Plasma lipids and plasma apolipoproteins in nephrotic patients

Ten euthyroid, non diabetic, non uremic nephrotic patients with normal liverandninenormalcontrols were investigated for serum apolipoproteins and serum lipid pattern. Age of both groups did not differ significantly.Nephrotic patients had a significantly higher total serum lipids [P<0.01], serum triglycerides [P<0.05] and serum cholesterol [P<0.01] than normal controls HDL cholesterol of patients did not differ significantly from controls [patients 65.95+ and - 36.3, controls61.5+ and - 29.4 mg/dl] VLDL cholesterol of patients was significantly [P<0.05] lower than controls [patients 150.4+ and - 173.1, controls20.2+ and - 9.3 mg/dk].LDL cholesterol of patients was significantly higher [P< 0.01] than controls [patients 329.2 + and - 192.9, control 109.2+ and - 26.2 mg/dl]. Patients apolipoprotein A ranged between 19.2 - 197.6 mg/dl [with a mean of 97 + and - 52.5 mg.dl] which was significantly lower than controls [which ranged between 117.6-248 mg/dl with a mean of 176.4+ and - 52.8 mg /dl].Apolipoprotein B of nephrotic patients ranged between 102-124.6 mg.dl [with a mean of 112.2+ and -6.68 mg/dl] which was significantly higher [P<0.001] than that of controls [which ranged between 8-94.2 mg/dl with a mean of 58.5+ and - 26.3 mg/dl]. So nephrotic patients have a lower level of Apo. A and a higher level of Apo.B. Low Apo.A may be due to increased production with no loss urine with HDL. The high Apo. B may be due to increased production with no loss in urine. Hence Nephrotic patients are at high risk of atherosclerosis because of increase Apo.B and low Apo.A

Serum reverse triiodothyronine in nephrotic patients

This work included fifteen nephrotic patients [eight females and seven males] in addition to ten healthy control subjects [six females and four males]. Patients and controls were subjected to the following investigations; serum thyroxine, triiodothyronine, thyroxine binding globulin, thyroid stimulating hormone and reverse triiodothyronine. The results showed that patients with nephrotic syndrome had low mean total serum thyroxine T4[5.99 +/- 0.41 Ugm/dl] and thyroxine binding globulin TBC levels [23.1 +/- 0.38 Ugm/dl]. The mean serum reverse triiodothyronine levels were within normal, while T3/T4 ratio was higher in nephrotic patients than the control subjects. Patients with nephrotic syndrome and ascites had a lower TBG than nephrotic patients with no ascites. Patients with nephrotic syndrome with serum creatinine levels more than 2 mg/dl had a significantly higher rT3 than nephrotic patients with normal kidney functions

effect of bicarbonate dialysis on lactate/ pyruvate ration after minimal exercise in regular dialysis patients

Muscle handling of lactate is known to be impaired in regular dialysis treatment [RDT] patients on acetate hemodialysis [AHD].This study was undertaken to evaluate the late after effect of bicarbonate hemodialysis [BHD] on lactate/pyruvate [L/P] ratio as an indicator of anaerobic muscle metabolism following minimal exercise. It included five normal volunteers and eight patients on RDT.The latter was first tested on conventional AHD and again after ten sessions of BHD. Assessment was done three-four days after dialysis, just before the next session.All subjects were exercised by walking on a tread-mill at 0 grade, 5 km/hr for 10 min. BCN, serum creatinine, Ca, Kand blood lactate and pyruvate were determined before and immediately after exercise. Basal L/P ratio was more or less similar in the controls and uremic patients whether on AHD or BHD. L/P changes in the AHD group were highly significantly different from the controls immediately and 10 min post exercise. L/P changes in BHD did not differ from the controls and significantly differ from AHD immediately and 10 min post exercise. None of the parameters tested [BCN, serum creatinine, serum Ca and potassium] correlated with L/P ratio. It was concluded that BHD led to sustained correction of the disturbed aerobic muscle glycolysis seen in AHD