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)

Intestinal-type alkaline phosphatase (IAP) has been localized to the S3 segment of the renal tubule in previous studies, a site believed to be particularly vulnerable to toxic and ischaemic damage. During a 17-month period a pilot study of the value of urinary enzyme measurements (IAP and tissue non-specific alkaline phosphatase--TNAP, using monoclonal antibody-based immunoassays, and N-acetyl-beta-glucosaminidase--NAG, using colorimetric assay) in 50 prospectively followed cases of acute renal failure (ARF) was performed. Urinary enzymes were measured at initial evaluation ('start'), and then each day for 14 days, with the highest enzyme value ('peak') also used for analysis. Patients were divided into prerenal (n = 16), renal (n = 28), postrenal (n = 6) categories according to standard criteria. Of the renal ARF patients 23 of 28 had acute tubular necrosis (ATN), 3 of 28 acute interstitial nephritis (AIN), and 2 of 28 acute glomerulonephritis (AGN); 18 of 50 had a fatal outcome and 1 of 50 was dialysis-dependent at discharge ('poor' prognosis group), while 31 of 50 survived hospital without becoming dialysis-dependent ('good' prognosis group). Median enzyme concentration were increased in 'poor' compared to 'good' prognosis patients: start IAP 3.2 versus 2.2 U/g creat (NS), start NAG 48.6 versus 13.7 (P < 0.01), start TNAP 3.5 versus 0.9 (P < 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)
Nephrol Dial Transplant 1993
PMID:Urinary enzymes in acute renal failure. 839 30

In order to know the pattern of renal osteodystrophy in haemodialysis patients in Saudi Arabia we conducted a multicentre study involving 209 patients. The mean age of the patients was 39.4 +/- 14 (18-70) years, 128 were males and 81 females. All patients were on acetate dialysate and their mean duration on dialysis was 3.5 +/- 1.5 years. The major symptom was bone and joint pain (25.8%). The mean serum calcium was 2.1 +/- 0.26 mmol/l, phosphorus 2.0 +/- 0.36 mmol/l, alkaline phosphatase 19.7 +/- 14.6 u/l and parathyroid hormone level was 8.9 +/- 3.9 mg/ml. The mean serum aluminium (AL) level was 25.4 +/- 17.7 micrograms/l, while that of 1,25 vitamin D3 was 8.1 +/- 4.2 ng/l and of fluoride was 92.2 +/- 31.4 micrograms/l. The major radiological finding was osteosclerosis (70%). Dual-photon absorptiometry (DPA) showed low bone mineral density (LBM) in 65% of the patients. Forty-one patients had bone biopsies with AL staining of the biopsies. Of this group, 92% had changes of hyperparathyroidism and 66% of them were pure hyperparathyroidism. Sixty percent of them had variable degrees of AL intoxication. The radiological skeletal survey of those patients could detect abnormalities in only 46% while 70% of them had abnormal bone mineral density (BMD). In conclusion, osteosclerosis is the commonest radiological finding in our dialysis patients while secondary hyperparathyroidism is the main histopathological diagnosis in bone biopsy, even in patients with normal skeletal survey. AL intoxication is a significant problem in our population. DPA is more sensitive in detecting bone abnormalities than X-radiography.
Nephrol Dial Transplant 1993
PMID:Pattern of renal osteodystrophy in haemodialysis patients in Saudi Arabia. 839 43

A lower-calcium dialysate has been advocated for continuous ambulatory peritoneal dialysis (CAPD) patients for the purpose of increasing oral calcium intake as a phosphate binder and decreasing the need for aluminum-containing phosphate binders and, hence, decreasing the risk of aluminum intoxication. Twelve CAPD patients were evaluated retrospectively after switching from a dialysate containing 3.5 mEq/L of calcium to a new dialysate containing 2.5 mEq/L of calcium. Patients were on the new dialysate for at least 1 year. Serum calcium, phosphate, alkaline phosphatase, aluminum, and intact or N-terminal parathyroid hormone (I-PTH, N-PTH) were measured. Calcium, phosphate, and aluminum did not change significantly. Alkaline phosphatase doubled, but was not statistically significant. I-PTH and N-PTH rose from 2.9 +/- 2.24 to 7.4 +/- 7.4 times normal (p < 0.012). Three of 7 patients who had x-ray evaluations before, during, and 1 year after change of dialysate had radiographic progression of bone disease. Three patients required a parathyroidectomy due to the development of severe secondary hyperparathyroidism. In conclusion, the indiscriminate use of dialysate containing 2.5 mEq/L of calcium, in CAPD patients, may place the patients at higher risk for progression of hyperparathyroidism.
Perit Dial Int 1993
PMID:Does low-calcium dialysate accelerate secondary hyperparathyroidism in continuous ambulatory peritoneal dialysis patients? 839 43

Procollagen-I carboxylterminal extension peptide (PICP) was determined in the serum and dialysate of 26 continuous ambulatory peritoneal dialysis (CAPD) patients and in the serum of 11 healthy controls. PICP serum levels were significantly higher in CAPD patients than in healthy controls (p < 0.001). There was no correlation between serum PICP levels and those of calcium, phosphorus, magnesium, alkaline phosphatase, osteocalcin, and intact parathyroid hormone (iPTH). Serum and dialysate levels of osteocalcin and iPTH showed a significant correlation (p < 0.001). The dialysate-to-serum PICP ratio in 21 patients was lower than 1.0. In the remaining 5 patients, however, the above ratio was higher than 1.0. We conclude that in CAPD patients serum PICP levels do not correlate with biochemical parameters of renal osteodystrophy. A dialysate-to-serum PICP ratio above 1.0 could implicate an increased local peritoneal fibroblastic activity and could be a useful marker of peritoneal fibrosis in CAPD.
Perit Dial Int 1993
PMID:Procollagen type-I in the serum and dialysate of continuous ambulatory peritoneal dialysis patients. 839 46

We monitored thyroid function in 75 peritoneal dialysis patients (55 +/- 15 years). A total of 20 (27%) were hypothyroid; 9 were diagnosed about the time of initiation of dialysis, and 11 prior to onset of renal failure. Thyroid function surveillance found an increase in serum thyrotropin (TSH) concentration to hypothyroid values in only one patient. On replacement therapy serum thyroxine was similar in euthyroid and hypothyroid patients (6.94 +/- 1.69 vs 6.52 +/- 1.65 micrograms/dL, respectively; p = 0.380), but TSH was higher in hypothyroid patients (5.61 +/- 5.67 vs 2.59 +/- 1.49 microU/mL, respectively; p = 0.001). Serum creatinine (8.6 +/- 3.1 vs 11.4 +/- 5.1 mg/dL, respectively; p = 0.049) and albumin concentrations (3.76 +/- 0.47 vs 3.33 +/- 0.71 g/dL, respectively; p = 0.006) were lower in hypothyroid than euthyroid patients. Hyperthyroid patients had higher serum triglyceride concentrations than euthyroid patients (306 +/- 176 vs 189 +/- 122 mg/dL, respectively; p = 0.013). Parathyroid hormone (PTH) was lower in hypothyroid than normothyroid patients (108 +/- 80 vs 261 +/- 265 pg/mL, respectively; p = 0.032). No differences were observed in serum calcium, phosphorus, and alkaline phosphatase. We conclude that hypothyroidism is common in peritoneal dialysis patients, usually antedates dialysis therapy, results in lower serum albumin and creatinine concentrations and higher serum triglyceride concentrations, is associated with lower serum PTH concentrations, and that thyroid function surveillance is not necessary in the absence of symptoms suggestive of hypothyroidism.
Adv Perit Dial 1995
PMID:Thyroid function surveillance in CAPD patients. 853 10

We studied 26 non-dialysed patients with chronic renal failure [creatinine clearance (CCr) 32.6 +/- 12.7 ml/min]. They were divided into three groups according to their CCr and serum intact parathyroid hormone (PTH) and were given 0.5 micrograms/day oral calcitriol (calcitriol group, n = 8), 3 g/day calcium carbonate (CaCO3 group, n = 10), or neither (control uraemic group, n = 8). Serum intact PTH decreased from 154 +/- 75 to 90 +/- 43 pg/ml in the calcitriol group (P < 0.01) and from 162 +/- 97 to 77 +/- 62 pg/ml in the CaCO3 group (P < 0.001). Calcium carbonate was also effective in suppressing serum tartrate-resistant acid phosphatase, alkaline phosphatase and intact osteocalcin levels, while calcitriol did not suppress serum osteocalcin. Secretion of interleukin-1 beta (IL-1 beta) and tumour necrosis factor-alpha (TNF-alpha) by phytohaemagglutinin A (PHA)-activated peripheral blood mononuclear cells (PBMC) was greater in uraemic patients than in age-matched healthy controls (n = 8). Calcitriol was effective in suppressing secretion of both cytokines, while calcium carbonate was capable of suppressing only TNF-alpha secretion. CCr decreased from 37.4 +/- 15.4 to 33.0 +/- 11.8 ml/min (P < 0.05) in the CaCO3 group, while it did not decrease in either the calcitriol group or the control uraemic group during a 6 month period. These results suggest that supplementation with calcitriol is necessary to maintain bone formation and normalize IL-1 beta and TNF-alpha secretion by activated PBMC in uraemic patients.
Nephrol Dial Transplant 1996
PMID:Comparison of effects of calcitriol and calcium carbonate on secretion of interleukin-1 beta and tumour necrosis factor-alpha by uraemic peripheral blood mononuclear cells. 884 Mar 6

Serum total alkaline phosphatase is the most commonly used biochemical marker of bone disease in renal patients, but alkaline phosphatase originates from different organs and sometimes lacks specificity. Bone isoenzyme measurement is considered superior to total alkaline phosphatase for the assessment of bone metabolism. We have studied the value of bone isoenzyme, determined by a new. IRMA (Tandem-R-Ostase), in haemodialysis patients with secondary hyperparathyroidism and renal osteodystrophy. Fifty-six haemodialysis patients were studied. Intact parathyroid hormone (PTH), osteocalcin, total alkaline phosphatase and bone alkaline phosphatase were determined. A transiliac bone biopsy was performed in 20 of the 56 patients after double tetracycline labelling. There was a significant correlation between bone alkaline phosphatase and PTH (r = 0.79, P < 0.001) and between bone and total alkaline phosphatase (r = 0.84, P < 0.001) in all patients. The patients who underwent a bone biopsy showed osteitis fibrosa in 17, mixed lesion in one, adynamic bone disease in one and normal bone in one. Bone alkaline phosphatase showed a significant correlation with static and dynamic histomorphometric indices similar to that obtained with PTH and better than those of total alkaline phosphatase and osteocalcin. It is concluded that bone alkaline phosphatase (ostase) seems to be a useful non-invasive marker of bone metabolism in patients on haemodialysis with high turnover bone disease. More studies are necessary to know its value in low turnover bone disease.
Nephrol Dial Transplant 1996
PMID:Bone alkaline phosphatase isoenzyme in renal osteodystrophy. 884 Mar 11

Intermittent high dose administration of calcitriol or alfacalcidol is effective in suppressing secondary hyperparathyroidism in chronic dialysis patients, however calcaemic action of these vitamin D derivatives is a major obstacle. 22-Oxacalcitriol (OCT) has been reported to have less calcaemic action than calcitriol, while preserving a comparable suppressive effect on parathyroid hormone (PTH) secretion. This preliminary study was conducted to examine the effects of OCT on secondary hyperparathyroidism in chronic dialysis patients. OCT was administrated intravenously immediately after every haemodialysis session three times a week for 12 weeks to three haemodialysis patients with secondary hyperparathyroidism. An initial dose of OCT of 5.5 micrograms/haemodialysis session was increased stepwise by 5.5 micrograms/haemodialysis up to 22 micrograms/haemodialysis according to the suppression of PTH and calcaemic action. OCT was discontinued for at least a week when serum calcium adjusted to albumin concentration measured just before haemodialysis exceeded 11.5 mg/dl. Marked reduction in plasma PTH, alkaline phosphatase and tartrate-resistant acid phosphatase was observed in all three patients. Although the dose of OCT was increased to 22 micrograms/haemodialysis in one patient, the final dose of OCT remained 5.5 micrograms/haemodialysis in the other two patients because of hypercalcaemia. It is concluded that OCT is highly effective in suppressing PTH in dialysis patients with secondary hyperparathyroidism. Hypercalcaemia may be a major factor which limits the use of OCT, though it may occur with higher doses of OCT than those of calcitriol usually given to suppress PTH hypersecretion.
Nephrol Dial Transplant 1996
PMID:Effect of 22-oxacalcitriol on hyperparathyroidism of dialysis patients: results of a preliminary study. 884 Mar 26

A sigmoidal relationship, fitting a four-parameter model, has been demonstrated in in vivo and in vitro studies to link the parathyroid hormone (PTH) secretion rate and calcium concentration changes. In uraemic patients different patterns of calcium-mediated PTH secretion were reported in different types of renal bone diseases and a shift to the right and a steeper slope has been observed in secondary hyperparathyroidism. To gain more information that could predict indexes for successful medical therapy we investigated the calcium-PTH sigmoidal relationship in 42 hyperparathyroid patients with different degrees of secondary hyperparathyroidism; we classified as moderate those patients presenting basal PTH (PTHbas) < 600 pg/ml and bone alkaline phosphatase (AP) < 500 U/l, and severe those with a PTHbas > or = 600 pg/ml and bone AP > or = 500 U/l. Changes in ionized calcium (iCa) were induced by calcium-free dialysis on the first day, to induce hypocalcaemia up to serum iCa 3.5 mEq/l, and calcium 8 mEq/l dialysis on the third day, to induce hypercalcaemia. The moderate hyperparathyroidism patients had PTHmax, PTHmin and slope, calculated in absolute values and relative values, lower than severe hyperparathyroidism patients but they did not differ in the minimal to maximal PTH ratio. In the moderate group the PTHbas correlated with all the curve parameters except PTHmin, calculated both in absolute and percentage values, while in the severe group PTHmin was the only parameter correlating to the PTHbas. In conclusion, by performing the dynamic test, we found that some glands were not suppressible among moderate hyperparathyroidism patients.
Nephrol Dial Transplant 1996
PMID:The PTH-calcium relationship curve in secondary hyperparathyroidism, an index of sensitivity and suppressibility of parathyroid glands. 884 Mar 29

In this study bone mineralization was evaluated using dual energy x-ray absorptiometry (DEXA), which measured regional bone mineral density [BMD (g/cm2)] at two skeletal sites, the lumbar spine and the femur, in 33 patients (15 male, 18 female) undergoing continuous ambulatory peritoneal dialysis (CAPD) with no history of chronic disease or medications affecting bone. The biochemical profile included measurements of plasma levels of calcium, phosphorus, alkaline phosphatase, and intact parathyroid hormone (iPTH). We did not find any statistically significant difference or correlation between BMD and the examined parameters, except for the lower BMD values in the female population. Because of the reported findings of significantly lower PTH levels in CAPD patients with low turnover bone disease (adynamic bone disease) and the higher prevalence in CAPD than in hemodialysis patients, we tried to evaluate any correlation between BMD and iPTH levels in CAPD patients that were separated into two groups: group A (iPTH < 200 pg/mL), 13 patients, and group B (iPTH > 200 pg/mL), 20 patients. Data analysis revealed a negative correlation between PTH levels and BMD values (r = -0.66, p = 0.014) as PTH and serum calcium (r = -0.77, p = 0.002) only in group A. No other statistically significant changes were observed. These findings suggest that there is a favorable influence of CAPD modality on bone mineralization, while no special DEXA findings are representative of the possible appearance of adynamic bone disease.
Adv Perit Dial 1996
PMID:Evaluation of bone mineral density in CAPD patients with dual energy X-ray absorptiometry. 886 13


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