Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0035078 (renal failure)
 31,970 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hydroxyproline (HYP) is an amino acid which is highly specific for bone collagen. Measurement of HYP provides an index of bone resorption, although the usefulness in this respect of the serum free HYP, which is the easiest HYP fraction to determine, has not yet been established. In the present study, the serum free HYP was measured using the method of Dabev et al., and the data were compared against other parameters of renal osteodystrophy (ROD). In comparison with values for the normal control group (n = 10), the serum free HYP was significantly elevated in the patient group with conservatively treated end-stage renal failure (n = 14) and in the patient group on chronic hemodialysis (n = 107), with the latter group showing the highest value. Also, in the group with radiographic evidence of bone resorption, the free HYP exhibited a significant elevation. Significant positive correlations were noted between the free HYP and both the parathyroid hormone (PTH) and alkaline phosphatase (Al-P) levels. When the subjects undergoing bone biopsy were divided according to their histological findings into an increased osteoid group and an increased osteoid + resorption group, the latter displayed a significantly higher free HYP value. In addition, the free HYP values were low in the group administered 1 alpha-OH-D3 and showing only slight bone resorption. These results suggest that since the free HYP closely reflects accelerated bone resorption in ROD and is easier to measure than non-protein-bound HYP, it can serve as a clinically useful index of ROD.
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PMID:Reevaluation of the usefulness of serum free hydroxyproline as a parameter for assessing renal osteodystrophy. 833

The aim of this study was to evaluate the clinical usefulness of the calcitonin test in predicting the hyperparathyroid bone disease severity in uremia. 200 IU of synthetic salmon calcitonin was given intranasally to 77 hemodialysed patients with end-stage renal failure. Before the test, serum calcium, PTH and serum alkaline phosphatase had been sampled; serum calcium was determined also in 2 to 4 hours after. The subjects were divided into 3 groups according to their serum PTH levels. Group I consisted of 24 patients with at least 10-fold serum PTH elevation, group II of 34 patients with intermediate values, and group III of 19 patients with serum PTH within normal range. In the group I the mean serum calcium fall was 0.32 +/- 0.16 mmol/l (1.28 +/- 0.64 mg/dl) (p < 0.001) and 0.27 +/- 0.15 mmol/l (1.08 +/- 0.60 mg/dl) (p < 0.001), after 2 to 4 hours respectively. In the group II serum calcium decreased by 0.16 +/- 0.12 mmol/l (0.64 +/- 0.48 mg/dl) after 2 hours and by 0.14 +/- 0.09 mmol/l (0.56 +/- 0.36 mg/dl) after 4 hours; the differences were statistically insignificant. In the group III no reduction in serum calcium was observed. In the whole 77 patients population significant linear correlations between the hypocalcemic response and iPTH as well as serum alkaline phosphatase were found. Our results confirm that the calcitonin-induced hypocalcemia a test can be, in addition to serum alkaline phosphatase and PTH evaluation, a simple and useful index of advanced hyperparathyroid bone disease in hemodialysed patients with chronic renal failure.
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PMID:[Test with calcitonin as an index of parathyroid function in chronic renal failure]. 850 92

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.
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PMID:Thyroid function surveillance in CAPD patients. 853 10

The limiting factor in the therapeutical use of cyclosporine A (Cs A) is its nephrotoxicity, which may lead to renal failure. Cs A nephrotoxicity may present itself as an acute decrease in GFR, or as a chronic renal injury. Nephrotoxicity is caused by the indirect vasoconstriction effect mainly on proximal tubule and afferent arteriols. In our study we have concentrated on the effect of Ca-channel blockers on Cs A nephrotoxicity. As parameters of toxic kidney damage we have used the urine levels of the following enzymes: N-acetyl-beta-D-glucosaminidase (NAG), gama-glutamyltransferase (GMT) and alkaline phosphatase (ALP). Daily intragastric application of verapamil (V) (dose 1.0 mg/kg BW) or nifedipine (N) (dose 0.1 mg/kg BW) was started in a group of male Wistar rats. Cs A (Sandimun Sandoz, Switzerland) was applied daily intraperitoneally 30 minutes after the application of V or N. The dose of Cs A ranged from 5 mg/kg BW to 25 mg/kg BW in individual groups. The animals were observed for 10 days after the drugs application. Urine samples were collected and examined at the end of the whole experiment. The individual parameters were evaluated in the groups receiving the 3 different doses of Cs A (5-25 mg/kg BW). The serum creatinine rose moderately during the experiment. When the Ca-channel blockers were administered, the rise was not as steep, but when the highest dose of Cs A was administered, the Ca-channel blockers did not influence the elevation of the serum creatinine. Using the standard dose of Cs A (5 mg/kg BW) the protective effect of Ca-channel blockers can be found. In higher doses of Cs A this protective effect was not expressed.
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PMID:The effect of calcium channel blockers on cyclosporine A (Cs A) induced nephrotoxicity in rats. 871 61

Twenty patients with end-stage renal failure on maintenance hemodialysis were studied for the effect of intravenous 1,25(OH)2 vitamin D3 on biochemical bone markers. Active vitamin D, 1,25(OH)2 vitamin D3, was given intravenously after hemodialysis, 1 microgram thrice weekly. Serum ionized calcium, phosphorus, alkaline phosphatase (AKPase), intact parathyroid hormone (PTH), osteocalcin (bone Gla protein), carboxy terminal propeptide of type I procollagen (PICP), cross-linked telopeptide of type I collagen (ICTP) and beta 2-microglobulin were measured before and after 3 and 6 months of treatment with 1,25(OH)2 vitamin D3. The serum ionized calcium and osteocalcin levels were significantly increased at 3 and 6 months after treatment. The serum beta 2-microglobulin level were also increased 6 months after treatment, whereas the serum levels of AKPase and intact PTH decreased after treatment. However, the serum levels of phosphorus, PICP and ICTP did not change significantly after treatment. The decreased levels of serum AKPase and intact PTH suggest reduced bone resorption. Increases of serum osteocalcin levels were caused by stimulation of the osteoblast by 1,25(OH)2 vitamin D3, baseline 20.6 +/- 12.5 micrograms/l, and 36.1 +/- 34.0 and 31.0 +/- 24.6 micrograms/l at 3 and 6 months, respectively (p < 0.01). The lower osteocalcin level at 6 rather than at 3 months may imply reduced bone resorption and/or increased bone mineralization. The meaning of the increase of serum beta 2-microglobulin in uremic patients after calcitriol treatment is unclear. It may indicate reduced deposition and is masked by increased bone resorption from secondary or tertiary hyperparathyroidism. This study did not validate PICP and ICTP measurements as bone markers in uremic patients.
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PMID:Changes of bone markers during long-term intravenous calcitriol therapy in maintenance dialysis patients. 880 25

In order to evaluate the recurrence of calcium kidney stones, 520 patients (275 males and 245 females), aged 14-79 years, previously treated with lithotripsy were followed up for 23 months on average (median = 24 months; range = 12-48 months), and 101 relapses (10%/year) were recorded. Among the possible predictors of recurrence, measured at the beginning of the follow-up and analyzed in univariate and multivariate statistical ways, age was inversely related with occurrence of event (multivariate t value = -2.12) whereas urinary calcium (UC; t = 2.78), alkaline phosphatase (AP; t = 3.55) and history of previous relapses (t = 2.07) were directly related to the recurrence. The levels of UC were not correlated to those of AP (linear correlation coefficient r = 0.0032), but the combination of their high levels increased the risk of recurrences. The contribution of the other considered factors to stone formation were not significant (sex, family history of stone disease, gallstone, renal failure, serum calcium, phosphate, uric acid, sodium and proteins, urinary phosphate, sodium, magnesium and uric acid.
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PMID:Incidence and prediction of stone recurrence after lithotripsy in idiopathic calcium stone patients: a multivariate approach. 882 89

The carboxyterminal propeptide of type I procollagen is a biochemical marker of type I collagen synthesis. We evaluated circulating carboxyterminal propetide of type I procollagen levels in patients with terminal renal failure before and after kidney transplantation. Serum carboxyterminal propeptide of type I procollagen, osteocalcin, total alkaline phosphatase, intact parathyrin, creatinine, calcium and phosphate levels were determined in 20 patients, before and 15, 30, 90 and 180 days after surgery. Serum creatinine and intact parathyrin concentrations showed a significant decrease after kidney transplantation. Immunosuppressive treatment consisted of low dose prednisone, cyclosporin and antilymphoblast globulin. In our group, only 5 patients (25%) showed serum carboxyterminal propeptide of type I procollagen levels higher than normal before kidney transplantation. At 15 and 30 days, carboxyterminal propeptide of type I procollagen concentrations showed a decrease, while at 90 and 180 days there was a significant increase above the normal range (p = 0.006; ANOVA). Serum osteocalcin and total alkaline phosphatase levels increased significantly at the same time. We found a significant correlation between carboxyterminal propetide of type I procollagen and osteocalcin at 15 and 30 days after kidney transplantation. We conclude that the significant increase in carboxyterminal propeptide of type I procollagen levels after kidney transplantation reflect an increase in bone turnover. The low doses of steroids employed do not seem to have a significant inhibitory effect on collagen synthesis.
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PMID:Evolution of circulating C-terminal propeptide of type I procollagen in patients with chronic renal failure pre and post renal transplantation. 896 Apr 63

The pharmacokinetics and effects of recombinant human granulocyte colony-stimulating factor (rhG-CSF) on neutrophils and immunological function were studied in 10 patients with end-stage renal failure. A single dose and 2-week consecutive dosing of 50 micrograms/m2 of rhG-CSF were drip infused intravenously, and plasma rhG-CSF levels, peripheral blood cell counts, coagulation, and neutrophil and immunological functions were determined during treatment. The mean half-life of rhG-CSF in patients (2.47 +/- 0.64 h) was prolonged to about twice that of healthy subjects, and hemodialysis did not affect the pharmacokinetics. A marked increase in neutrophils and a slight increase in lymphocytes were observed with the single and consecutive administration of rhG-CSF, but no significant changes were noted in other leukocyte fractions and erythrocyte and platelet counts. The neutrophil alkaline phosphatase value increased significantly following rhG-CSF administration, and other neutrophil functions were also ameliorated in several patients with neutrophil dysfunction. In consecutive administration, however, mild bone pain and increased serum alkaline phosphatase were observed in about half the patients, but neither accumulation of rhG-CSF nor antibody production was detected. From these results, it is concluded that rhG-CSF is safe and effective for the treatment of neutropenia and neutrophil dysfunction in patients with renal failure.
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PMID:The effects and pharmacokinetics of rhG-CSF in patients with chronic renal failure. 896 84

The consumption of plants containing the diterpenoid atractyloside (ATR) causes selective proximal tubule injury, renal failure and death in humans. We have compared the effects of ATR in freshly isolated renal proximal tubules and glomeruli from rat and also in cell lines: NRK, derived from the proximal tubules, and MDBK and MDCK more closely representing the distal nephron. The effects of ATR (10-500 microM) on proximal tubules and glomeruli were assessed by changes in lipid peroxidation, de novo protein synthesis and the leakage of alkaline phosphatase (ALP), lactate dehydrogenase (LDH), glutamate dehydrogenase (GDH) and N-acetyl-beta-D-glucosaminidase (NAG). The susceptibility of NRK, MDBK and MDCK cell lines to ATR was assessed by the 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay, measuring mitochondrial reduction. Enzyme leakage was the most sensitive of the markers of cell injury in fresh fragments and ranked LDH > GDH > ALP > NAG in proximal tubules. As little as 20 microM ATR caused significant enzyme leakage from proximal tubules, but there were no increases in enzyme leakage from glomeruli at concentrations < and = 500 microM ATR. De novo protein synthesis was only inhibited 50% at ATR concentration > 5 mM in the proximal tubules, but there were no effects in glomeruli. Malondialdehyde production was significantly elevated at 1 mM ATR for proximal tubules, and 500 microM for glomeruli. NRK cells were sensitive to ATR (IC50, 120 microM), but MDBK or MDCK cells were unaffected by < and = 1 mM of this diterpenoid. Both freshly isolated fragments and continuous cell lines representing the proximal tubules are more sensitive to ATR than either glomeruli or cells representing the distal nephron. These data also show that protein synthesis is a less specific and sensitive measure of ATR cytotoxicity than enzyme leakage in fragments. MTT reduction to formazan was the most sensitive in the NRK cell line. The low levels of lipid peroxidation products in proximal tubular fragments or sensitive renal cell lines at toxic levels of ATR suggest that oxidative injury is not a key mechanism.
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PMID:Selective cytotoxicity associated with in vitro exposure of fresh rat renal fragments and continuous cell lines to atractyloside. 901 May 90

The safety of amphotericin B colloidal dispersion (ABCD) was tested in five open-label Phase I/II clinical trials in 572 selected patients who had a fungal infection secondary to a severe underlying disease. In 442 cases ABCD was administered after therapy with amphotericin B, which had been withdrawn in 192 of them because of toxicity. One hundred and forty patients had pre-existing nephrotoxicity. ABCD doses of up to 6 mg/kg/day resulted in no differences in serum creatinine levels, even in patients with pre-existing renal failure. ABCD therapy resulted in no difference in liver function as measured by SGOT, alkaline phosphatase and total bilirubin levels in serum. Apart from thrombocytopenia, there was no significant alteration in hematological or other biochemical parameters in the blood. Adverse events attributable to ABCD requiring discontinuation of therapy occurred in 70 patients (12.2%). The most frequent of these were infusion-related adverse events, which occurred in 5.4% of patients. As a consequence, the maximum tolerated dose was set at 7.5 mg/kg/day. These studies show clearly that ABCD can be administered safely to patients without the risk of renal toxicity, even when renal impairment has already developed following therapy with conventional amphotericin B deoxycholate.
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PMID:Safety of amphotericin B colloidal dispersion. 906 77


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