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)

Twenty-three patients with bone disease and chronic renal failure were treated for periods of 4--28 months with 1alpha-hydroxyvitamin D3 (1alpha-OHD3). Improvements in bone histology were consistently seen in patients with features both of osteitis fibrosa and osteomalacia but were not invariably observed in patients with osteitis fibrosa or osteomalacia alone (37 and 50% improved respectively). Several factors influencing the outcome of treatment were assessed on the basis of histological responses in bone. A low level of plasma calcium before treatment, rather than the dose of 1alpha-OHD3 tolerated, was the major detectable factor which favourably affected the histological outcome. Other factors examined, including initial plasma concentrations of phosphate, immunoreactive parathyroid hormone and alkaline phosphatase, and treatment with haemodialysis or dietary supplements of calcium did not apparently influence the response.
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PMID:Factors influencing the response to 1alpha-hydroxyvitamin D3 in patients with renal bone disease. 60 25

Biochemical tests (serum calcium, inorganic phosphate and alkaline phosphatase), as well as clinical, radiological, scanning and histological investigations were undertaken in 24 patients in chronic renal failure. The frequency with which the diagnosis of renal osteopathy could be made depended in the method of investigation, the biochemical findings proving to be completely unreliable. There were positive radiological signs in ten patients and clinical signs in 12, predominantly in the progressive stages of osteopathy. A positive scan was obtained in 23 patients, typical histological bone changes in an equal number. Since it correlates so well with the histological findings, bone scan is suitable particularly in the early diagnosis of osteopathy. Since this test is easily performed and hardly stresses the patient, it should routinely be the initial one for the diagnosis of renal osteopathy.
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PMID:[Bone scan in the diagnosis of renal osteopathy (author's transl)]. 63 Oct 29

Six patients with chronic renal failure on regular dialysis treatment were given low doses (0.5--1.0 microgram/day) of 1alpha-hydroxyvitamin D3, monitoring the serum calcium, inorganic phosphate, immunoreactive parathyroid hormone concentration (IPTH) and alkaline phosphatase activity. The serum calcium rose in all patients after 7 days' treatment, in some subjects to hypercalcemic range; this effect persisted 6--14 days after withdrawal of 1alpha-hydroxyvitamin D3. The elevated serum IPTH rose in the first days of treatment, but later decreased to normal values. It is suggested that active vitamin D metabolites are necessary for normal response of parathyroid glands to variation in serum calcium. Low-dose 1alpha-hydroxyvitamin D3 treatment appears to be a promising method of correcting hypocalcemia and secondary hyperparathyroidism in chronic renal failure. Careful control of serum calcium is necessary, as hypercalcemia may occur even after minute doses of 1alpha-hydroxyvitamin D3.
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PMID:Effects of 1alpha-hydroxyvitamin D3 on serum calcium and immunoreactive parathyroid hormone in patients with chronic renal insufficiency. 70 Sep 46

Biochemical tests (serum calcium, inorganic phosphate and alkaline phosphatase), as well as clinical, radiological, scanning and histological investigations were undertaken in 24 patients in chronic renal failure. The frequency with which the diagnosis of renal osteopathy could be made depended in the method of investigation, the biochemical findings proving to be completely unreliable. There were positive radiological signs in ten patients and clinical signs in 12, predominantly in the progressive stages of osteopathy. A positive scan was obtained in 23 patients, typical histological bone changes in an equal number. Since it correlates so well with the histological findings, bone scan is suitable particularly in the early diagnosis of osteopathy. Since this test is easily performed and hardly stresses the patient, it should routinely be the initial one for the diagnosis of renal osteopathy.
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PMID:[Bone scans in the diagnosis of renal osteopathy]. 74 Feb 85

Successful treatment of osteitis fibrosa with 1alpha-hydroxycholecalciferol (1alpha-OHD3) in 9 patients with end-stage chronic renal failure was associated with a significant increase in plasma levels of immunoreactive calcitonin (iCT) independently of changes in plasma calcium, and a decrease in levels of parathyroid hormone (iPTH). In 9 further patients whose plasma alkaline phosphatase activity failed to suppress with 1alpha-OHD3, changes in iPTH were associated with proportionate changes in iCT. This suggests that a rise in endogenous calcitonin (CT) secretion contributes to the success of treatment with 1alpha-OHD3. In 13 further patients, injections of salmon CT induced a fall in plasma calcium and phosphate which was proportional to the prevailing level of plasma alkaline phosphatase. These data provide further evidence that bone resorption can be effectively inhibited when CT levels are raised either by exogenous CT or its endogenous stimulation.
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PMID:Biological activity of endogenous and exogenous calcitonin in patients with osteitis fibrosa and chronic renal failure. 74 Jun 83

1. The extent to which skeletal involvement in hyperparathyroidism can be detected by X-ray remains an unsolved issue. The present investigation, aimed at resolving this problem, was carried out in 44 patients with primary (PHPT) and 57 subjects with secondary hyperparathyroidism (SHPT) due to terminal renal insufficiency. For comparison, 49 age-matched controls were included in this series. Subperiostal resorption of the phalanges of the hand was considered pathognomonic and graded according to a semiquantitative system using a magnifying lens. The data were compared with the serum calcium and alkaline phosphatase values. 2. Pathological subperiostal resorption was detected in 38.5% of the PHPT and in 56% of the SHPT patients while the controls showed 4% (false) positive results. A highly significant correlation between the extent of bone resorption and alkaline phosphatase was found (PHPT: r=0.80, SHPT: r=0.71, p less than 0.001). No correlation of the X-ray findings to the serum calcium could be detected. Compared to the degree of skeletal involvement demonstrated by X-ray, the alkaline phosphatase was significantly lower in SHPT than in PHPT. In PHPT on the other hand, subperiostal resorption was prominent among female patients aged over 40 years, while no prevalence for sex and age was found in the SHPT group. 3. These results demonstrate that a clinically relevant degree of bone involvement in hyperparathyroidism may be easily and reliability assessed by evaluating X-rays of the hands by means of a magnifying lens. Increased bone resorption in hyperparathyroidism appears to be paralleled by an increase of osteoblastic activity as assessed by elevation of alkaline phosphatase. In SHPT due to chronic renal failure, however, a relative osteoblastic insufficiency seems to exist. In PHPT, the prevalence of subperiostal bone resorption in women aged over 40 years may be compatible with a skeletal protecting effect of intact ovarian function (estrogens).
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PMID:[Hyperparathyroidism. Quantitative determination of specific skeletal changes in the radiography of the hand]. 84 37

We studied the effects of bilateral nephrectomy on bone metabolism in 27 patients on maintenance hemodialysis. After nephrectomy plasma alkaline phosphatase fell rapidly in 10 patients whose preoperative plasma levels had been higher than normal. This fall was associated with a transient decrease in osteoblast counts of iliac-bone biopsies. A fall in plasma phosphate and a rise in plasma immunoreactive calcitonin also occurred, but calcium and immunoreactive parathyroid hormone levels did not change. Alkaline phosphatase levels remained unchanged in a control group of 17 patients on dialysis who had undergone an operation other than nephrectomy. In 26 nonsurgical patients on dialysis, immunoreactive calcitonin was inversely related to osteoblast counts. Rises in immunoreactive calcitonin may be partly responsible for the transient decreases in bone turnover after bilateral nephrectomy. Low levels of endogenous calcitonin may allow an increase in bone turnover in chronic renal failure.
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PMID:Changes in histologic and biochemical indexes of bone turnover after bilateral nephrectomy in patients on hemodialysis. Evidence for a possible role of endogenous calcitonin. 85 May 17

Liver, intestinal, and bone alkaline phosphatase isoenzymes were measured using heat stability and L-phenylalanine inhibition techniques in 78 patients on intermittent haemodialysis. Fifty-five patients had abnormalities in one or more of the isoenzymes. Changes in bone and intestinal alkaline phosphatase activities seemed to be related and raised liver isoenzyme activity was associated with the development of liver disease. Abnormal histological and radiological findings were better correlated with bone alkaline phosphatase levels than with total alkaline phosphatase, and serial estimations of bone isoenzyme activity were useful in assessing the response of renal osteodystrophy to treatment with a vitamin D analogue. Serum alkaline phosphatase isoenzyme measurement provides another useful and non-invasive index for monitoring metabolic bone disease in patients with chronic renal failure.
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PMID:Comparative study of alkaline phosphatase isoenzymes, bone histology, and skeletal radiography in dialysis bone disease. 86 92

The effects of small oral doses (1-2 microgram/day) of 1alpha-hydroxycholecalciferol, given for 1 to 2 years, have been examined in four nondialysed adolescents with chronic renal failure and bone disease. Treatment increased calcium retention and plasma calcium, and decreased plasma levels of alkaline phosphatase, hydroxyproline, and immunoreactive parathyroid hormone. X-ray abnormalities of bone regressed, and 2 patients underwent successful surgical correction of knock-knees; bone histology in these 2 was normal at the time of operation. 2 patients developed hypercalcaemia which promptly reversed when 1alpha-hydroxycholecalciferol was withdrawn. In one patient treatment was initially successful, but later there was biochemical, radiographic, and histological evidence of relapse. Long-term treatment of such patients with 1alpha-hydroxycholecalciferol may be effective and facilitate the surgical correction of deformities, but this is not invariable. Toxic effects are similar to those of vitamin D itself, but are more readily reversible.
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PMID:Renal osteodystrophy in nondialysed adolescents. Long-term treatment with 1alpha-hydroxycholecalciferol. 87 33

The development of bone abnormalities has been studied in 24 patients with severe chronic renal failure. The glomerular filtration rate (GFR) was between 5 and 25 ml/min. The mean values of plasma calcium, degree of bone mineralization (P/Hypro) and bone mineral content (BMC) were subnormal, whereas the mean values of plasma phosphorus and serum parathyroid hormone (PTH) were elevated. Analysis of the data revealed that the various parameters became increasingly pathological with decreasing renal function. Serum PTH correlated inversely with both GFR and plasma calcium. The decrease in bone P/Hypro with decreasing renal function could be explained by an inverse correlation to serum PTH. Plasma alkaline phosphatase correlated inversely to both bone P/Hypro and BMC. The present study on individual patients with varying degrees of renal insufficiency shows that the development of secondary hyperparathyroidism correlates with a reduction in the degree of bone P/Hypro and suggests that significant bone changes appear when the GFR falls below 15 ml/min.
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PMID:Bone composition and parathyroid function in chronic renal failure. 89 80


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