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)

To determine the factors associated with low-output left ventricular failure (LVF) in endstage renal disease (ESRD), we performed echocardiography and gated cardiac scan on 217 nondiabetic dialysis and transplant patients. The prevalence of low-output LVF (ejection fraction less than 55% and left ventricular end diastolic diameter greater than or equal to 5.5 cm) in dialysis patients was 18% and in transplant patients 2%. The 26 patients with LVF were compared to 52 controls without LVF, matched by age, sex and year of starting treatment for ESRD, but not for current ESRD therapy. Mean age was 55 +/- (SEM) 14 years; 73% of the patients in both groups were males. Duration of treatment for ESRD was 5.6 +/- 4.3 years in patients, compared to 5.1 +/- 4.1 years in controls. Significant differences between LVF patients and controls included current treatment (73% of cases were on hemodialysis and 8% were transplanted, compared to 48 and 42%; chi 2 = 9.9, p less than 0.01), high serum creatinine, smoking and high serum alkaline phosphatase. There were no differences for current blood pressure, proportion on treatment for hypertension, left ventricular wall thickness, symptomatic ischemic heart disease, proportion with functioning vascular access, degree of weight gain between dialyses, hemoglobin level or high transfusion requirement. Multiple logistic regression demonstrated the most significant and independent variables associated with LVF were high alkaline phosphatase (suggestive of hyperparathyroidism), smoking and high serum creatinine levels (reflecting degree of uremia). Dialysis patients with LVF (n = 23) were compared to dialysis patients who had normal echocardiograms (n = 29).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Low-output left ventricular failure in end-stage renal disease. 330 13

A study of 75 myeloma patients diagnosed at the Kenyatta National Hospital, Nairobi, is presented. The male to female ratio was 1.7:1; the mean age +/- s.d. was 51.5 +/- 12.5 (range 16-80) years; the peak age incidence of 32% occurred in the sixth decade. A combination of: anaemia (81.3%), osteolytic lesions on X-ray skeletal survey (80%), bone pains (66.7%) and an ESR above 50mm/hr (77.3%) formed an important diagnostic tetrad. Other significant findings included: hypoalbuminaemia (76%), elevated leukocyte alkaline phosphatase (61.3%), uraemia (54.7%), upper respiratory tract infections (44%), elevated serum creatinine (34.7%), raised alkaline phosphatase (33.3%), pathological fractures (32%), hyperuricaemia (30.7%) and hypercalcaemia (29.3). The study confirms that the disease is not infrequent in indigenous Kenyan Africans as previous literature seemed to suggest. Poor prognosis was significantly (p less than 0.05) associated with hypoalbuminaemia, raised serum blood urea, hyperuricaemia and an elevated serum creatinine level.
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PMID:Pattern of multiple myeloma in Kenyans. 338 12

The activity and localization of alkaline phosphatase activity (AP) in aorta and heart, and the incidence of calcifications in aorta, heart and kidney as well as cardial fibrosis were studied in uraemic rats treated with 1,25-dihydroxycholecalciferol (1,25-DCHH) and Nifedipine. 1,25-DHCC treatment elevated the serum Ca x P product and aggravated the development of renal and aortic calcifications and cardial fibrosis. Nifedipine did not protect against calcifications, but decreased the incidence of cardial fibrosis. The activity of AP was increased in the thoracic aorta in uraemia independent of 1,25-DHCC or Nifedipine treatment or presence of calcification. No changes of the AP activity were found in the heart.
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PMID:Tissue calcification and alkaline phosphatase activity in uraemic rats. 338 11

45 bone biopsies from patients with chronic uremia were reviewed to define which noninvasive investigations were of value in predicting the histological diagnosis and to quantify the spectrum of uremic bone disease at a center that has consistently used an aluminum-free dialysis bath. 17 biopsies were taken postmortem. 15 patients received conservative treatment, the rest were on maintenance dialysis. 13 patients had symptomatic bone disease. Virtually all patients with a uremia duration greater than 3 years had uremic osteodystrophy. All patients with clinical bone disease, hypercalcemia or raised alkaline phosphatase activity had osteodystrophy, but the specific histology was not indicated. Greatly raised parathyroid levels suggested secondary hyperparathyroidism, but the test was only 100% specific when 20 times normal. Total aluminum consumption was highly indicative of bone aluminum concentration (p less than 0.0001) and aluminum-related osteomalacia (5 cases), suggesting that a considerable proportion of uremic bone disease is iatrogenic. Serum aluminum was of some use in the diagnosis of aluminum-related osteomalacia, but was not wholly reliable. Bone mineral content (BMC) using both forearm measurements and total body bone mineral levels (TBBM) were assessed in 32 patients and were found to be reduced in 12, with a preponderance of secondary hyperparathyroidism. BMC and TBBM were negatively correlated to resorbing surfaces and bone formation rate, suggesting that secondary hyperparathyroidism is the uremic bone disease that represents the greatest threat to bone mass. It is concluded that while noninvasive investigations give considerable information, reliable diagnosis requires the use of histological methods.
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PMID:Noninvasive diagnosis of uremic osteodystrophy: uses and limitations. 363 Nov 50

Parathyroidectomy is now rarely undertaken for hyperparathyroid bone disease in chronic uraemia unless treatment with 1 alpha-hydroxylated vitamin D3 derivatives is unsuccessful. However, no comparisons have been reported of the use of parathyroidectomy with 1 alpha-hydroxylated vitamin D3 derivatives in patients with bone disease of comparative severity. We studied 14 uraemic patients on maintenance haemodialysis treatment before and after treatment with 1 alpha-hydroxyvitamin D3 (alfacalcidol) and compared the findings with those from 12 patients studied before and after parathyroidectomy followed by treatment with vitamin D. The initial severity of the bone disease in the two groups was similar as judged by biochemical, radiographic and histological findings. Both groups demonstrated significant falls in plasma alkaline phosphatase (p less than 0.005) and healing of radiographic erosions after treatment. The histological changes in bone, however, were more marked in patients after parathyroidectomy. Significant reductions were observed in the active osteoblastic surface (p less than 0.005), the total resorption surface (p less than 0.05), the active resorption surface (p less than 0.02) and the index of marrow fibrosis (p less than 0.001), but these indices did not change significantly in the alfacalcidol-treated patients. We concluded that the responses to alfacalcidol in bone are less complete than those obtained with parathyroidectomy despite similar biochemical and radiographic responses.
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PMID:Comparative effects of alfacalcidol and parathyroidectomy with vitamin D in hyperparathyroid renal bone disease. 376 17

The clinical, pathomorphological and serological features of acute canine leptospirosis are evaluated and the IgM- and IgG-specific ELISA for leptospirosis serology in dogs is assessed. The clinical syndrome of acute canine leptospirosis was characterized by depression, anorexia, vomiting and often haemorrhagic diarrhoea. In addition, jaundice, uraemia, elevated creatinine and alkaline phosphatase were observed in the majority of the dogs. In pups invagination of the intestines was a noteworthy finding. The clinical signs and the post-mortem findings were rather non-specific so that the clinical and post-mortem diagnosis had to be confirmed serologically. In acute clinical cases of canine leptospirosis a high anti-leptospiral IgM titre, ranging from 160 in pups to 10240 in adults, was always present, whereas the anti-leptospiral IgG titre and the agglutination titre usually were negative or low. Dogs died from leptospirosis in spite of a high anti-leptospiral IgM titre. Only two dogs having, at the first examination, a high IgM titre in conjunction with a high IgG titre survived an acute infection. The possible role of IgM and IgG in the pathogenesis of an acute leptospiral infection is discussed. Different serological patterns in reference dogs, which were not suffering from acute leptospirosis, are presented.
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PMID:Clinical, pathological and serological features of spontaneous canine leptospirosis. An evaluation of the IgM- and IgG-specific ELISA. 379 34

Serum osteocalcin (BGP), a vitamin K-dependent gamma-carboxyglutamic acid (GLA) containing bone protein, provides an index of bone turnover in patients with a variety of metabolic bone diseases. BGP increases with increasing age in both sexes, but more so in women. BGP rises above normal when the glomerular filtration rate falls below 30 ml/min. Because of its importance in bone disease, its low mol wt, and the effect of uremia, we measured BGP by RIA in serum and dialysate fluid in patients on hemodialysis (HD) or peritoneal dialysis (PD). In 32 HD patients (22 women and 10 men), serum BGP was not different pre- and postdialysis [67.5 +/- 4.4 (+/- SEM) ng/ml vs. 67.7 +/- 5.2), but was significantly elevated compared to the level in normal subjects (7.3 +/- 0.8 ng/ml). The sex difference previously reported in normal subjects was not found in patients with renal failure. The serum BGP level in 8 PD patients was 49.4 +/- 6.9 ng/ml, with a peritoneal fluid concentration of 27.6 +/- 9.3 ng/ml. The hemodialysate fluid concentration of BGP was 1.7 +/- 0.4 ng/ml, which was significantly lower than the serum BGP levels in the HD patients, the PD patients, and peritoneal fluid (P less than 0.01). A significant correlation existed among BGP, alkaline phosphatase, immunoreactive PTH, creatinine, and blood urea nitrogen. We conclude that BGP is markedly elevated in patients with renal failure, not altered in the serum by HD or PD, but very low in HD dialysate fluid. These findings may reflect a combination of impaired clearance and increased skeletal production. The difference in clearance between the peritoneal and hemodialysis fluid is compatible with the mol wt of BGP. In 15 patients who had successful kidney transplantation, serum BGP was normal despite an elevated serum PTH level.
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PMID:Serum and dialysate osteocalcin levels in hemodialysis and peritoneal dialysis patients and after renal transplantation. 388 31

Healthy mixed-bred dogs of both sexes had renal mass surgically reduced and were allowed 2 to 3 months for hypertrophy of the remnant kidney. They were then allotted into 3 groups with equal renal function and were fed 1 of 3 diets that differed in composition. Group 1 dogs (n = 6) were fed moist food that contained 50% protein, 2.34% Ca, and 1.64% P with a P-binding agent (basic aluminum carbonate gel) added. Group 2 dogs (n = 6) were fed a dry diet that contained 24.5% protein, 1.26% Ca, 1.21% P, and the same P-binding agent as used for group 1. Group 3 dogs (n = 7) were fed a moist diet that contained 16.1% protein, 0.38% Ca, and 0.3% P without a P-binding agent. Each group was fed its diet for 92 days and monitored for responses. Mortality associated with uremia occurred in 2 of 6 group 1 dogs, 0 of 6 group 2 dogs, and in 2 of 7 group 3 dogs. Among survivors, clinical signs were seen in the more azotemic dogs of group 1, but not in dogs of groups 2 and 3. The blood urea nitrogen, plasma P concentrations, and PCV values were most favorable in group 3 and least favorable in group 1. Marked differences between groups were not seen in plasma concentrations of protein, albumin, or Ca or in plasma alkaline phosphatase activity. Values for glomerular filtration rate did not change in any group during the experiment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effects of three diets on dogs with induced chronic renal failure. 399 28

1. Injection of sublethal doses of hornet venom to cats was followed by increases in serum aminotransferases and alkaline phosphatase, together with hyperglycemia, uremia and hyperkalemia. 2. The blood pH and PO2 fell significantly. 3. All changes occurred within 30 min of injection and were found to be partially reversible. 4. These results may be due to specific liver cell injury. 5. The possibility of a generalized metabolic effect, such as shock, cannot be discounted, although it is quite unlikely.
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PMID:Hornet (Vespa orientalis) venom sac extract causes hepatic injury in cats. 613 94

Predictive value of plasma levels of bone Gla-protein (BGP) for bone histology was evaluated in 30 chronically dialyzed patients. All patients underwent bone biopsies and serum biochemical parameters, including BGP, parathyroid hormone, and alkaline phosphatase; calcium and phosphate were measured at the time of biopsy. Bone histology showed renal osteodystrophy with low bone turnover and osteomalacia (LT-ROD) in 13 patients, and renal osteodystrophy with high bone turnover and prevailing hyperparathyroid bone disease (HT-ROD) in 17 patients. Values for BGP were above normal in LT-ROD (47.3 +/- 7.9 vs. 6.8 +/- 0.2 ng/ml) and extremely elevated in HT-ROD (831 +/- 170 ng/ml). Similar differences were not found with the other serum biochemical parameters, even though BGP correlated with parathyroid hormone (r = 0.64) and alkaline phosphatase (r = 0.85). There were significant correlations between BGP and cellular and non-cellular parameters of bone formation (r = 0.73 to 0.91). Weaker or no correlations were found between BGP and histologic parameters of bone, reflecting mainly mineralization or resorption. These correlations and the finding of significant differences in plasma BGP between LT-ROD and HT-ROD indicate that plasma levels of BGP reflect bone formation in uremia and predict underlying bone histology.
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PMID:Plasma levels of bone Gla-protein reflect bone formation in patients on chronic maintenance dialysis. 633 5


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