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.
Nephron 1984
PMID:Relationship between vitamin A and bone disease in chronic renal failure. 653 95

During a period of 2 years, bone mineral content (BMC) was measured regularly in patients undergoing regular dialysis treatment (RDT). Low BMC values were found to be correlated to long duration of uremia, raised alkaline phosphatase activity, hyperaluminemia, hypermagnesemia, hypophosphatemia and clinical osteodystrophy. High levels of BMC loss were found among patients with relatively high initial BMC levels and severely calciopenic patients actually gained bone density during the investigation. Serum alkaline phosphatase activity and serum immunoreactive parathyroid hormone (PTH) levels were positively related to bone loss. It is suggested that the low BMC among RDT patients is caused by a predialytic loss that is arrested by entrance into a dialysis programme. Investigations using BMC or total body calcium as a measure of therapeutic effect must take account of this. The role of hypermagnesemia and hyperaluminemia remains undefined. Patients with BMC reduced below ca. 80% of normal may be candidates for treatment with active vitamin D metabolites.
Nephron 1983
PMID:Use of bone mineral content determination in the evaluation of osteodystrophy among hemodialysis patients. 662 54

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)
Nephron 1983
PMID:Influence of aluminium on the effect of 1 alpha (OH)D3 on renal osteodystrophy. 663 56

Parathyroidectomy was carried out in 26 patients over a 14-year period. Excellent results were obtained in patients with severe hyperparathyroidism. Vascular calcification, hypercalcaemia and pruritus did not justify surgery unless associated with unequivocal hyperparathyroidism. 13 patients required intravenous calcium infusion for up to 2 weeks to control post-operative hypocalcaemia. Calcium requirements could be predicted from the pre-operative plasma alkaline phosphatase level. Following operation continued treatment with vitamin D was necessary to prevent hypocalcaemia. Hyperparathyroidism recurred in 1 patient after 8 years and 4 patients developed osteomalacia. Since parathyroid hormone may have toxic effects other than those on bone, maintenance of normal levels should be a long-term objective in the treatment of patients with chronic renal failure. Where large parathyroid glands are present, surgical reduction in gland mass is a logical prelude to long-term suppression of parathyroid hormone with vitamin D and phosphate-binding agents.
Nephron 1983
PMID:Parathyroidectomy in chronic renal failure. 668 30

A 1-year controlled trial was performed to confirm the effects of 1 alpha-hydroxycholecalciferol (1 alpha-OH-D3) in chronic hemodialysis patients. Initially, a daily dose of 2 micrograms of 1 alpha-OH-D3 was given orally to 24 patients and its placebo to another 24 patients during the first 3 months. For the following 9 months the dose of 1 alpha-OH-D3 or its placebo was reduced to 1 microgram per day in the individual groups. Serum calcium was significantly increased to the normal level after 1 month of treatment and sustained at this level for 1 year. Serum parathyroid hormone was significantly decreased at 3 months. Serum alkaline phosphatase was decreased to the normal level at the 5th month and thereafter. At 2 months serum phosphorus was significantly increased in the 1 alpha-OH-D3 group. None of the patients on 1 alpha-OH-D3 showed increased subperiosteal resorption on X-rays, whereas 8 out of 20 patients on placebo did (p less than 0.002). No adverse effects were seen apart from 3 patients with the 'red eye' of scleral calcification.
Nephron 1981
PMID:1-year controlled trial of 1 alpha-hydroxycholecalciferol in patients on maintenance hemodialysis. 702 62

In 27 patients with end-stage chronic renal failure an elevated calcitonin (CT) and parathyroid hormone was found. On stimulation with Ca i.v. there were 9 cases in whom delta CT proved to be higher than the maximal response of 50 pg ml-1 in controls. Supranormal CT responses were found predominantly in patients with normal alkaline phosphatase, who as a group increased their CT from 94.5 +/- 61 to 142.0 +/- 94 pg ml-1 (p less than 0.02). In contrast to this, patients with elevated alkaline phosphatase who also had a higher level of parathyroid hormone maintained unchanged CT on Ca stimulation. It is concluded that in chronic renal failure with severe secondary hyperparathyroidism, delta CT on stimulation is normal, while an enhanced delta CT often exists when hyperparathyroidism is of insufficient degree to cause a raised alkaline phosphatase.
Nephron 1982
PMID:Enhanced calcitonin release in chronic renal failure depending on the absence of severe secondary hyperparathyroidism. 712 54

Renal osteodystrophy in part due to secondary hyperparathyroidism, is one of the major unresolved problems affecting patients on chronic hemodialysis. In addition, evidence has shown that parathyroid hormone (PTH) is toxic to other organ systems besides bone. The results of a prospective study on the effect of propranolol in reducing PTH levels in chronic renal failure patients on hemodialysis are reported. Propranolol administration reduced PTH levels by over 50-75%. The levels of calcium, phosphorus, alkaline phosphatase and hematocrit were variable, but patients with severe derangements in these measurements also seemed to benefit from propranolol. It should now be determined by larger and longer studies whether these biochemical improvements can be translated into clinical benefits.
Nephron 1981
PMID:Suppression of secondary hyperparathyroidism by propranolol in renal failure patients. 721 43

Phosphorus (Pi) retention linked to chronic renal failure (CRF) favors secondary hyperparathyroidism (HPT). Reduction of Pi and protein intake has been shown to prevent the development of HPT in CRF. The aim of the present study was to assess in patients with advanced CRF the long-term effects on phosphate and calcium metabolism of a low-Pi (5-7 mg/kg/day), low-protein (0.4 g/kg/day) diet providing 300 mg/day calcium (Ca) and supplemented with amino acids and ketoacids, Ca carbonate (400-800 mg/day) and vitamin D2 (1,000 IU/day). Twenty-nine patients with advanced CRF (glomerular filtration rate (GFR) 13.7 +/- 4.5 ml/min) were selected for the study, on the basis of a follow-up of a least 2 years and a satisfactory compliance to the prescribed diet. At the start of the study, biological evidence of HPT was present with increased plasma PTH concentration (144 +/- 95 pg/ml), increased plasma Pi (1.57 +/- 0.33 mmol/l), an increase in alkaline phosphatase activity and plasma osteocalcin concentration. Plasma PTH concentration was positively correlated with plasma Pi and inversely with plasma Ca concentrations and GFR. Pi and protein restriction induced a significant correction of HPT within 3 months after starting the diet. After 2 years of diet, despite the diminution of GFR (11.1 +/- 3.7 ml/min, p < 0.0001), plasma PTH was still lower than at the start of the diet (88 +/- 57 pg/ml, p < 0.01), as was plasma Pi (1.32 +/- 0.24 mmol/l, p < 0.001), total plasma Ca being higher (p < 0.01). Plasma PTH levels were correlated only to plasma Ca concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)
Nephron 1995
PMID:Long-term control of hyperparathyroidism in advanced renal failure by low-phosphorus low-protein diet supplemented with calcium (without changes in plasma calcitriol). 747 15

The effects of recombinant human erythropoietin (rHuEPO) treatment on parathyroid function in patients on maintenance hemodialysis (HD) with secondary hyperparathyroidism (HPT) is poorly understood. We compared the levels of serum intact parathyroid hormone (PTH) and the suppressibility of PTH by intravenous calcium infusion before and after 12 weeks of rHuEPO treatment in 8 HD patients with secondary HPT. The suppressibility of PTH by calcium infusion in HD patients was also compared with that of normal subjects. After rHuEPO treatment, in HD patients hematocrit and hemoglobin levels increased significantly from 20.1 +/- 1.3% and 6.65 +/- 0.46 g/dl to 28.7 +/- 1.0% and 9.68 +/- 0.39 g/dl, respectively. The serum intact PTH levels did not change significantly (541.9 +/- 65.3 pg/ml before versus 572.9 +/- 75.3 pg/ml after rHuEPO treatment), nor did serum ionized calcium, phosphate, magnesium, aluminum, alkaline phosphatase, and 1.25(OH)2D levels. Calcium infusion significantly increased serum ionized calcium and suppressed serum PTH levels. However, the increment in serum calcium levels and the percent decrement of serum PTH showed no significant differences before and after rHuEPO treatment in HD patients. Elevations in serum calcium levels during calcium infusions were not significantly different between normal subjects and HD patients. However, the percent maximal decrement in serum PTH level was less in HD patients both before and after rHuEPO treatment than in normal subjects (-75.4 +/- 3.9 and -76.4 +/- 4.1% versus -91.4 +/- 1.4%). We conclude that rHuEPO treatment has no influence on parathyroid function in maintenance HD patients with secondary HPT. In addition, PTH secretion is less suppressed by calcium infusion in the same group of patients.
Nephron 1995
PMID:Lack of influence of recombinant human erythropoietin on parathyroid function in hemodialysis patients with secondary hyperparathyroidism. 756 8

Male albino mice had one daily intraperitoneal injection of 4.25 g/100 ml glucose concentration fluid for peritoneal dialysis at pH 5.0-5.2, for a period of 30 days. At the end of the experimental periods, mesothelial cell imprints were taken from the peritoneal layer of the anterior liver surface. Histochemical staining of imprints obtained from mice exposed to the peritoneal dialysis fluid showed a consistently increased activity of: (a) enzymes associated with the cell membrane: Na-K-ATP-ase, alkaline phosphatase and 5-nucleotidase; (b) cytoplasmic enzymes: acid phosphatase and cytochrome oxidase, and (c) a modestly increased activity of glucose-6-phosphatase. These changes, which are not far from those observed in activated mesothelial cells, suggest that exposure of mesothelial cells to high glucose concentrations of PD fluid is associated with increased production and disposal of energy to be used for maintaining the constancy of the cellular environment and, probably, for fuelling the transcellular transport of solutes of large molecular size.
Nephron 1995
PMID:The cytochemical profile of visceral mesothelium under the influence of lactated-hyperosmolar peritoneal dialysis solutions. 777 14


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