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Tartrate resistant acid phosphatase (TRAP) as an index of bone resorption in patients with chronic renal failure (CRF)
Abstracts from the Advances in Renal Osteodistrophy Symposium BECONDARY HYPEiwAHATEYHoIDIsMINExPERIMENl~ f&JVirgdix,P MenBndez. JB Dfaz. JB Cam&a. Bone and Mineral Research Unit. Hospital Central de Asturias. Oviedo. Espafia. The most widely used approach to induce renal failure is to reduce
renal mass, and amon all of the methods the S/6 nefrectomy model ir the easiest to make and the most widely used. However some aapecta of this modiel are unknow. Tbe aims of this paper were ta analyze the extent of renal failure+ the progression with time, to investigate the advantage of one surgery operation over two and finally to study the biochemical and histological change11 in the 5/6 nefrectomy model. Eighty-five male Wistar rata were separated into 3 groups: Group 1 (both left or right nephrmtomys were performed at the aame time), Group 2 (the right kidney nephrectomy was removed one week aRer thelefi), Group 3:withnormal renal function (control). We measured in serum: Ca, P, protein , creatinine and urea; in urine: Ca, P, and creatinine et the start and at different times after the surgery. We removed I/3 of the distal tibia in five uraemic rata and in the controls. (week@
0
4
ClCr
2,12i1,7
0,59*0,29
PTH
114*47
7
16
0.66tO.34
0,59f0,4
342*191
In the above table are the results with clearly shown evidence of chronic renal failure and secondary hyperparathyroidism in the rats. From histological we ,round a decrease in the bone volume. In addition osteoid and rc!sorption indices were increased in uraemic rats. This model decreased by Z/3 the renal function, with the average mortality rate at 20%. There were no differences in these parameters between group 1 or 2.
73 TARTRATE WANT ACID FHOSPHATASE (TRAF) AS AN INDEX OF BONE RESORPTION IN PATJENTS WlTH CHRONIC RENAL FAILURE (Cap) E. Gon*UaPPn,E.L6paGwilana,R.,‘C. delrPiedra.lR. hiosquera, B. Moop(, ‘A. Rqado, C. Caramdo. Servlcios de NaMogla y Vnidad M&lica, Fundacidn Jim&z Dfaz, Madrid. We have assessed TRAP activity as a serum marker of bone resorption us&l for patients with renal failure, beuuse of irs hqatic metabolism. We also have studied the course of TRAP levels In four patientrwkhseco&qhypeqar&yroklIsmtilowIngpMth idscmmy. m W+zxIiai3Opi&atswith 3 (Crc < 3OmWmiii). Six&nbeahbyi&iiualswaeused as acfmtro~proup. In all of than, senun TRAP, PTH (ll molecule) and alkaline phosphpve (AP) were measured. In the four patients with hypaparathyroidiim we recorded serum TRAP levels before, and 24 h, 4.8.15 and 30 days after parathyroidcctomy. ~:Paticnts witb!CRP hd:signiticantly.higha TRAP, AP aad PTH sexam concentrationsthan amrol group: TRAP: 9.20 f 7.64 vs 6.84 f 0.9 IUlL bCO.05); AP: 81.33 f 63.9 vs 66 f 14 UiL @
This degree of uraemia was accompanied by secondary hyperparathyroidism both in biochemical and histological levels.
EFFECTS OF lliE DECREASE OF ~GNESIUM (IX+) IN THE DIALYSED FLUID ON THE CON-TION BRYTHROCYTE MS, IPLASHATIC PARATIiOHORHONE WTIil AND BONYMATRIX. m Garcia. R Espinosa. H Opazo, G Silva Medicine. A Nef :Hospital. Faculty of et al. Chile. Universidad de Valparafso. It has been demonstrated that renal patients in chronic hemodialysis UID) have nom1 plasma levels of HG but high I% erythrocyts concentrations MGEC). Experimental studies have associated DEC with bone thus suggesting a concentrations of this catebn. pathogenic function of HG on renal osteodistrophy. A reduction in the FIG concentration of dialysed fluid from 0.5 to 0.25~ maol/L - was done, to study the variation of the concentrations of plasmatic lK (PHG) and its relations with PTH. calcium (Cal. phosphorus alkaline rhosphatase (AP) and bony matrix (PI * applied to 11 patjsnts under study. They undet%ent HD In this period. standard technique during 6 months. their biochemical parameters were controlled, a bone biopsy and a samp:le for PTli plasma level were taken. fluid to 0.25 Then. MG was reduced in the dialized ml/l for two months, repeating bone biopsy and P’llf. The biochemical parameters were, before and after the change of MG in ,the dialysed fluid: Ca: 9.1 t 0.6. 8.4 t 0.7 mg/dL [:p(O.OS): P: 6.0 i 1.4. 5.5 t 1.9 mg/dL INS). AP: 102 + 113. 122 t 167 U/L (NS); PTH: 2.3 f 0.8 ns/mL: l&EC: 2.4 k 0.6, 2.6 i 2.0 f 0.9, 0.3 mpol/L (p-0.08); PMG: 1.3 t 0.3, 0.9 f 0.2 amol/L Bony matrix analysis did not reveal any (p
DEFBROXAMI~ TEST: CAN DDSE BE REDUCED? Xn Lens, R Alonso, C Uartin. V Arcocha. B Correa. D Arza, C Alonso. D Novas, R Rornero.D Sanchez-Cuiasnde Hospital Xeral de Cslicia-Santiago de Ccnnpostela Deferoxsmine (DFO) test gives ua information about aluminum (Al)-related disease but it can be accompanied by serious side-effects. In order to study if lwer doses yield similar results ritb less side-effects, we have compared the Al mobilization and auditive toxicity (nomsl and highfrequency sudiameter) of standard (30 mg/ Xg) versus la-dose DFO test (10 m&Kg) administrated during the last 30 minutes of one dialysis session. Ye have studied 12 hemodialyzed patients (6 males). 56 +15 (ii+SD) years old with basal blood Al: 77% n&L. Post-DFO 10 administration, Al (rss169236, with a mean increment of 141k3 per cent over basal vsluee. three patients had hearing less till 25 db between 1000 and 15OW c/s frequencies. Post-DFO 30 sdrinistration. Al was 206k. with s mean increment of 21of-109per cent over basal values; five patients had auditive impairment till 45 db between 4OiXJand 15000 c/a frequencies. Sensivity ras 60% and specifity 43%. Positive and negative predictive values were 50% end 75%. respsctively. There was not lineal correlation betreen percentusl increments post-DFO 10 snd post-DFO 30 administration (r;O.D697). Low-dose deferoxsmine test is s useful method, virtuslly free from adverse effects, to study alminrrm - related disease. High-doses should be reserved only for patients with a positive la-dose defemxsmine test.
renal mass, and amon all of the methods the S/6 nefrectomy model ir the easiest to make and the most widely used. However some aapecta of this modiel are unknow. Tbe aims of this paper were ta analyze the extent of renal failure+ the progression with time, to investigate the advantage of one surgery operation over two and finally to study the biochemical and histological change11 in the 5/6 nefrectomy model. Eighty-five male Wistar rata were separated into 3 groups: Group 1 (both left or right nephrmtomys were performed at the aame time), Group 2 (the right kidney nephrectomy was removed one week aRer thelefi), Group 3:withnormal renal function (control). We measured in serum: Ca, P, protein , creatinine and urea; in urine: Ca, P, and creatinine et the start and at different times after the surgery. We removed I/3 of the distal tibia in five uraemic rata and in the controls. (week@
0
4
ClCr
2,12i1,7
0,59*0,29
PTH
114*47
7
16
0.66tO.34
0,59f0,4
342*191
In the above table are the results with clearly shown evidence of chronic renal failure and secondary hyperparathyroidism in the rats. From histological we ,round a decrease in the bone volume. In addition osteoid and rc!sorption indices were increased in uraemic rats. This model decreased by Z/3 the renal function, with the average mortality rate at 20%. There were no differences in these parameters between group 1 or 2.
73 TARTRATE WANT ACID FHOSPHATASE (TRAF) AS AN INDEX OF BONE RESORPTION IN PATJENTS WlTH CHRONIC RENAL FAILURE (Cap) E. Gon*UaPPn,E.L6paGwilana,R.,‘C. delrPiedra.lR. hiosquera, B. Moop(, ‘A. Rqado, C. Caramdo. Servlcios de NaMogla y Vnidad M&lica, Fundacidn Jim&z Dfaz, Madrid. We have assessed TRAP activity as a serum marker of bone resorption us&l for patients with renal failure, beuuse of irs hqatic metabolism. We also have studied the course of TRAP levels In four patientrwkhseco&qhypeqar&yroklIsmtilowIngpMth idscmmy. m W+zxIiai3Opi&atswith 3 (Crc < 3OmWmiii). Six&nbeahbyi&iiualswaeused as acfmtro~proup. In all of than, senun TRAP, PTH (ll molecule) and alkaline phosphpve (AP) were measured. In the four patients with hypaparathyroidiim we recorded serum TRAP levels before, and 24 h, 4.8.15 and 30 days after parathyroidcctomy. ~:Paticnts witb!CRP hd:signiticantly.higha TRAP, AP aad PTH sexam concentrationsthan amrol group: TRAP: 9.20 f 7.64 vs 6.84 f 0.9 IUlL bCO.05); AP: 81.33 f 63.9 vs 66 f 14 UiL @
This degree of uraemia was accompanied by secondary hyperparathyroidism both in biochemical and histological levels.
EFFECTS OF lliE DECREASE OF ~GNESIUM (IX+) IN THE DIALYSED FLUID ON THE CON-TION BRYTHROCYTE MS, IPLASHATIC PARATIiOHORHONE WTIil AND BONYMATRIX. m Garcia. R Espinosa. H Opazo, G Silva Medicine. A Nef :Hospital. Faculty of et al. Chile. Universidad de Valparafso. It has been demonstrated that renal patients in chronic hemodialysis UID) have nom1 plasma levels of HG but high I% erythrocyts concentrations MGEC). Experimental studies have associated DEC with bone thus suggesting a concentrations of this catebn. pathogenic function of HG on renal osteodistrophy. A reduction in the FIG concentration of dialysed fluid from 0.5 to 0.25~ maol/L - was done, to study the variation of the concentrations of plasmatic lK (PHG) and its relations with PTH. calcium (Cal. phosphorus alkaline rhosphatase (AP) and bony matrix (PI * applied to 11 patjsnts under study. They undet%ent HD In this period. standard technique during 6 months. their biochemical parameters were controlled, a bone biopsy and a samp:le for PTli plasma level were taken. fluid to 0.25 Then. MG was reduced in the dialized ml/l for two months, repeating bone biopsy and P’llf. The biochemical parameters were, before and after the change of MG in ,the dialysed fluid: Ca: 9.1 t 0.6. 8.4 t 0.7 mg/dL [:p(O.OS): P: 6.0 i 1.4. 5.5 t 1.9 mg/dL INS). AP: 102 + 113. 122 t 167 U/L (NS); PTH: 2.3 f 0.8 ns/mL: l&EC: 2.4 k 0.6, 2.6 i 2.0 f 0.9, 0.3 mpol/L (p-0.08); PMG: 1.3 t 0.3, 0.9 f 0.2 amol/L Bony matrix analysis did not reveal any (p
DEFBROXAMI~ TEST: CAN DDSE BE REDUCED? Xn Lens, R Alonso, C Uartin. V Arcocha. B Correa. D Arza, C Alonso. D Novas, R Rornero.D Sanchez-Cuiasnde Hospital Xeral de Cslicia-Santiago de Ccnnpostela Deferoxsmine (DFO) test gives ua information about aluminum (Al)-related disease but it can be accompanied by serious side-effects. In order to study if lwer doses yield similar results ritb less side-effects, we have compared the Al mobilization and auditive toxicity (nomsl and highfrequency sudiameter) of standard (30 mg/ Xg) versus la-dose DFO test (10 m&Kg) administrated during the last 30 minutes of one dialysis session. Ye have studied 12 hemodialyzed patients (6 males). 56 +15 (ii+SD) years old with basal blood Al: 77% n&L. Post-DFO 10 administration, Al (rss169236, with a mean increment of 141k3 per cent over basal vsluee. three patients had hearing less till 25 db between 1000 and 15OW c/s frequencies. Post-DFO 30 sdrinistration. Al was 206k. with s mean increment of 21of-109per cent over basal values; five patients had auditive impairment till 45 db between 4OiXJand 15000 c/a frequencies. Sensivity ras 60% and specifity 43%. Positive and negative predictive values were 50% end 75%. respsctively. There was not lineal correlation betreen percentusl increments post-DFO 10 snd post-DFO 30 administration (r;O.D697). Low-dose deferoxsmine test is s useful method, virtuslly free from adverse effects, to study alminrrm - related disease. High-doses should be reserved only for patients with a positive la-dose defemxsmine test.