[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.
Full-text · Article · Apr 1981 · Canadian Medical Association journal
[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.
No preview · Article · Jan 1980 · Metabolic Bone Disease and Related Research
[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.
No preview · Article · Dec 1979 · Canadian journal of surgery. Journal canadien de chirurgie
[Show abstract][Hide abstract] ABSTRACT: The results of CAPD to date are very encouraging. 66 patients had excellent biochemical control, and more impressively, the biochemical values do not fluctuate. The mean serum protein and albumin levels remain close to the normal range, which supports our observation that daily protein losses are not as high as those Popovich, et al described in his original paper. Because of the excellent biochemical control, no dietary restrictions (fluid, potassium and sodium) are necessary, and the patient is required only to restrict phosphorus intake. The most serious of the various complications of CAPD seem to be hypotension, hypertriglyceridemia and back pain. The most serious problem encountered in patients on continuous ambulatory peritoneal dialysis is still peritonitis.
No preview · Article · Feb 1979 · Transactions - American Society for Artificial Internal Organs