90 research outputs found
Supplementary_Figure_1_and_2 – Supplemental material for A Survey Study of Self-Rated Patients’ Knowledge About AKI in a Post-Discharge AKI Clinic
No full textSupplemental material, Supplementary_Figure_1_and_2 for A Survey Study of Self-Rated Patients’ Knowledge About AKI in a Post-Discharge AKI Clinic by Victor Ortiz-Soriano, Joseph L. Alcorn, Xilong Li, Madona Elias, Taha Ayach, B. Peter Sawaya, Hartmut H. Malluche, Ron Wald, Samuel A. Silver and Javier A. Neyra in Canadian Journal of Kidney Health and Disease</p
Update on vitamin D and its newer analogues: Actions and rationale for treatment in chronic renal failure
No full textUpdate on vitamin D and its newer analogues: Actions and rationale for treatment in chronic renal failure. Vitamin D is an important hormone for mineral homeostasis and the proper formation and maintenance of bone. In addition, vitamin D has broader functions in the body that expand its traditionally known role in mineral balance. In chronic renal failure, calcitriol deficiency contributes to the development and progression of secondary hyperparathyroidism, bone disorders, and altered mineral metabolism. Recent revelations of the broader role of vitamin D also suggest calcitriol deficiency may contribute to decreased cardiac and immune function in chronic renal failure patients. Research on vitamin D has led to a more complete understanding of the actions of vitamin D at the transcriptional level and with respect to the clinical use of vitamin D and its analogs to control parathyroid hormone overactivity and to replace the other D hormone-dependent actions in patients with renal failure. Limitations of vitamin D and its metabolites include hypercalcemia, hyperphosphatemia and suppression of bone turnover with the risk of adynamic bone disease. Vitamin D analogs may offer greater selectivity and potentially greater safety as compared to calcitriol because of their altered relative potency on calcium and phosphorus metabolism. This review focuses on the current understanding of the biological actions of vitamin D and its analogs and the rationale for treating patients with chronic renal failure
Stainable aluminum and not aluminum content reflects bone histology in dialyzed patients
No full textStainable aluminum and not aluminum content reflects bone histology in dialyzed patients. Quantitative evaluation of stainable bone aluminum and measurement of bone aluminum content were done in 55 patients on chronic maintenance dialysis. All patients underwent bone biopsies. Histomorphometry of static and dynamic parameters of bone structure, bone formation and resorption, and quantitation of stainable bone aluminum at the osteoid–bone interface were performed. In addition, bone aluminum content was measured by atomic absorption spectrophotometry. Bone aluminum content was elevated in all patients (81 ± 9.6 vs. 18 ± 6 µg/g dry wt) and stainable aluminum was found in 47% of them. All patients with predominant low–turnover osteomalacia or adynamic bone disease displayed stainable bone aluminum. In contrast, stainable bone aluminum was not present in individuals with predominant–hyperparathyroid bone disease. Patients with stainable aluminum had lower bone mass (P < 0.05), higher volume and surface of lamellar osteoid (P < 0.01), less volume and surface of woven osteoid (P < 0.05 and P < 0.01), lower osteoblastic and osteoclastic indices (P < 0.01), less doubly labelled osteoid seams, lower mineral apposition rate and lower bone formation rates (P < 0.05 to P < 0.01). Stainable aluminum correlated with volume of lamellar osteoid and cellular parameters of bone formation and resorption, mineral apposition rate, and bone formation rates (P < 0.05 to P < 0.001). In contrast, bone aluminum content correlated with volume of lamellar osteoid only (P < 0.001). These findings indicate that stainable aluminum at the mineralization front and not aluminum content of bone reflects the histopathologic changes found in bone of dialyzed patients
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