Polymorphism of the ACE Gene in Dialysis Patients: Overexpression of DD Genotype in Type 2 Diabetic End-Stage Renal Failure Patients

Abstract Background: Little is known about trace metal alterations in the bones of dialysis patients or whether particular types of renal osteodystrophy are associated with either increased or decreased skeletal concentrations of trace elements. Because these patients are at risk for alterations of trace elements as well as for morbidity from skeletal disorders, we measured trace elements in bone of patients with end-stage renal disease. Methods: We analyzed bone biopsies of 100 end-stage renal failure patients enrolled in a hemodialysis program. The trace metal contents of bone biopsies with histological features of either osteomalacia, adynamic bone disease, mixed lesion, normal histology, or hyperparathyroidism were compared with each other and with the trace metal contents of bone of subjects with normal renal function. Trace metals were measured by atomic absorption spectrometry. Results: The concentrations of aluminum, chromium, and cadmium were increased in bone of end-stage renal failure patients. Comparing the trace metal/calcium ratio, significantly higher values were found for the bone chromium/calcium, aluminum/calcium, zinc/calcium, magnesium/calcium, and strontium/calcium ratios. Among types of renal osteodystrophy, increased bone aluminum, lead, and strontium concentrations and strontium/calcium and aluminum/calcium ratios were found in dialysis patients with osteomalacia vs the other types of renal osteodystrophy considered as one group. Moreover, the concentrations of several trace elements in bone were significantly correlated with each other. Bone aluminum was correlated with the time on dialysis, whereas bone iron, aluminum, magnesium, and strontium tended to be associated with patient age. Bone trace metal concentrations did not depend on vitamin D intake nor on the patients’ gender. Conclusions: The concentration of several trace elements in bone of end-stage renal failure patients is disturbed, and some of the trace metals under study might share pathways of absorption, distribution, and accumulation. The clinical significance of the increased/decreased concentrations of several trace elements other than aluminum in bone of dialysis patients deserves further investigation.

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Faculty Opinions recommendation of The effect of angiotensin II receptor blockade on an end-stage renal failure model of type 2 diabetes.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1079756.532670 ◽

2007 ◽

Author(s):

Matthew Breyer

Keyword(s):

Type 2 Diabetes ◽

Renal Failure ◽

Angiotensin Ii ◽

Receptor Blockade ◽

Failure Model ◽

Angiotensin Ii Receptor ◽

End Stage Renal Failure ◽

Angiotensin Ii Receptor Blockade ◽

End Stage

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End-Stage Renal Failure in Primary Hyperoxaluria Type 2

New England Journal of Medicine ◽

10.1056/nejm199406093302318 ◽

1994 ◽

Vol 330 (23) ◽

pp. 1690-1690 ◽

Cited By ~ 21

Author(s):

Martino Marangella ◽

Michele Petrarulo ◽

Domenico Cosseddu

Keyword(s):

Renal Failure ◽

Primary Hyperoxaluria ◽

End Stage Renal Failure ◽

Primary Hyperoxaluria Type ◽

End Stage ◽

Hyperoxaluria Type

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The effect of different methods of storage on the results of serum total CO2 assays

Clinical Science ◽

10.1042/cs1000609 ◽

2001 ◽

Vol 100 (6) ◽

pp. 609-611 ◽

Cited By ~ 3

Author(s):

Matthew L. P. HOWSE ◽

Maureen LEONARD ◽

Michael VENNING ◽

Laurence SOLOMAN

Keyword(s):

Renal Failure ◽

Metabolic Acidosis ◽

Room Temperature ◽

Dialysis Patients ◽

End Stage Renal Failure ◽

Clinically Significant ◽

End Stage

Metabolic acidosis frequently complicates end-stage renal failure. In haemodialysis patients its severity is usually monitored by measurement of the total CO2 (TCO2) level. Samples from ‘satellite dialysis’ patients are often stored prior to analysis. We investigated the affect of storage of 21 samples for 24 h under different conditions prior to analysis. If samples were stored at room temperature the TCO2 fell from 22.7±4.2 mmol/l to 21.6±3.7 mmol/l (P = 0.001). If the same samples were spun and stored at 4 °C the TCO2 was 22.4±3.9 mmol/l (P = not significant). We conclude that the magnitude in the fall of TCO2 stored at room temperature for 24 h is unlikely to be clinically significant and can be prevented by spinning the sample and refrigerating it.

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