ABSTRACT
In 14 nondialyzed patients with chronic renal failure (CRF) and at the start of treatment a glomerular filtration rate (GFR) of 14--47 ml/min changes in bone mineral mass (BMM), expressed in percentage of the initial value, showed a significant correlation with the mean GFR during an observation period of 16 +/- 2 mo. During a predialysis period of 6 mo BMM decreased to 97.8 +/- 3.2% of the original value in 9 patients, while after 6, 12, and 16 mo of dialysis treatment, BMM in the same patients fell to 94.5 +/- 3.0%, 92.0 +/- 3.2% and 91.8 +/- 4.6% of the initial value. As after the onset of regular hemodialysis the fractional intestinal absorption of 47Ca does not decrease but even increases in most patients, the importance of the level of intestinal calcium absorption for the development of dialysis bone disease may be questioned.
Subject(s)
Bone and Bones/metabolism , Calcium/metabolism , Intestinal Absorption , Kidney Failure, Chronic/metabolism , Adult , Female , Glomerular Filtration Rate , Humans , Kidney/physiopathology , Kidney Failure, Chronic/physiopathology , MaleABSTRACT
In 34 patients with chronic renal failure (CRF), fractional 47calcium absorption (Fa47Ca) was measured by an external counting method. A significant correlation was found with impairment of renal function, as expressed by the creatinine clearance. There was also a significant correlation of Fa47Ca with the serum phosphate (SeP) level and of immunoreactive parathyroid hormone (iPTH) with renal function. When the relationship of both SeP and Fa47Ca with creatinine clearance was excluded, no partial correlation between SeP and Fa47Ca appeared to exist. A significant increase of Fa47Ca and serum Ca and a significant decrease of SeP and iPTH were found in 12 patients 2 to 15 months after they were put on intermittent hemodialysis. The possible influence of SeP on intestinal calcium absorption is discussed, and it is suggested that impairment of intestinal absorption of calcium is not a main factor in development of renal osteodystrophy.
Subject(s)
Calcium/metabolism , Chronic Kidney Disease-Mineral and Bone Disorder/metabolism , Kidney Failure, Chronic/metabolism , Parathyroid Hormone/blood , Phosphates/blood , Renal Dialysis , Adolescent , Adult , Aged , Chronic Kidney Disease-Mineral and Bone Disorder/etiology , Creatinine/metabolism , Female , Humans , Intestinal Absorption , Kidney Failure, Chronic/therapy , Male , Middle AgedABSTRACT
Two methods of measurement of fractional calcium absorption have been compared in the same individuals. There is a significant correlation between fractional 47Ca absorption as measured with a blood counting method and with an external counting method after intravenous and oral administration of 47Ca (P less than 0.001). Two varieties of the external counting method, namely with intervals of 2 h and 7 days between the i.v. and oral doses, have been compared. In a group of twenty-one patients with chronic renal failure (not on haemodialysis), 47Ca absorption as measured by external counting was significantly lower than in the control group (P less than 0.001). When put on a dialysis programme a group of six patients showed a significant increase of the fractional 47Ca absorption (P less than 0.01).
