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Exogenous calcitonin protects against renal bone disease in rats with early renal failure.
No full textChronic renal failure was induced in four groups of male Sprague-Dawley rats by unilateral nephrectomy followed by removal of the outer poles and cautery of the remnant kidney. The four groups of animals received isocaloric diets with normal (groups 1 and 4) or low (groups 2 and 3) phosphate contents and variable amounts of calcium. In addition, rats in group 4 were given salmon calcitonin. After 90-160 days the 4 groups of rats had developed comparable levels of chronic renal failure. The serum phosphate values were significantly lower in rats on low phosphate intake than in those on normal phosphate diet. Bone histology was evaluated on tibiae, lumbar vertebrae and ribs. The rats kept on low phosphate diet (groups 2 and 3) had significantly lower frequency of osteomalacia and bone resorption than those fed a normal phosphate diet. Rats treated with calcitonin (group 4) had the lowest frequency of osteomalacia and virtually no association with bone resorption, despite normal phosphate intake. The serum levels of parathyroid hormone were not significantly different in rats in groups 1 and 4 as compared to controls. Serum 1,25-dihydroxycholecalciferol levels were significantly lower in group 1 than in controls and were significantly higher in group 4 than in group 1. These data show that calcitonin effectively prevents bone lesions in rats with early chronic renal failure
Efficacy of captopril in hypertensive diabetic patients.
No full textTwenty hypertensive diabetic patients (10 with type I and 10 with type II) were treated with captopril, 50 mg twice a day, for three months. The drug was effective as monotherapy in 16 patients. An additional nine months of follow-up was obtained in 12 of these patients (four with type I and eight with type II) who did not need the addition of diuretics to achieve normal blood pressure. For these patients with long-term treatment, since there was no substantial difference between those with type I and those with type II, the data were pooled. Mean arterial pressure significantly decreased shortly after treatment was begun and the reduction was maintained. No significant change was induced by captopril in urine volume, osmolar clearance, and serum and urinary values of sodium, chloride, calcium, and magnesium, whereas significant reduction was found in fractional excretion of potassium and phosphate. The baseline levels of proteinuria were only slightly elevated, yet they fell in all patients during treatment. All patients maintained satisfactory control of carbohydrate metabolism, and none of them required substantial changes in hypoglycemic treatment. The administration of captopril as monotherapy appears to be an effective and safe way of lowering blood pressure in diabetic hypertensive patients, even in the long term, without effects on renal function and in carbohydrate metabolism
Hypercalciuria is a common and important finding in postmenopausal women with osteoporosis.
No full textLongitudinal study on osteodystrophy in primary biliary cirrhosis (PBC) and a pilot study on calcitonin treatment.
No full textThe aims of this study were to evaluate bone metabolism in primary biliary cirrhosis (PBC) and the effect of ADFR (activate, depress, free, repeat) therapy with vitamin D, calcium and calcitonin in preventing bone resorption. Sixty-nine female subjects entered the study: 38 PBC (AMA + ve) patients, 11 AMA-negative chronic liver disease patients and 20 age-matched healthy controls. Bone metabolism was evaluated by biochemical parameters and dual-photon absorptiometry of the lumbar spine at time 0, 6 and 18 months. Both PBC and chronic liver disease (CLD) patients showed low levels of serum 25-hydroxyvitamin D, osteocalcin and bone mineral content expressed as AAD (average area density) compared to healthy controls. Serum parathyroid hormone in PBC patients was at the lower limit of the normal range and was significantly lower than patients with chronic liver disease. At a 6-month interval, AAD significantly decreased in PBC patients (p less than 0.005). At the 6-month period PBC patients were allocated into two groups according to a cut-off AAD of 0.800 g/cm2: group A (no treatment, AAD greater than 0.800, n = 11), group B (treatment, AAD less than 0.800, n = 13). The latter group received a 4-week course with oral calcium carbonate (1500 mg daily) + oral 1,25-dihydroxyvitamin D (0.5 micrograms twice a day for 5 days) + carbocalcitonin (40 U MRC) i.m. thrice a week. The treatment was repeated with the same protocol at 2-month intervals for 12 months
Hypercalciuria is a common and important finding in postmenopausal women with osteoporosis
No full textOsteoporosis associated with idiopathic hypercalciuria: a peculiar form of metabolic osteopathy.
No full textFrequenza ed importanza dell'ipercalciuria idiopatica nelle donne in menopausa con ridotta massa ossea.
No full textHyperparathyroidism: cause or consequence of recurrent calcium nephrolithiasis?
No full textPrimary hyperparathyroidism (PHP) might be characterized by either prevailing bone or renal stone patterns with different metabolic features. To explore the possibility of different hormonal patterns we studied 129 patients with PHP: 95 stone formers (SF) and 34 nonstone formers (NSF). Females prevailed over males in both groups. Severe and specific bone lesions were more evident in NSF than SF. Parathyroid gland histology displayed a prevalence of adenoma in NSF, whereas isolated hyperplasia prevailed in SF. SF had lower levels of serum Ca, urinary Ca, ALP and serum PTH than NSF. As expected serum 1,25-dihydroxyvitamin D [1,25(OH)2 D] levels were greater in both groups of patients than in controls but we found no difference between the two groups. 25-Hydroxyvitamin D was neither increased with respect to controls nor different between groups. We conclude that patients with PHP may represent well separated metabolic and clinical entities, but we cannot confirm that serum 1,25(OH)2D levels play a key role in discriminating the different clinical features. In addition, the findings of predominant parathyroid hyperplasia in SF and the clinical evidence of recurrent hyperparathyroidism only in these patients suggest the possibility that the endocrine disorder might be the consequence over time rather than the cause of nephrolithiasis
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