RESUMO
BACKGROUND AND AIM: The physiological mechanisms regulating zinc homeostasis in humans have been elucidated and described, but the knowledge of zinc status and zinc distribution in the tissues and in the different biological compartments of patients with conservatively treated chronic renal failure (CRF) and on peritoneal dialysis is still insufficient. This investigation examines and compares zinc content in urine, erythrocytes, plasma, and outflow dialysis solution in a group of continuous ambulatory peritoneal dialysis (CAPD) patients, a group of patients with CRF on conservative treatment and in healthy controls. MATERIAL AND METHODS: Data from the last 6 months of 22 adult hemodialysis patients with a mean age of 61 ± 14 years were analyzed retrospectively. Dialysis vintage, normalized protein catabolic rate (nPCR), serum biochemical parameters, mid arm muscle circumference (MAMC) were determined as mean and standard deviation. Correlations between the variables were computed by coefficient p of Pearson. RESULTS AND CONCLUSION: In patients on CAPD treatment (group 3) compared to healthy controls (group 1) plasma zinc level was diminished (Ñ<0.05), while erythrocyte zinc elevated (Ñ<0.01). The investigation found out difference between plasma, erythrocyte and urine levels of zinc between the patients with chronic renal failure (group 2) on conservative treatment and those treated by CAPD (group 3), which proves, that continuous ambulatory peritoneal dialysis influences redistribution of zinc in human organism "per se".
RESUMO
Cardiovascular manifestations are very common in patients with end stage renal disease and those undergoing dialysis treatment. One of the factors, causing cardiovascular disorders due to mineral metabolism disturbances in uremia is the appearance of cardiovascular calcification. The precise mechanism of the mineral metabolism disturbances acting through the existing metabolic acidosis in chronic renal failure is not yet clarified. The influence of acidosis is a complex one, acting as a stimulator of the solubility of Ca-P deposits, a suppressor of parathyroid secretion, an inhibitor of some osteogenic enzymes, a blocker of formation of bone matrix, a modulator of the up-regulation of Pit-1 and finally as a blocker of phosphate uptake by the arterial smooth muscle cells.
RESUMO
In the past it was widely believed that pain and itching are transmitted by the same nerve pathway with the low intensity stimulation of unmyelinated polymodal C fibers resulting in sensation of pruritus whereas high intensity stimulation causing pain. In recent experiments however, stimulation of single unmyelinated C fibers led to the identification of two kinds of fibers. Stimulation of most of these fibers induces pain, whereas a small number of fibers provoke the sensation of itching. Pruritus is an unpleasant sensation, often accompanied by scratching. It may present due to a number of cutaneous diseases or internal disorders. Pruritus may be caused by some chemical substances as histamine, prostaglandins, proteases and substance P. This review describes the existence of pruritus in different internal disorders. It is quite important the reason of pruritus to be discovered, for the application of an adequate therapy.
RESUMO
BACKGROUND: A non-invasive method for evaluation of high-turnover and low-turnover bone diseases is the measurement of certain important serum bone markers such as osteocalcin, procolagen-I-propeptide, dioxypiridinoline, hydroxyproline and alkaline phosphatase. Renal osteodystrophy (ROD) in pre-dialysis and dialysis patients, is manifested in 3 forms: high-turnover ROD, related to secondary hyperparathyroidism; low-turnover ROD and mixed ROD. MATERIAL AND METHODS: Serum levels of intact parathyroid hormone (iPTH), osteocalcin (OC), procolagen-I-propeptide (PIPC) and dioxypiridinoline (DYP) were measured in 20 patients on hemodialysis (HD) and 20 patients on continuous ambulatory peritoneal dialysis (CAPD) to assess the prevalence of ROD type in the HD and CAPD groups. RESULTS: We found lower mean levels of all bone markers in CAPD patients, (iPTH: 219+/-235 vs. 428+/-285 pg/ml; p<0.01; OC 10.2+/-7.5 vs. 21.3+/-7.2 ng/ml; p<0.01; PIPC 111+/-57.3 vs. 218+/-62.4 ng/ml; p<0.01; DYP 7.3+/-6.4 vs. 55.2+/-23.3nm/l; p<0.001; AP 164+/-66 vs. 325+/-188 U/l; p<0.01) and lower than normal in 11 of them and higher than normal PTH, AP and some of the other serum markers (PICP; DYP) in 14 HD patients. CONCLUSIONS: The lower levels of the investigated serum bone markers in CAPD patients suggest that low-turnover ROD prevails in these patients than in HD pts.
