On the disturbances in carbohydrate metabolism in pre-dialysis patients with chronic renal failure.

UNLABELLED: We describe some of the aspects of impaired carbohydrate metabolism in predialysis uremic patients. METHODS: A total of seventy-five nondiabetic patients with chronic renal failure (CRF) were enrolled in the present study. The level of glycosylated hemoglobin was measured in 51 patients using kits from Merck and an oral glucose challenge test was performed in 20 according to a standard protocol. The levels of immunoreactive insulin and growth hormone (GH) were measured in all predialysis patients using original kits and an automatic minigamma counter (Abbott, USA). The results were compared with those from 30 healthy controls. RESULTS: In patients with first degree CRF the level of glycosylated hemoglobin was 5.9 +/- 05%. In patients with second and third degree CRF there was a trend towards higher glycosylated hemoglobin levels--6.3 +/- 0.6% (P > 0.05; u = 1.1) as compared with the controls--5.5 +/- 0.4%. The analysis of the results from the oral glucose challenge test revealed impaired glucose tolerance in 12 predialysis patients with CRF with blood glucose levels of 9.1 +/- 1.6 mmol/l at the second hour following the ingestion of glucose. Nine of those had second or third degree CRF. The baseline levels of plasma immunoreactive insulin showed a tendency towards increase in the patients with uremia as compared with the controls (7.2 +/- 1.1 IU/ml versus 6.4 +/- 0.7 IU/ml) whereas no significant difference was found at the 1st, 2nd or 3rd hour following the ingestion of glucose as compared with the healthy controls. Five of our patients had significantly elevated basal insulin levels. With regard to GH levels, we found similar baseline values in our study patients and the controls. At the 1st hour following the glucose challenge the GH values showed a tendency towards increase in the uremic patients--6.1 +/- 1.1 ng/ml. In 4 of our study patients we found significantly elevated GH levels at the 1st hour following the ingestion of glucose (6.6 +/- 0.7 ng/ml). CONCLUSIONS: 1. No significant disturbances in carbohydrate metabolism were found in patients with mild (initial) CRF. 2. In patients with moderate and advanced CRF we found changes consistent with impaired carbohydrate metabolism and a tendency towards an increase in the basal immunoreactive insulin levels. 3. Growth hormone levels showed a different pattern of change in predialysis patients and those changes cannot be explained by the changes in carbohydrate metabolism.

In vitro and in vivo studies of the effect of the concentration of plasticizer di(2-ethylhexyl) phthalate on the blood compatibility of plasticized poly(vinyl chloride) drain tubes.

Evaluation of the effect of the plasticizer di(2-ethylhexyl) phthalate (DEHP) has been carried out on the properties of blood compatibility of plasticized poly(vinyl chloride) (PVC) through an in vitro registering of the amount of total protein in relation to the amount of DEHP. The influence of DEHP on the properties of blood compatibility has also been evaluated in vivo by tracing through a modified method of Gott (LV Gott and A Feruse, Bull NY Acad Med 1972; 48(2): 482-491) the presence of a thrombus and the patency of tubes made from the material tested, as well as the patency of tubes made from the same material having surfaces coated with paraffin and complexone. For all implanted samples the changes in coagulation time and the amount of haemoglobin after their stay inside a blood vessel in the abdominal cavity of a dog have been registered.

[Alkaline phosphatase in the leukocytes of pregnant women with pre-eclampsia]. / Alkalna fosfataza v levkotsitite na bremenni s preeklampsiia.

The authors studied 74 pregnant women with preeclampsia presenting various degrees of gravity. The activity of alkaline phosphatase was determined cytochemically in the leucocytes. It was established that the activity of the enzyme was unchanged in mild preeclampsia and diminished progressively with advancement of the pathological process, compared with the respective values of normally progressing pregnancy at the same gestational period. A cytochemical criterium is proposed for differentiating the mild form of preeclampsia form the moderate form of preeclampsia.

[Alkaline phosphatase in the leukocytes of women with a normal pregnancy]. / Alkalna fosfataza v levkotsitite na zheni s normalno protichashta bremennost.

280 women were studied--30 of whom were nonpregnant and 250 were pregnant at various periods of normal progressing pregnancy. The activity of leucocytic alkaline phosphatase was determined cytochemically. It was established that the activity of the enzyme was elevated even at the earliest periods of pregnancy compared with the activity of nonpregnant women. The activity increased continuously up to 25-27 week's gestation. After this period up to 35-37 week's gestation the activity of leucocytic alkaline phosphatase was constant. New elevation of enzymic activity was established at the term of pregnancy. Possible causes for the observed changes were discussed. Reference values for the activity of leucocytic alkaline phosphatase during the second half of normal progressing pregnancy are described.

[Alkaline phosphatase isoenzyme activity in the serum of women during the second half of pregnancy]. / Aktivnost na izoenzimite na alkalnata fosfataza v seruma na zheni prez vtorata polovina na bremennostta.

The authors determined total alkaline phosphatase activity as well as the activity of placental, bone marrow and liver isoenzymes in sera of 185 pregnant women with normal pregnancy, divided, into 6 groups according to their gestational age (from 20 to 40 weeks' gestation). It was established an increase of bone marrow and placental isoenzymes of alkaline phosphatase parallel to an increase of gestational age, while the values of liver isoenzyme were comparatively constant, with the exception at 34-36 weeks' gestation when was elevated. Inferences are made for the origin of hyperphosphatemia during pregnancy.