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)

29 patients receiving haemodialysis treatment for chronic renal failure were divided into two groups on the basis of the presence or absence of bone disease as defined by radiology and bone alkaline phosphatase. The group of patient with bone disease showed a significantly greater increase in protein-bound calcium during dialysis compared with the control group. There were no significant differences in the changes in total calcium, albumin or hydrogen ion concentration during dialysis between each group. The data suggest that there is a relationship between the increase in protein-bound calcium during dialysis and the incidence of bone disease.
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PMID:Changes in protein-bound calcium during haemodialysis in relation to bone disease. 3 10

Plasma concentrations of calcium, phosphate, alkaline phosphatase (A.P.), immunoreactive calcitonin (iC.T.), and immunoreactive parathyroid hormone (iP.T.H.) were measured in fifty-two patients with chronic renal failure on maintenance haemodialysis. On the basis of a bimodal distribution of values for plasma-A.P. the patients were dividied into 2 groups. In those patients with normal A.P. concentratons as well as in twenty-eight normal subjects there was a positive correlation between iP.T.H. and iC.T. which was independent of plasma calcium or phosphate. Patients with increased plasma-A.P. had higher concentrations of iP.T.H., lower concentrations of iC.T., and showed a negative relation between the concentrations of the two hormones. It is suggested that a possible factor in the pathogenesis of renal bone disease is a failure to secrete C.T. in adequate amounts.
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PMID:Evidence that endogenous calcitonin protects against renal bone disease. 6 2

An oral dose of 0.5 microgram of 1,25-dihydroxycholecalciferol (1,25-[OH]2D3) and 4 g of calcium carbonate was given daily to two dialysed patients and three undialysed patients in chronic renal failure with renal osteodystrophy. Treatment was given for 4-16 months. Intestinal calcium absorption became normal in all five patients. Plasma alkaline phosphatase, hydroxyproline, and immunoreactive parathyroid hormone were considerably reduced in all of the patients and in four of them these values were restored to normal. Bone histology was improved in all patients after treatment with 1,25-(OH)2D3. As well as a dramatic improvement in bone mineralisation, there was remodeling of trabecular architecture and a decrease in fibrosis in patients with initial parathyroid overactivity.
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PMID:Long-term effects of small doses of 1,25-dihydroxycholecalciferol in renal osteodystrophy. 7 68

In six infants aged between 4 and 8 months with chronic renal failure, we have studied blood levels of calcium (Ca), phosphorus (P), alkaline phosphatase, immunoreactive parathyroid hormone (PTH), and calcitonin (CT), as well as urinary excretion of Ca, P, hydroxyproline and cyclic AMP under basal conditions and during an infusion of 20 mg/kg of 10% Ca gluconate in normal saline over 4 h. Under basal conditions four infants had normal serum Ca and P values, alkaline phosphatase levels at the upper limit of normal, and very high PTH (range: 1450--2550 pg Eq/ml) and CT (range: 700--1900 pg/ml) levels. The urinary Ca excretion was low, whereas the urinary excretion of P, hydroxyproline and cyclic AMP was high. During Ca infusion, the total serum Ca and CT levels increased, PTH fell without however reaching the normal upper limit, and urinary P and cyclic AMP excretion decreased. In two infants with osteodystrophy and the highest levels of PTH (2900 and 3500 pg Eq/ml respectively) there was no suppression of PTH during Ca infusion.
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PMID:Parathyroid hormone and calcitonin secretion in uraemic infants. 21 73

By means of a photon densitometer utilizing a 125I-source, bone mineral content was measured in 15 chronic renal failure patients on conservative management, 46 patients on maintenance hemodialysis and 20 patients after renal transplantation. The determinations were made at 4 sites in both radius and tibia. In patients with chronic renal failure on conservative treatment the bone mineral content did not differ significantly from that in normals. Patients on hemodialysis showed a low bone mineral content in 61 percent of females and 53 percent of males. Especially low values were obtained from 5 females who had undergone bilateral nephrectomy. After renal transplantation all female patients showed low values, whereas 50 percent of male patients showed decreased values. No correlations were found between bone mineral content and serum parameters (calcium, phosphate, alkaline phosphatase, creatinine), duration of renal failure, hemodialysis treatment or steroid medication.
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PMID:[Mineral content of the skeleton in chronic kidney insufficiency treated with dialysis and after kidney transplantation. Results of isotope densitometry]. 33 6

During the hemodialysis treatment of 543 uremic patients for 10 years, significant complications concerning metabolic calcium disturbances, subperiosteal resorption, calcification of soft tissue or peripheral vessels, and fractures were noted. Significant elevation of alkaline phosphatase was induced for 5 years under hemodialysis using 5.0--6.0 mg/dl dialysate calcium, but not under 7.5 mg/dl dialysate calcium. Plasma immunoreactive parathyroid hormone (iPTH) values were abnormally high with a few exceptions, without relationship to serum calcium levels. Among the patients with chronic renal failure on dietary control, osteomalacic changes were predominant, but their iPTH values were not always elevated. When the patients were treated for a long time with hemodialysis, the mixed type of osteomalacia and osteites fibrosa appeared. Administration of dihydrotachysterol and 1 alpha-hydroxycholecalciferol to the patients on hemodialysis changed the mixed type of osteomalacia and osteitis fibrosa to the osteomalacic type with the marked reduction of osteoid seam thickness.
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PMID:Azotemic renal osteodystrophy; clinical features and bone pathology. 46 54

Five radiologists graded 49 series of bone X-rays of 20 patients with chronic renal failure treated by hemodialysis. There was a high incidence of osteodystrophy which progressed identifiably over intervals exceeding 12 months. The severity grade of osteodystrophy was poorly reproducible among patients, among radiologists, and even between interpretations by the same radiologist after an interval of 10 months. Although the severity of osteodystrophy correlated with serum alkaline phosphatase values, the latter was not an accurate predictor of the severity of the bone lesions. Radiographic reassessment at intervals of one year or less in the asymptomatic patient has less reproducibility than the anticipated changes. More sensitive and reliable techniques are recommended.
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PMID:Inconsistency in radiographic evaluation of progressive renal osteodystrophy. 47 48

The effects of phosphate restriction and of 1 alpha OH D3 administration were investigated in patients with advanced chronic renal failure. Few modifications of the various biochemical parameters in the patients were achieved with the restriction of dietary phosphate while better results were obtained with 1 alpha OH D3 administration. In dialyzed patients the treatment with this drug resulted in a normalization in serum calcium and alkaline phosphatase levels and in a remarkable significant decline in plasma parathyroid hormone and a reduction in the bone disease associated with uremia. This treatment in dialyzed uremic patients could avoid the employment of higher dialysate calcium concentration potentially dangerous for postdialysis hypercalcemia with the risk of metastatic calcifications.
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PMID:Effects of 1-alpha OH D3 therapy in uremic patients in conservative or dialytic treatment. 47 81

(1) The bone histology of 233 non-dialysed and 276 haemodialysed patients with chronic renal failure is reviewed. In non-dialysed patients osteitis fibrosa occurred in 83.7% and osteomalacia in 23.6% of patients. Osteomalacia was not found in the absence of osteitis fibrosa. In haemodialysed patients there was a more variable bone histology, sometimes resembling non-dialysed bone disease, but in general with a greater incidence of osteomalacia, especially with increasing time on dialysis. In some patients there was a predominance of osteomalacia accompanied by no or only mild osteitis fibrosa and the serum alkaline phosphatase was normal. (2) The results of treating twenty-six haemodialysed patients with 1alpha-hydroxyvitamin D3 (1alpha-OHD3) are described. Patients with osteomalacia and minimal or no osteitis fibrosa and a normal serum alkaline phosphatase (Group I) in general failed to respond and it is suggested that 1,25-dihydroxyvitamin D3 deficiency is not the sole factor responsible for the osteomalacia in these patients. In contrast, 1alpha-OHD3 therapy was effective in improving osteitis fibrosa and osteomalacia in some patients with moderate to severe degrees of osteitis fibrosa and osteomalacia (Group IIa) and in improving osteitis fibrosa where this occurred alone (Group IIb).
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PMID:Histopathology of renal osteodystrophy with particular reference to the effects of 1alpha-hydroxyvitamin D3 in patients treated by long-term haemodialysis. 60 22

Thirty-five patients with bone disease and chronic renal failure (twenty-four on maintenance haemodialysis) were treated for 7--39 months with 1alpha-hydroxyvitamin D3, 2--2.5 microgram daily by mouth. Symptoms (bone pain and muscle weakness) and radiographic appearances improved and plasma alkaline phosphatase returned to normal in the majority of patients (87, 76 and 75% respectively). In contrast, histological appearances in bone improved in only 46% twenty-three patients from whom paired biopsies were available, and this change was not greatly different from that seen in a comparable group of untreated patients. Significant correlations were noted in individual patients between the changes in symptoms, X-rays, plasma alkaline phosphatase and immunoreactive parathyroid hormone and these, in turn, were related to histological changes in bone, although these latter changes were often small. It is concluded that 1alpha-hydroxyvitamin D3 is a useful new drug in the treatment of renal bone disease, but that the evaluation of the response depends critically on the method of assessment used.
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PMID:Correlation of clinical, biochemical and skeletal responses to 1alpha-hydroxyvitamin D3 in renal bone disease. 60 24


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