Effect of age on markers of bone metabolism in renal hemodialysis patients

Bone metabolic markers were investigated in the male hemodialysis patients within and over 60 years old and the female hemodialysis patients within and over 50 years old. Our results indicated that bone metabolic markers were more increased in the lower values of serum estradiol in the male patients, but inversely were more enhanced in higher values of serum estradiol in the female patients.     

The measurement of parathyroid hormone in sera of hemodialysis patients with renal insufficiency by employing the various kinds of parathyroid hormone kits

This study focussed on elucidating difference of blood PTH levels, by employing the various kinds of PTH kits. We carried out the measurements of PTH levels in sera of the hemodialysis patients with renal insufficiency presumably inactivated PTH degradative regulation in kidney. Our results showed the remarkable significant relationships among blood PTH levels of carboxyl and mid-region PTH and intact PTH in hemodialysis patients and was deduced that the difference of PTH levels by using various kinds of PTH kits was responsible of PTH cleavage effect in the kidney.     

The relation of various metabolic bone markers in renal hemodialysis patients classified by serum estradiol levels

The bone metabolic markers showed the significant differences in age and sex of the hemodialysis patients with renal insufficiency. It is likely that the evaluations of bone change and biochemical metabolic markers should be based on serum estradiol level, sex and age of the renal hemodialysis patients.     

Determination of total arsenic in serum and packed cellsof patients with renal insufficiency

In order to investigate the arsenic level in serum and packed cells of patients with renal insufficiency, total arsenic (As) concentrations were determined with hydride generation atomic absorption spectrometry (HGAAS) in serum (S) and packed cells (PC) of 31 non-dialyzed patients. The accuracy of the method was tested by the analysis of arsenic in 3 certified reference materials. Patients showed a three-fold increase of arsenic concentrations in serum and a two-fold increase of arsenic in packed cells compared with controls. Patients (n=10) with higher serum creatinine (>2.0 mg/dL), urea (>0.70 g/L) and urinary protein (mean ±SD: 1.12±0.82 g/L) showed higher arsenic concentrations (5.8±3.3 g/L in serum and 18.0±16.7 g/kg in packed cells) compared with those with lower creatinine (<1.6 mg/dL), urea (<0.6 g/L) and urinary protein (mean ±SD: 0.27±0.82 g/L) (n=16, serum arsenic 1.2±1.2 g/L, packed cells arsenic 2.6±1.9 g/kg). The significant differences (both p<0.001) in S and PC-arsenic levels of patients in group I and II implies a relationship between the arsenic level and the degree of chronic renal insufficiency.Dedicated to Professor Dr. Peter Brätter on the occasion of his 60th birthday     

Determination of total arsenic in serum and packed cellsof patients with renal insufficiency

In order to investigate the arsenic level in serum and packed cells of patients with renal insufficiency, total arsenic (As) concentrations were determined with hydride generation atomic absorption spectrometry (HGAAS) in serum (S) and packed cells (PC) of 31 non-dialyzed patients. The accuracy of the method was tested by the analysis of arsenic in 3 certified reference materials. Patients showed a three-fold increase of arsenic concentrations in serum and a two-fold increase of arsenic in packed cells compared with controls. Patients (n=10) with higher serum creatinine (>2.0 mg/dL), urea (>0.70 g/L) and urinary protein (mean+/-SD: 1.12+/-0.82 g/L) showed higher arsenic concentrations (5.8+/-3.3 microg/L in serum and 18.0+/-16.7 microg/kg in packed cells) compared with those with lower creatinine (<1.6 mg/dL), urea (<0.6 g/L) and urinary protein (mean+/-SD: 0.27+/-0.82 g/L) (n=16, serum arsenic 1.2+/-1.2 microg/L, packed cells arsenic 2.6+/-1.9 microg/kg). The significant differences (both p < 0.001) in S and PC-arsenic levels of patients in group I and II implies a relationship between the arsenic level and the degree of chronic renal insufficiency.     

Parathyroid hormone and bone mineral content in male and female patients receiving hemodialysis

Relative bone mineral content in the lumbar spine was measured by phantom B-MAs with the apparatus of computerized tomography in order to study the relationships between bone mineral content with age and parathyroid hormone in sera of randomized out- and in-patients and the hemodialysis patients. There exists a significant difference between male and female in the loss of bone mineral content of three groups.     

Significance of renal high uptake in bone marrow scintigraphy with 111In-chloride

The significance of high renal uptake found in patients with hematological disease who underwent bone marrow scintigraphy with 111In-chloride was investigated. In patients with a high renal uptake, the uptake in bone marrow was low, suggesting a reflection of erythropoietic activity. The reversal relationship, however, was not necessarily present. With regard to correlation with iron metabolism, significantly higher uptake of serum Fe and lower UIBC were found among those with high renal uptake, suggesting that the level of free trans ferrin in the serum is largely involved in the high uptake in the kidney.     

Trace elements in head hair of hemodialysis patients

Instrumental neutron activation analysis /INAA/ was applied to measure trace elements in head hair of 19 patients with impaired renal function /14 males and 5 females/ and of 40 normal individuals /20 males and 20 females/. It was the aim to use head hair as a possible indicator of total body trace elements status and to investigate whether significant changes occur as a result of chronic hemodialysis. The elemental concentrations of 20 elements /i.e. Na, Mg, Al, Cl, K, Ca, V, Mn, Fe, Co, Cu, Zn, As, Se, Br, Ag, Cd, Sb, I and Au/ are presented and compared with published data. The present study revealed that the hair of the dialysis patients contained about ten times more iodine than that of the control group. No significant differences were observed for the other elements measured, except for sodium and antimony.     

High-performance liquid chromatographic determination of naltrexone in plasma of hemodialysis patients

A simple, sensitive, selective and reliable reversed-phase high-performance liquid chromatographic (HPLC) method with UV detection is described for the determination of naltrexone in plasma samples. Naltrexone and the internal standard, naloxone, were isolated from plasma either with a liquid-liquid extraction method using ethyl acetate or with a solid-phase extraction method using Sep-Pack C18 cartridge before chromatography. The extracts were dried under a stream of nitrogen and the samples were reconstituted in the mobile phase, then 20 microL were injected on a Waters Symmetry C18 column (5 microm particle size, 4.6 x 150 mm). The mobile phase consisted of 0.06% triethylamine (pH 2.8)-acetonitrile (92:8, v/v) pumped at 1 mL/min. The peak-area ratio versus plasma concentration was linear over the range of 10-500 ng/mL and the detection limit was less than 8 ng/mL. Quantification was by ultra-violet detection at 204 nm. The present method was applied to the determination of the plasma concentration of naltrexone in dialyzed patients. Patients (n = 8) with severe generalized pruritus received 50 mg of naltrexone orally per day for 2 weeks. The variability in the therapeutic response in treated patients required plasma concentration investigations of this opioid antagonist.     

In vivo monitoring of skeletal aluminum burden in patients with renal failure

In vivo neutron activation analysis was used to examine the total body and partial body (hand) aluminum levels in patients with end-stage renal failure. Patients maintained on chronic hemodialysis had higher mean body burdens of aluminum than, did those clinically managed without dialysis. Approximately 70% of the patients examined indicated elevated levels of body or skeletal aluminum. A significant correlation was observed between the in vivo aluminum/calcium ratio obtained for the hand measurement and the increase in serum aluminum levels following a disferroxamine infusion test. The direct in vivo monitoring of hand Al/Ca values in patients may provide an alternate choice to bone biopsy for the detection of aluminum intoxication.     

Clinical evaluation of osteocalcin in sera of the patients with neoplasms of bone

The clinical significance of osteocalcin in sera of bone tumors were measured in sera of various kinds of bone tumors. The levels of osteocalcin were higher in bone tumors than those in normal subjects. Serum osteocalcin levels in hypercalcemic groups of bone metastasis and myeloma showed a remarkable increase in a parallelism with serum ALP and LDH levels. These results suggested to be directly or indirectly activated on osteoblast by bone tumors and to be synthesized osteocalcin in osteoblast.     

Evaluation of Zn and Fe in diets of patients with chronic renal failure

Having in mind the importance of Fe and Zn content in the diets of nondialyzed patients with chronic renal failure, diets of 39 patients with ages varying from 18 to 79 years under a conservative treatment were analyzed by INAA. The 24-hour recall method was used for sample collection. The content of proximate composition was also determined. The average daily dietary intake was compared to the new recommended values by the Food and Nutrition Board. It was observed that the diets were deficient for these elements and, therefore, there should be a nutritional follow-up to avoid possible negative effects. This revised version was published online in August 2006 with corrections to the Cover Date.     

B cell-associated immune profiles in patients with end-stage renal disease (ESRD)

Most of the previous studies on immune dysregulation in end-stage renal disease (ESRD) have focused on T cell immunity. We investigated B cell subpopulations in ESRD patients and the effect of hemodialysis (HD) on B cell-associated immune profiles in these patients. Forty-four ESRD [maintenance HD patients (n = 27) and pre-dialysis patients (n = 17)] and 27 healthy volunteers were included in this study. We determined the percentage of B cell subtypes, such as mature and immature B cells, memory B cells, and interleukin (IL)-10+ cells, as well as B cell-producing cytokines (IL-10, IL-4 and IL-21) by florescent activated cell sorting (FACS). B cell-associated gene expression was examined using real-time PCR and B cell producing cytokines (IL-10, IL-4 and IL-21) were determined using an enzyme- linked immunosorbent assay (ELISA). The percentage of total B cells and mature B cells did not differ significantly among the three groups. The percentages of memory B cells were significantly higher in the pre-dialysis group than in the HD group (P < 0.01), but the percentage of immature B cells was significantly lower in the pre-dialysis group than in the other groups. The percentages of IL-10-expressing cells that were CD19+ or immature B cells did not differ significantly (P > 0.05) between the two subgroups within the ESRD group, but the serum IL-10 concentration was significantly lower in the pre-dialysis group (P < 0.01). The results of this study demonstrate significantly altered B cell-associated immunity. Specifically, an imbalance of immature and memory B cells in ESRD patients was observed, with this finding predominating in pre-dialysis patients.