ABSTRACT
A prospective study was made of sequential changes in the metabolism of vitamin D and calcium in 19 allograft recipient during the first year after successful renal transplantation. All but one of the patients received cyclosporine A combined with corticosteroids and azathioprine as immunosuppressive therapy. Shortly after transplantation most patients showed transient hypocalcemia and hypophosphatemia. At the time of transplantation 17 of 19 patients had an elevated plasma intact parathyroid hormone (PTH) level, and at the close of follow-up one in four patients. In six other patients intact PTH was within the reference range, but high in relation to simultaneously measured serum ionized calcium. According, one year after transplantation less than half of the patients showed complete resolution of hyperparathyroidism. The change towards normal in the metabolism of vitamin D began within the first post-transplantation week irrespective of the onset of diuresis. One to two weeks after transplantation 1,25(OH)2D3 and 24,25(OH)2D3 reached the lower limit of normal range. In these renal allograft recipients who received cyclosporine A the long-term values of serum 1,25(OH)2D3 did not differ from those of normal subjects.
Subject(s)
Calcium/blood , Kidney Failure, Chronic/surgery , Kidney Transplantation/physiology , Postoperative Complications/blood , Vitamin D/blood , 24,25-Dihydroxyvitamin D 3/blood , Adult , Calcifediol/blood , Calcitriol/blood , Chronic Kidney Disease-Mineral and Bone Disorder/blood , Creatinine/blood , Female , Follow-Up Studies , Humans , Kidney Failure, Chronic/blood , Kidney Function Tests , Male , Middle Aged , Osteocalcin/blood , Parathyroid Hormone/blood , Phosphates/blood , Prospective Studies , Serum Albumin/metabolismABSTRACT
The Behring Nephelometer is a new automatic analyzer designed for the measurement of specific proteins. The authors evaluated the nephelometer in the determination of M proteins as compared with immunodiffusion and cellulose acetate electrophoresis. In addition, the effects of sample dilution and antigen excess on the nephelometric measurement of M proteins were studied in 24 patient samples containing a single monoclonal IgG, IgA, or IgM M component. Immunodiffusion cannot be recommended for the determination of M proteins. Nephelometry and protein electrophoresis gave similar results with few exceptions. Sera with immunoglobulin monomer-oligomer pairs involve difficulties in serum electrophoresis. In certain cases, special care must be taken to adjust the nephelometric measurement of the M protein to the most accurate part of the calibration curve. All in all, the new Behring Nephelometer proved precise and reliable in M protein determination without risk of antigen excess.
