ISSN:1660-8151    

DOI:10.1159/000180180

出版商:S. Karger AG    

年代:1973

数据来源: Karger

摘要:

This report reviews the various hormonal and non-hormonal factors involving the renal handling of calcium and magnesium and the effect of these factors on the relationship between the excretions of these divalent ions and that of sodium. Among the factors discussed are: (1) extracellular volume expansion, (2) renal vasodilatation, (3) changes in glomerular filtration rate, Parathyroid hormone (4) hypercalcemia and hypermagnesemia, (5) diuretics, (6) phosphate depletion and loading, (7) alterations in acid base balance, (8) diet, (9) fasting, (10) activity, (11) diurnal variation, and (12) various hormones including parathyroid hormone, calcitonin, vitamin D, growth hormone, thyroid hormone, and adrenal steroids.

ISSN:1660-8151    

DOI:10.1159/000180181

出版商:S. Karger AG    

年代:1973

数据来源: Karger

摘要:

Various aspects of calcium and bone metabolism were studied in 50 cases of chronic renal failure. It was found that elevation of plasma alkaline phosphatase was generally associated with reduced metacarpal cortical thickness and in a small number of biopsies reflected the osteomalacic rather than the resorptive component of renal bone disease. Patients with an elevated plasma alkaline phosphatase tended to have a lower plasma calcium, lower plasma bicarbonate and lower radiocalcium absorption than patients with a normal alkaline phosphatase. Hypocalcaemia was frequently associated with, and attributed by the authors to reduced tubular reabsorption of calcium, which in turn appeared to be related to the degree of metabolic acidosis. The authors conclude that metabolic acidosis predisposes to hypocalcaemia and, therefore, to renal osteomalacia.

ISSN:1660-8151    

DOI:10.1159/000180182

出版商:S. Karger AG    

年代:1973

数据来源: Karger

摘要:

Renal osteodystrophy is very rare in undialysed chronic renal failure in Israel, and common in Western Europe and North America. In a dietary survey it was found that there was a lower dietary phosphorus intake in Israel (942 ± 23.1 mg/ day) compared to a mean of 1,238 ± 65.0 mg/day in the UK in healthy subjects on their normal diet, whereas the daily intake of calcium was higher in Israel (1,071 ± 58.5 mg/day) compared to 887 ± 33.5 mg/day in the UK. In an investigation of non-dialysed chronic renal failure patients in Israel it was found that at all levels of renal failure in Israel plasma phosphate levels were lower than in a personal series from England and that plasma calcium levels were more frequently lower than in the UK or USA series. The plasma Ca × P product was below 70 in all cases in Israel. The data were interpreted as indicating that a lower P load in Israel resulting from a lower protein intake results in a lower plasma phosphate level at all levels of renal failure and so the development of hyperparathyroidism is delayed until a very late stage of renal failure. The results are compatible with the Bricker ‘trade-off’ hypothesis suggesting that a reduction of phosphorus intake daily in renal disease may prevent the development of renal osteod

ISSN:1660-8151    

DOI:10.1159/000180183

出版商:S. Karger AG    

年代:1973

数据来源: Karger

摘要:

This review has dealt with some aspects of the growing points in divalent ion metabolism in renal disease and its treatment. Further advances will only be made when the exact mechanisms of the uraemic toxic state and its action on the variety of cellular membrane and intracellular metabolic functions has been elucidated. The interaction of hormones and these toxins are beginning to be looked at in the isolated cellular systems and many clinical observations remain to be worked out at this level.

ISSN:1660-8151    

DOI:10.1159/000180184

出版商:S. Karger AG    

年代:1973

数据来源: Karger

摘要:

Gastrointestinal (GI) absorption of radiocalcium was measured by the application of a computerized deconvolution technique to data obtained by external arm counting. When compared to normals, hyperparathyroid subjects displayed an exaggerated rate of initial entry of calcium into the GI tract. Total tracer absorbed was also increased. A similar increase in the rate of initial entry of calcium and total calcium absorbed from the GI tract was found in a non-hyperparathyroid subject with distal tubular acidosis of the adult type. It is concluded that in addition to the abnormal function of renal tubular cells in the handling of hydrogen ion there may be in this case, and possibly in others with renal tubular acidosis, an abnormality in the handling of calcium by the GI cells.

ISSN:1660-8151    

DOI:10.1159/000180185

出版商:S. Karger AG    

年代:1973

数据来源: Karger

摘要:

Chronic renal failure in the rat was shown to be associated with parathyroid enlargement, a decreased ash content of the femoral shaft and elevated trabecular bone resorption. The diphosphonate, ethane-1 -hydroxy-1,1-diphosphonate was ineffectual in the dose used in altering the manifestation of hyperparathyroidism even though more of the compound was retained in the skeleton of the uremic animals than in the controls.

ISSN:1660-8151    

DOI:10.1159/000180186

出版商:S. Karger AG    

年代:1973

数据来源: Karger

摘要:

Some more controversial points in the interpretation of metabolic bone disease in end-stage renal failure are dealt with in this communication. The pattern of clinical signs changes with duration of dialysis and is strikingly different in dialysed children as compared with adults. Haemodialysed women bear children with apparently no skeletal disease. Animal experiments failed to show defective mineralisation in the fetal skeleton of the offsprings of uraemic pregnant rats, possibly pointing to a compensatory role of the fetal kidney in the metabolism of vitamin D. Some fallacies in the interpretation of X-ray signs in azotaemic patients are stressed: replacement of lamellar bone by woven bone and especially replacement of primary spongiosa underneath the growth plate by fibrous tissue (roentgenologically misinterpreted as rickets) are mentioned. The discrepant behaviour of cancellous vs. cortical bone is analysed.

ISSN:1660-8151    

DOI:10.1159/000180187

出版商:S. Karger AG    

年代:1973

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000180188

出版商:S. Karger AG    

年代:1973

数据来源: Karger