[show abstract][hide abstract] ABSTRACT: Nine patients with renal osteodystrophy were tested for 6.5 to 35 months with 1,25-dihydroxycholecalciferol (1,25-DHCC). A close biochemical follow-up was performed during the first 6 months of treatment, including biweekly determinations of serum calcium, phosphorus, magnesium, alkaline phosphatase and creatinine levels. A bone biopsy, radiologic investigations and determinations of plasma levels of immunoreactive parathyroid hormone (IPTH) and intestinal absorption of calcium 47 were performed before and after the 6 months. Although the five patients with osteitis fibrosa showed a significant improvement, the four with predominantly osteomalacic lesions showed no response to treatment. These four had a normal initial plasma iPTH level, higher serum calcium levels than the other five patients, extreme sensitivity to 1,25-DHCC, with frequent episodes of hypercalcemia, and only a slightly increased serum alkaline phosphatase level, which remained unchanged during treatment. All but one of the patients, irrespective of the histologic abnormality, showed a decrease in the uptake of radionuclide by bone after treatment. The renal function of one patient, a man with long-standing stable renal failure who had not undergone dialysis, deteriorated during treatment.
Canadian Medical Association journal 04/1981; 124(5):577-83. · 7.27 Impact Factor
[show abstract][hide abstract] ABSTRACT: Dialysate effluent protein content was measured in 22 patients undergoing continuous ambulatory peritoneal dialysis (9 with and 13 without previous peritonitis). The average amount of protein in those patients without peritonitis was 1.3 g/2 liters exchanged over a 6-hour period, while that of patients with previous peritonitis was 2.6 g/2 liters exchanged over the same period. 71% of protein found in the dialysate of 2 patients was albumin. Despite the difference in the amount of protein lost between those without and those with peritonitis, there was no significant difference in their mean serum albumin levels (3.2 and 3.4 g%, respectively) which were only slightly below the normal range. The previously reported high protein losses in patients undergoing CAPD are probably the result of frequent episodes of peritonitis and a higher number (five) of daily exchanges.
[show abstract][hide abstract] ABSTRACT: Quantitative microradioscopic methods were used for separate assessment of endosteal, intracortical and periosteal bone resorption and formation in hand bones of eight patients suffering from renal osteodystrophy before and during treatment with 1,25-dihydroxyvitamin D3 (1,25-D) for periods of 6 to 14 months. It was found that endosteal resorption rate, which before treatment was higher than that known to occur in involutional osteoporosis, was not influenced by 1,25-D treatment, whereas phalangeal periosteal and metacarpal intracortical resorption spaces decreased significantly during the treatment period. Measurements of periosteal resorptive surface lengths correlated well with plasma parathyroid hormone concentrations and with histologic grading of osteitis fibrosa. The overall results confirm the findings of several authors that 1,25-D is highly effective in most cases for treatment of skeletal manifestations of hyperparathyroidism in renal osteodystrophy.RésuméLa résorption et la formation osseuses endostées, intracortical es et périostées ont été évaluées séparément par des méthodes microredioscopiques quantitatives sur les os de la main chez 8 malades atteints d'ostéodystrophie rénale, avant et après traitement pendant 6 à 14 mois par la 1,25 dihydroxyvitamine D3 (1,25 D). II a été observé quo le taux de résorption endostée, qui était plus haut avant traitement quo dans l'ostéoporose sénile, n'est pas influencé par (e traitement au 1,25 D, par contre, la résorption périostée des phalanges et la résorption intracorticale du métacarpien ont diminué sigrtiflcativement au cours du traitement Les mesures de la longueur de la surface périostée on rśorption sont bien corrélées avec la concentration plasmatique de PTH et over l'évaluation histologique de l'ostéite fibreuse. Ces résultats confirment les observations d'autres auteurs montrant que le 1,25 D est très afficace dans la plupart des cas pour le traitement des manifestations squelettiques de l'hyperparathyroïdisme dans l'ostéodystrophie rénale.
Metabolic Bone Disease and Related Research 01/1980; 2(4):223-231.
[show abstract][hide abstract] ABSTRACT: The authors have studied the distribution and total volumes of large and small crystals in the urine of healthy individuals and of those who form stones. Studies carried out on randomly obtained specimens were as reliable in identifying differences as were fasting specimens. Stone forming individuals had a greater number of large crystals and a greater total volume of crystals in the urine than had healthy persons. The urine of stone forming patients who had received treatment showed no difference in crystal volume from that of a similar group who had not been treated, and the same was true of a group of stone forming patients studied before and 6 months after the start of treatment.
Canadian journal of surgery. Journal canadien de chirurgie 12/1979; 22(6):527-9. · 1.63 Impact Factor