ABNORMAL RESPONSE OF THYROTROPHIN AND GROWTH HORMONE TO THYROTROPHIN RELEASING HORMONE IN CHRONIC RENAL FAILURE

1975 ◽  
Vol 79 (4) ◽  
pp. 635-643 ◽  
Author(s):  
Koichi Hasegawa ◽  
Yoshiki Matsushita ◽  
Seima Otomo ◽  
Noboru Hamada ◽  
Yoshiki Nishizawa ◽  
...  

ABSTRACT Serum levels of TSH and GH were measured by radioimmunoassay after iv injection of 500 μg of TRH in 9 undialysed patients and 12 dialysed patients with chronic renal failure and in 6 healthy subjects. The basal level of the serum TSH was significantly higher in patients with chronic renal failure than that in healthy subjects. In healthy subjects, serum TSH rose to a maximum level 30 min after TRH injection, while in patients with chronic renal failure, serum TSH rose to a maximum level 60 min after TRH injection. The mean maximum increment of serum TSH in healthy subjects was significantly higher than that in patients with chronic renal failure. Although TSH levels rapidly decreased after initial rise at 30 min after TRH administration in healthy subjects, these did not show significant changes at 60 and 120 min compared with values at 30 min after TRH administration in both dialysed and undialysed patients. The basal level of serum GH was significantly higher in dialysed patients with chronic renal failure than in healthy subjects. Serum GH level was much higher in dialysed patients at 30 min after TRH injection compared with that in healthy subjects. These findings may indicate that the response of the pituitary to TRH is abnormal and that the turnover of TSH and GH is decreased in patients with chronic renal failure.

1982 ◽  
Vol 99 (4) ◽  
pp. 508-516 ◽  
Author(s):  
C. Marti Henneberg ◽  
J. M. Domenech ◽  
E. Montoya

Abstract. In order to study the hypothalamic-pituitarythyroid function in children with chronic renal failure (CRF), the serum levels of l-thyroxine (l-T4), l-triiodothyronine (l-T3), reverse T3 (rT3), thyrotrophin (TSH) and prolactin (Prl) were measured by radioimmunoassay (RIA). Values were compared with those of normal subjects. Low levels of l-T4 were present in CRF patients as compared to controls. l-T3 was also found to be low but less than l-T4, and rT3 was lower in patients with long evolution. No alterations were observed in TSH basal levels, whereas Prl values in patients were high. After thyrotrophin-releasing hormone (TRH) administration, TSH and Prl rose to similar levels in both groups, but high values were maintained throughout (120 min) in CRF. A significant negative correlation was found between the peak rise of the TSH response and the CRF evolution time. The l-T3 response to TRH administration (120 min) was similar in both CRF and controls. The rate of in vivo and in vitro exogenous TRH degradation was decreased in patients with CRF or by their sera, respectively. Our data seem to confirm that the hypothyroid syndrome described in CRF patients is of hypothalamic origin, and the low in vivo and in vitro TRH degradation rates are a consequence of this state.


1978 ◽  
Vol 87 (3) ◽  
pp. 467-475 ◽  
Author(s):  
Koichi Hasegawa ◽  
Yoshiki Matsushita ◽  
Kenzo Hirai ◽  
Seima Otomo ◽  
Teruo Okamoto ◽  
...  

ABSTRACT Serum levels of LH, FSH, testosterone and oestradiol were measured by radioimmunoassay in 10 healthy subjects and 7 undialysed and 15 dialysed patients with chronic renal failure. The basal level of serum LH was significantly higher in patients with chronic renal failure than in healthy subjects. The basal level of serum FSH in male subjects was significantly higher in dialysed patients with chronic renal failure than in healthy subjects. Regarding testosterone secretion in male subjects and oestradiol secretion in female subjects, it was shown that the basal level of serum testosterone was significantly lower in patients with chronic renal failure than in healthy subjects, and that serum oestradiol levels were within the normal range in most of the patients with chronic renal failure. Serum levels of LH, FSH and testosterone were determined after iv injection of 100 μg of LH-RH in three groups of subjects. Responses of serum LH and FSH to LH-RH were exaggerated and prolonged in patients with chronic renal failure compared with healthy subjects. The peaks of serum LH and FSH were observed 30 min after LH-RH injection in healthy subjects while those in chronic renal failure appeared at 60 to 120 min. The levels of serum testosterone after LH-RH injection did not change within 120 min. These findings may indicate that the pituitary gonadotrophin response to LH-RH is abnormal and that the turnover of LH, FSH and LH-RH is decreased in patients with chronic renal failure.


1974 ◽  
Vol 75 (2) ◽  
pp. 274-285 ◽  
Author(s):  
A. Gordin ◽  
P. Saarinen ◽  
R. Pelkonen ◽  
B.-A. Lamberg

ABSTRACT Serum thyrotrophin (TSH) was determined by the double-antibody radioimmunoassay in 58 patients with primary hypothyroidism and was found to be elevated in all but 2 patients, one of whom had overt and one clinically borderline hypothyroidism. Six (29%) out of 21 subjects with symptomless autoimmune thyroiditis (SAT) had an elevated serum TSH level. There was little correlation between the severity of the disease and the serum TSH values in individual cases. However, the mean serum TSH value in overt hypothyroidism (93.4 μU/ml) was significantly higher than the mean value both in clinically borderline hypothyroidism (34.4 μU/ml) and in SAT (8.8 μU/ml). The response to the thyrotrophin-releasing hormone (TRH) was increased in all 39 patients with overt or borderline hypothyroidism and in 9 (43 %) of the 21 subjects with SAT. The individual TRH response in these two groups showed a marked overlap, but the mean response was significantly higher in overt (149.5 μU/ml) or clinically borderline hypothyroidism (99.9 μU/ml) than in SAT (35.3 μU/ml). Thus a normal basal TSH level in connection with a normal response to TRH excludes primary hypothyroidism, but nevertheless not all patients with elevated TSH values or increased responses to TRH are clinically hypothyroid.


2017 ◽  
pp. 88-92
Author(s):  
Van Hien Pham ◽  
Huu Vu Quang Nguyen ◽  
Tam Vo

Background: Cardiovascular diseases are the leading cause of death in patients with chronic renal failure. When a patient undergoes dialysis, making AVF or AVG causes cardiovascular events. Understanding the relationship between complications: hypertension, heart failure, AVF or AVG (formation time, position, diameter) helps us monitor, detect, prevent and treatment of complications to limit the risk of death in patients with dialysis. Objective: Relationship between cardiovascular diseases and anatomosis of arteriovenous fistular in patients with regularly hemodialysis at Cho Ray Hospital. Methods: A cross-sectional study was conducted at Cho Ray Hospital from 2015 to 2016. The survey some cardiovascular diseases are done by clinical examination, tests for diagnostic imaging such as X-ray, electrocardiogram and echocardiogram: heart and diameter of anastomosis AVF, AVG. Results: The study population included 303 patients with chronic renal failure who were dialysis. Of which, patients aged 25-45 accounted for the highest proportion (43.9%). The proportion of male and female patients was similar (48.5% and 51.5% respectively). The mean value of systolic blood pressure on patients made AVF, AVG less than 12 months is higher than patients made AVF, AVG over 12 months, and there is negative correlation (r = -0.43) between AVF, AVG and systolic blood pressure (p <0.05). The mean value of diastolic blood pressure on patients made AVF, AVG less than 12 months is lower than patients made AVF, AVG over 12 months, and and there is positive correlation (r = -0.43) between AVF, AVG and diastolic blood pressure (p <0.05) (p <0.05). The prevalence of patients with heart failure made AVF, AVG over 12 months is higher than that of the under 12 months group, there is a negative correlation (r = - 0.43) between AVF, AVG diameter and EF index (p <0.05). Conclusion: It is important to note the diameter of anastomosis AVF, AVG in patients with chronic renal failure dialysis to limit cardiovascular complications, especially heart failure. Key words: Chronic kidney disease, hemodialysis.


2017 ◽  
Vol 68 (6) ◽  
pp. 1325-1328
Author(s):  
Andrada Raluca Doscas ◽  
Mihail Balan ◽  
Mihai Liviu Ciofu ◽  
Doriana Agop Forna ◽  
Marius Cristian Martu ◽  
...  

Chronic kidney disease (CKD) is a multifactorial syndrome and a global health concern. As renal function declines, there is a progressive deterioration of mineral homeostasis. Starting from stage 3 of CKD oral manifestations of mineral disorders can occasionally appear and become more frequent and evident in stage 5. We retrospectively analysed 43 patients diagnosed with end stage renal failure undergoing dialysis, hospitalized in our clinic for different oral and maxillofacial pathologies. The mean dialysis period was 5.43 years. Radiographic alterations afecting the jaws were found in all patients. The most common feature was partial or total loss of lamina dura, followed by alterations of the bony trabeculae. 9 patients presented brown tumors which are considered the final stage of secondary hyperparathyroidism associated with renal failure.


Author(s):  
Elżbieta Kimak ◽  
Andrzej Książek ◽  
Janusz Solski

AbstractStudies were carried out in 183 non-dialyzed, 123 hemodialysis, 81 continuous ambulatory peritoneal dialysis and 35 post-transplant patients and in 103 healthy subjects as a reference group. Lipids and apolipoprotein (apo)AI and apoB were determined using Roche kits. An anti-apoB antibody was used to separate apoB-containing apoCIII and apoE-triglyceride-rich lipoprotein (TRL) in the non-high-density lipoprotein (non-HDL) fraction from apoCIIInonB and apoEnonB in the HDL fraction in four groups of patients with chronic renal failure (CRF) and healthy subjects. Multivariate linear regression analysis was used to investigate the relationship between triglyceride (TG) or HDL-cholesterol (HDL-C) concentrations and lipoproteins. Dyslipidemia varied according to the degree of renal insufficiency, the type of dialysis and therapy regime in CRF patients. Lipoprotein disturbances were manifested by increased TG, non-HDL-C and TRL concentrations, and decreased HDL-C and apoAI concentrations, whereas post-renal transplant patients showed normalization of lipid and lipoprotein profiles, except for TG levels and total apoCIII and apoCIIInonB. The present study indicates that CRF patients have disturbed lipoprotein composition, and that hypertriglyceridemia and low HDL-C concentrations in these patients are multifactorial, being secondary to disturbed lipoproteins. The method using anti-apoB antibodies to separate apoB-containing lipoproteins in the non-HDL fraction from non-apoB-containing lipoproteins in HDL can be used in the diagnosis and treatment of patients with progression of renal failure or atherosclerosis. The variability of TG and HDL-C concentrations depends on the variability of TRL and cholesterol-rich lipoprotein concentrations, but the decreases in TG and increases in HDL-C concentrations are caused by apoAI concentration variability. These relationships, however, need to be confirmed in further studies.


1994 ◽  
Vol 87 (3) ◽  
pp. 363-368 ◽  
Author(s):  
Aubrey Blumsohn ◽  
Brian Morris ◽  
Richard Eastell

1. Stable strontium (Sr) has been proposed as an alternative to calcium (Ca) isotopes for the measurement of intestinal Ca absorption. The aim of this study was to compare the time course and fractional absorption of Ca and Sr, when both are measured using dual-tracer techniques. 2. 45Ca and Sr absorption tests were carried out on consecutive days in patients with osteoporosis (n = 10) or chronic renal failure (n = 7). Both tests were repeated in four patients with chronic renal failure after treatment with calcitriol (1 μg daily for 10 days). 3. The time course of Ca absorption was determined using the 85Sr (intravenous)/45Ca (oral) dual-tracer technique, and the time course of Sr absorption using 85Sr (intravenous)/stable Sr (oral). Oral tracers were administered on consecutive days with a test meal containing 5.3 mmol of Ca and 2.5 mmol of either stable Sr or Ca carrier. The fractional absorption of 45Ca and Sr at 6 h (FA360) and the absorption rate as a function of time were calculated by deconvolution. 4. The mean FA360 for Sr (20.2%) was lower than the mean FA360 for 45Ca (37.8%, P < 0.001, paired t-test), but the time course of Sr absorption was similar to that of Ca. There was a significant correlation between the FA360 for 45Ca and Sr, although the relationship was improved by including a quadratic term (R2 = 0.89, P < 0.001, significance of quadratic term, P < 0.05). After 1,25-dihydroxyvitamin D treatment, the FA360 of stable Sr increased 4.29-fold, whereas the FA360 of 45Ca increased only 2.4-fold. 5. Although the fractional absorption of Sr determined by dual-tracer deconvolution was the best predictor of FA360 for 45Ca, little was lost by confining the analysis to a single serum Sr measurement taken 3 h or more after oral administration. 6. We conclude that Sr absorption is qualitatively similar to that of Ca, although absorption of Sr is much lower than that of Ca. Furthermore, the relationship does not appear to be linear. Stable Sr may be useful in place of Ca isotopes in the routine clinical evaluation of Ca absorption.


1990 ◽  
Vol 5 (2) ◽  
pp. 85-88 ◽  
Author(s):  
X. Filella ◽  
A. Cases ◽  
R. Molina ◽  
J. Jo ◽  
J.L. Bedini ◽  
...  

In order to evaluate the specificity of tumor markers in chronic renal failure, we have determined serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen 19.9 (CA 19.9), carbohydrate antigen 50 (CA 50), alfafetoprotein (AFP), neuron-specific enolase (NSE), prostatic acid phosphatase (PAP), prostatic specific antigen (PSA), squamous cell carcinoma antigen (SCC), carbohydrate antigen 15.3 (CA 15.3) and carbohydrate antigen 125 (CA 125) in 30 patients with cronic renal failure and in 36 hemodialyzed patients without clinical evidence of neoplasia. CEA, CA 50, NSE and SCC frequently show increased serum levels, suggesting a renal metabolism, while others remain, generally, within the normal levels.


1980 ◽  
Vol 26 (5) ◽  
pp. 562-567 ◽  
Author(s):  
R Bouillon ◽  
P De Moor ◽  
E G Baggiolini ◽  
M R Uskokovic

Abstract We describe a radioimmunoassay for 1,25-dihydroxycholecalciferol in human serum. We raised antisera in rabbits to 1,25-dihydroxycholecalciferol-3-hemisuccinate coupled to bovine serum albumin, and obtained sensitive, high-titer antibodies. These antibodies had a high affinity for 1,25-dihydroxycholecalciferol and cross reacted mainly with 25-hydroxycholecalciferol and 24,25-dihydroxycholecalciferol. Addition of 1 mL of normal rabbit serum per liter reduced this interference to 5 and 4%, respectively. However, these interfering steroids are present in large excess, so extensive purification of 1,25-dihydroxycholecalciferol from serum is necessary. The steroid was extracted with ethyl acetate/cyclohexane, purified on Sephadex LH-20, and then chromatographed on a column of silicic acid. The radioimmunoassay is sensitive to 5 pg/tube (3 ng/L of serum). The between-assay CV was 14%. The mean concentration of 1,25-dihydroxycholecalciferol in the serum of 54 healthy adults was 38 (SD 12) ng/L, with no sex-related difference. The assay was further validated by the finding of low or undetectable concentrations in patients with chronic renal failure and of increased concentrations in the serum of patients with primary hyperparathyroidism. In comparison with previously described methods, the major advantage of the present assay is the use of stable gamma-globulins, which are available in large amounts, as binding protein.


1986 ◽  
Vol 6 (3) ◽  
pp. 130-135 ◽  
Author(s):  
Kostas Sombolos ◽  
Peter McNamee ◽  
Ahmed Mitwalli ◽  
Sol Rabinovich ◽  
Dimitrios G. Oreopoulos

From October 1977 to October 1985, our pathology department did autopsies on 19 patients (14 men, five women) treated by CAPD for four to 55 (mean 29.3) months. Their mean age was 60.2 (range 28–79) years and the primary renal diseases were diabetes mellitus (eight), nephrosclerosis (five), polycystic kidneys (three), chronic glomerulonephritis (one) and chronic renal failure associated with sarcoidosis and congestive cardiomyopathy in two. During the same period, the authors selected as controls 18 autopsied patients (14 men, four women), who had not had chronic renal failure, and these were matched with the CAPD patients for age, sex, longstanding hypertension and insulin-dependent diabetes. Direct causes of death for CAPD patients were cardiovascular incidents (12) infection (5), pancreatitis (1) and lung cancer (1); in controls, the causes were cardiovascular in 11 and infection in two. Thirteen of the CAPD and 12 autopsied controls had coronary artery stenosis equal to or greater than 70%, and affecting one or more arteries. The mean weight of organs in CAPD patients and controls were similar except for kidneys and the spleen; we found the latter weighed more in those on CAPD (p = 0.002). In CAPD patients the most important organ changes were: evidence of myocardial infarction, old or acute, in nine, acquired cystic disease of the kidney in five, and thickening and adhesions of peritoneum in nine and five respectively.


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