Calcium and Strontium Metabolic Studies in Patients on Capd

1998 ◽  
Vol 18 (4) ◽  
pp. 410-414 ◽  
Author(s):  
Nicholas Apostolidis ◽  
Themis Paradellis ◽  
Andreas Karydas ◽  
Andreas Manouras ◽  
Nicholas Katirtzoglou ◽  
...  

Background Strontium is known to affect calcium metabolism both experimentally and in clinical studies on conditions other than end-stage renal failure (ESRF) and continuous ambulatory peritoneal dialysis (CAPD). Objective To investigate Sr metabolism in relation to that of Ca in ESRF patients undergoing CAPD, and the possible influence of the duration of treatment. Design Cross-sectional observational study. Setting University medical center and Institute of Nuclear Physics. Patients Twenty-four patients on CAPD; 14 chronic renal failure (CRF) patients not on dialysis, and 52 healthy controls. Measurements Calcium and Sr content of serum, urine or dialysate effluent, and selected dietary products. Results Calcium and Sr are absorbed by the intestinal tract of healthy subjects with equal efficiency. Serum Ca levels were considerably lower in CRF patients than in healthy subjects and patients on CAPD (p < 0.001). Serum Sr was significantly higher in both CAPD and CRF patients than in healthy controls (p < 0.001). The Sr/Ca ratio in the sera of the healthy subjects was defined by the preferential excretion of Sr over Ca by the kidney. This preferential excretion was lost during renal failure. During treatment there was a tendency for the uptake of both Ca and Sr to increase. Conclusions Strontium is accumulated in the body during renal failure and CAPD cannot restore normal levels. Considering the varying effects of different doses of Sr on bone metabolism experimentally, it would be interesting to determine by further studies the possible significance of the observed Sr accumulation for renal bone disease.

2020 ◽  
Vol 11 (2) ◽  
pp. 1748-1753
Author(s):  
Sazan D. Saeed ◽  
Ansam N. Al-Hasani ◽  
Marwan S. Al-Nimer

Metallothioneins (MTs) are intracellular metal-protein which not alone have inactivated heavy metals but also have traced elements while improving the antioxidant status. Serum levels of some heavy metals and trace elements showed toxic levels in the end-stage renal failure. This study is aimed to determine the serum level of metallothionein in patients with chronic kidney disease (CKD) and to show the effects of hemodialysis on its level. This cross-sectional study included 125 patients with CKD managed with regular hemodialysis. Estimated glomerular filtration rate (eGFR) was calculated by using the Cockroft and Gault equation adjusted to the body surface area (ml/min/m2), and 4 variable modified diet in renal disease (4-v MDRD) equation (ml/min/1.73m2). The mean ± SD of serum metallothionein was significantly less than the corresponding level of healthy subjects (1113.4±289.5 pg/ml versus 1536.0±341.4 pg/ml). Hemodialysis improves the serum level of metallothionein to attain 1437.6±406.1 pg/ml. There is a non-significant correlation between serum metallothionein with the eGFR and hemodialysis did not produce a significant effect on the correlation between serum metallothionein with eGFR.  We conclude that serum metallothionein level is a useful prognostic marker for CKD and hemodialysis plays a role in the recovery of serum metallothionein level.


2016 ◽  
pp. 7-11
Author(s):  
Vinh Phu Hoang ◽  
Tam Vo ◽  
Van Tien Le ◽  
Thi Hoai Huong Vo

Objective: To review disorders elements of the metabolic syndrome in patients with end-stage chronic renal failure on dialysis cycle. Materials and methods: A cross sectional descriptive study of 85 patients including end-stage chronic renal failure in dialysis cycle from 5/2015 - 9/2016 at the Department of Artificial Kidney, Hue Central Hospital. Results: The prevalence of metabolic syndrome in dialysis patients was 37.65%. The prevalence of abdominal obesity was 30.6%; The prevalence of hypertension was 72.9%, the average value systolic blood pressure and diastolic blood pressure were 142.24 ± 27.53, 80.35 ± 12.48 mmHg; The prevalence of hyperglycemia was 28%, the average value blood glucose was 4.9 ± 1.19 mmol/l; The prevalence of triglyceride increase was 34.1%, the average value triglyceride was 1.59 ± 0.84 mmol/l. The prevalence of HDL-C increase was 47.1%, the average value HDL-C was 1.24 ± 0.33 mmol/l. Conclusion: The prevalence of metabolic syndrome in dialysis patients is very high, in which hypertension and HDL disturbances are the highest. Key words: chronic renal failure, dialysis, metabolic syndrome


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1386.2-1387
Author(s):  
P. E. Bermudez Bermejo ◽  
R. Jimenez-Soto ◽  
A. Sanchez Rodríguez ◽  
A. Turrent ◽  
D. Mercado Velasco ◽  
...  

Background:Nailfold capillaroscopy is a relatively easy-to-access, low-cost clinical tool that could help identify early coagulopathy in subjects with SARS-CoV-2, but specific findings vs. controls and its possible prognostic role has not been studied.Objectives:To describe capillaroscopic findings and their usefulness in patients with COVID-19 compared to healthy controls.Methods:We designed a cross-sectional study, carried out in a single care center for critical patients with SARS-CoV-2 pneumonia at the ABC Medical Center, Mexico City, which included patients from an intensive care unit (ICU) and internal medicine ward from March to April 2020. Demographic, biochemical and clinical features were collected. All patients signed the informed consent and the study was approved by the hospital ethics committee. All patients underwent nail capillary imaging of the 3 central fingers of each hand with a portable microscope with 60-100x magnification coupled to a smartphone with 7 megapixel images in an immersion medium. Capillaroscopy was performed in patients who did not have fever or hypothermia, or need vasopressors at the time of evaluation. Control subjects are healthy subjects matched on age and sex from a database of healthy controls without rheumatic diseases. Image evaluation of COVID-19 patients was performed in a blinded way for their characteristics. Prior to the analysis of the images, a pilot test was obtained with 4 rheumatologists in random cases, obtaining an acceptable global agreement in the visualization of capillaries and specific alterations of the nail bed. (Kappa = 0.58, p = 0.0019). Obtained data from capillaroscopies were used to be compared between severe and moderate cases of SARS-CoV-2 pneumonia. Additionally, we compared the findings against a healthy population in order to establish a reference.Results:We included data from 27 patients and 32 controls with similar demographic features. Patients with COVID-19 patients had a mean age of 43 +/- 13.8 years, 63% female. Comorbidities were present in 44.4% with: type II Diabetes Mellitus 18.5%, systemic arterial hypertension 18.5%, and rheumatoid arthritis 3.7%. The mean length of stay time was 13 +/- 7.1 days, 48.1% were admitted to the ICU, and 40.7% required invasive mechanical ventilation. In the capillaroscopic review remarkable findings of patients vs. controls were hemosiderin deposits (33 vs 12.5%, p=0.05), less frequently observable capillaries (77 vs 100%, p=0.005), any abnormality in capillaries (25.9 vs. 6.3%, p=0.03). Of notice, specific findings in COVID-19 patients were capillary tortuosities in 19%, dilatation in 9.5%, serpentine pattern in 4.8%, bush pattern in 9.5% and decreased density in only 4.8% of the cases. No avascular areas or capillaries of neoformation were observed. Finally, the presence of hemosiderin was associated with worse presentation and risk factors for severe COVID-19: Male sex 66.7 vs. 27.8%, (p = 0.024); Admission to ICU 77% vs 33% (p = 0.029); BMI > 30 kg/m2 66.7 vs. 27.8% (p = 0.053). And risk for ICU admission OR = 7.0 (95% CI 1.098 - 44.6). No significant associations were found for abnormalities in capillary morphology.Conclusion:We present one of the first reports of nailfold capillaroscopic findings in patients with COVID-19 and the first to compare to healthy controls. Previous data on this regard suggests the presence of endothelial dysfunction and microvascular complications such as micro hemorrhage or micro thrombosis. Further studies may confirm these findings and prognostic value for worse outcomes in COVID-19 patients.References:[1]Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395:507–13.[2]Cutolo M, Cortes S. capillaroscopic patterns in rheumatic diseases. Acta Reumatol Port. 2007 Jan-Mar;32(1):29-36.[3]Natalello G, De Luca G, Gigante L, et al. Nailfold capillaroscopy findings in patients with coronavirus disease 2019: Broadening the spectrum of COVID-19 microvascular involvement. Microvasc Res. 2021;133:104071.Disclosure of Interests:None declared


2012 ◽  
Vol 12 (53) ◽  
pp. 6553-6566
Author(s):  
GC Onyemelukwe ◽  
◽  
D Ogoina ◽  
GE Ibiam ◽  
GH Ogbadu

Aflatoxins are natural contaminants of food crops implicated in the pathogenesis of various human diseases. This study aimed to determine the associations between aflatoxins and protein- energy malnutrition ( PEM) by measurements of aflatoxins in serum, urine and food on plate of Nigerian children with PEM. A cross - sectional study was undertaken in 3 agro - ecological regions of Nigeria (Guinea savannah, Sudan savannah and Rain forest), where aflatoxins B1 , B2, G1, G2, M1, and M2 were measured in sera, urine and food on plate of 79 children with PEM (kwashiorkor n=36, marasmic kwashiorkor n=29 and marasmus n=13) and 33 healthy controls, matched for age and sex. Among healthy controls, aflatoxin detection rates were higher in the Guinea Savannah (72.2%) than in the Sudan Savannah (53.8%), albeit statistically insignificant. In relation to nutritional groups, the rates of detection of aflatoxins were higher in marasmic kwashiorkor (93.1%) and kwashiorkor patients (88.9%) , compared to marasmus (76.9%) and controls (63.6%, p=0.013). The rates of detection of B1 aflatoxin followed a similar trend viz. marasmic kwashiorkor (82.4%), kwashiorkor (69.4%), marasmus (53.8%) and controls (42.4%, p=0.007). Of all types of aflatoxins detected in serum, M2 had the highest rates of detection in all patient groups and controls. The median concentrations of aflatoxins detected in sera of each PEM group were significantly higher than those of controls, but comparisons between PEM groups were not statistically significant. The frequency and concentration of aflatoxins detected in urine and food of PEM groups and controls were not statistically different. However, controls had the lowest serum / urine aflatoxin ratio as well as lowest median aflatoxins concentrations in their food as compared to PEM patient s. In conclusion, aflatoxins are commonly detected in the body fluids and food of Nigerian children , but more frequently and at higher concentrations in children with PEM , possibly due to decreased excretion or increased exposure. Future prospective studies are desirable to determine if aflatoxins contribute to the pathogenesis of all types of PEM and not necessarily kwashiorkor alone.


2012 ◽  
Vol 52 (187) ◽  
Author(s):  
R K Agrawal ◽  
S Khakurel ◽  
R Hada ◽  
D Shrestha ◽  
A Baral

Introduction: Hemodialysis is the preferred method of treatment for Nepalese patients with End Stage Renal Disease. Despite the technological advances and better understanding of physiology associated with hemodialysis, a number of complications are known to be associated with hemodialysis. This study was undertaken to study the frequency of acute intradialytic complications in patients undergoing hemodialysis. Methods: A cross-sectional study was conducted at Nephrology unit of a tertiary care hospital from 15 June, 2007 to 15 December, 2007. A total of 28 patients were included in the study. Patients with acute renal failure and acute on chronic renal failure were excluded from the study. Results: Total sessions of hemodialysis during the period were 1455. Hypotensive episode were 66 (4.5%) and was the commonest complication and followed by hypertensive episodes were 58 (3.8%). Other problems encountered were transfusion reactions were 23 episodes (1.5%), rigors not related to transfusions were 13 episodes (0.8%), nausea/vomiting were 20 episodes (1.4%), muscle cramps were 12 episodes (0.8%), hypoglycemia were 6 episodes 5(0.4%). Conclusions: The frequency of intradialytic complications is low and many of them are not life threatening. Keywords: complications; end stage renal disease; hemodialysis; hypertension; hypotension.


1977 ◽  
Vol 53 (5) ◽  
pp. 479-484
Author(s):  
J. M. Letteri ◽  
R. M. Biltz ◽  
K. J. Ellis ◽  
A. Martino ◽  
S. Yasumura ◽  
...  

1. Young, sub-totally nephrectomized rats were used to study the altered mineral metabolism of renal failure and its effects on bone growth and mineral maturation. 2. Rats killed at 4 weeks after sub-total nephrectomy demonstrated less bone growth than the age-matched control animals. These differences diminished in successive 4 week periods and were not significant at 12 weeks after operation. 3. The major differences in bone mineral composition between the uraemic rats and the control rats were: (i) lower CO23;− concentrations, and (ii) higher PO34;− and HPO24;− concentrations. 4. These differences are consistent with the view that bone mineral matures by the conversion of an acidic calcium phosphate precursor into a carbonate-containing apatite, an essential feature of this conversion being the replacement of PO34;− or HPO24;− by CO23;−. By this definition, uraemic rats at 4 weeks after operation contained more immature bone mineral than the control rats. These differences corresponded to the changes in bone weight, and were similarly unaffected at 12 weeks after operation. 5. The effects observed were transient and were reversed as renal function recovered. If renal failure is sustained, however, as in patients with end-stage renal disease, the maturation defect could become a feature of renal bone disease. Specific aetiological factors are discussed, but not identified.


2017 ◽  
Vol 44 (5) ◽  
pp. 609-612 ◽  
Author(s):  
Marie-Alix Lanfranchi ◽  
Olivier Leluc ◽  
Alice Tavano ◽  
Cécile Wormser ◽  
Sophie Morange ◽  
...  

Objective.Enthesitis is the spondyloarthritis (SpA) landmark, but can also be seen after entheses overuse, such as during intensive sport.Methods.We aimed to compare entheses ultrasound (US) findings in a prospective cross-sectional study of 30 axial SpA cases, 30 athletes, and 29 controls.Results.Mean (SD) MAdrid Sonographic Enthesis Index (MASEI) score was 26.3 (13), 12.2 (7), and 10.4 (6) in patients with SpA, athletes, and non-athlete control groups, respectively (p < 0.0001).Conclusion.The MASEI score was significantly higher in patients with SpA compared with healthy controls, athletes, and non-athletes, and can be of value to distinguish SpA from healthy subjects, whatever their physical activity.


Sign in / Sign up

Export Citation Format

Share Document