mL of either 200 mmol NaCl (N = 5) or 100 mmol Na2SO4 (N = 6), after ligation of the renal arteries and veins and withdrawal of 2 mL blood for baseline studies. The animals were killed by exsanguination from the aorta after a five-minute equilibration period. In rats administered NaCl, no difference in Ca2+ or sulfate concentration was found between pre- and postinfusion sera. In the Na2SO4 treated rats, however, a significant mean increase of 0.635 mmol (p less than .005) in serum sulfate concentration was associated with a significant mean decrease of -0.062 mmol (p less than .01) in serum Ca2+ concentration. We conclude that the acute in vitro and in vivo addition of sulfate results in a decrease in serum Ca2+ concentration. Thus, hypersulfatemia, which is present chronically in patients on sorbent dialysis systems, may contribute to elevated alkaline phosphatase levels in these patients.
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PMID:The effect of sulfate on serum ionized calcium. 684 35


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