Abstract:
BACKGROUND:Since dialysis has brought long-term survival to uremic patients, we can now speculate on more subtle problems derived from imbalance or sub-optimal regulation of some elements such as trace metals. We focused on the rubidium (Rb) status in dialysis patients (HD), as concerns about its possible deficiency have been raised. METHODS:Rb in uremic patients was evaluated by: A) serum concentration (graphite furnace atomic absorption spectroscopy) from blood samples of 70 patients on chronic hemodialysis (HD) in comparison with 75 controls; B) tissue concentration (neutron activation analysis) from autopsy or biopsy samples (20) of HD patients in comparison with 21 controls; C) in vivo intradialytic mass balance during standard bicarbonate dialysis in 8 HD patients. RESULTS:A) Serum Rb concentrations in HD patients significantly were lower than in normal controls (304 +/- 81 micrograms/L versus 350 +/- 74 micrograms/L p < 0.001, log-transformed 5.68 +/- 0.28 versus 5.84 +/- 0.20, p < 0.001). Univariate logistic regression analysis found a significantly higher risk of serum Rb < 250-300 and 350 micrograms/L in uremic patients than in controls (Odd ratios or 12.6, 95% CI 2.77-57.04; 4.0, 95% CI 1.92-8.4; 2.08, 95% CI 1.02-4.25, respectively). B) Rb was significantly lower in tissues of HD patients, including brain (2250 +/- 1520 ng/g versus 5490 +/- 1250 ng/g, p = 0.0002) than normal controls. C) Rb was transferred from the patients' blood to the dialysis bath during a standard bicarbonate dialysis session, giving mean intradialytic Rb removal of 4.0 +/- 1.1 mg/session. CONCLUSIONS:These results confirm that Rb deficiency may arise in uremic patients, and indicate that diffusive dialysis treatments allow Rb removal which, however, with a standard bicarbonate schedule does not seem to be any greater than that expected with normal urine output (20 mg/week). Further studies are needed to clarify the roles of many factors in this Rb deficiency, including the effects of uremia by itself, pre-dialysis factors (diet, impaired renal function and drugs), dialysis procedures (frequency, hours, diffusive/convective components) or other biochemical/clinical parameters (hemoglobin, body mass index, age). The finding of a Rb deficiency in uremia is important as it has a role in neurobehavioural functions, mainly as an antidepressant. As Rb deficiency may be implicated in central nervous system alterations which strongly influence the quality of life, we believe that monitoring serum Rb in uremic patients and clarifying the causal mechanisms of deficiency will facilitate future therapeutic approaches.
journal_name
J Nephroljournal_title
Journal of nephrologyauthors
Canavese C,DeCostanzi E,Branciforte L,Caropreso A,Nonnato A,Pietra R,Fortaner S,Jacono F,Angelini G,Gallieni M,Fop F,Sabbioni Esubject
Has Abstractpub_date
2001-05-01 00:00:00pages
169-75issue
3eissn
1121-8428issn
1724-6059journal_volume
14pub_type
杂志文章abstract::The kidney maintains systemic acid-base homeostasis through proximal tubular reclamation of filtered bicarbonate, and excretion of the daily mineral acid load by collecting duct type A intercalated cells. Impairment of either process produces renal tubular acidosis (RTA). This article will provide an overview of famil...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2010-11-01 00:00:00
abstract::Aim of the study was the definition of a predictive model for the initial diagnosis of thrombotic microangiopathies (TMA). We retrospectively collected data on all adult patients admitted to the Gemelli Hospital from 2010 to 2014. ICD-9 codes from primary diagnoses were used for TMA diagnosis. Demographic and laborato...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.1007/s40620-018-0468-4
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:This study investigated whether modifications of placental expression of endothelin-1 (ET-1), nitric oxide synthase (NOS) and tissue factor (TF) are associated with abnormal Doppler waveforms. METHODS:Fourteen pre-term severe preeclamptic (PE) women with fetal growth restriction (FGR) and 14 normal preg nan...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2003-09-01 00:00:00
abstract::Clinical immunology laboratories play an essential role in diagnosis and monitoring of systemic lupus erythematosus (SLE). To obtain the best results in terms of diagnostic performance and clinical usefulness, the following recommendations should be fulfilled: Indirect immunofluorescence on Hep-2 cells remains the met...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2002-11-01 00:00:00
abstract::Hypertension is prevalent and remains an important risk factor in elderly and very elderly. Randomized controlled outcome trials have shown benefit of antihypertensive treatment in patients with systolic diastolic hypertension and in patients with isolated systolic hypertension, aged 60 years and over. More recently b...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2009-09-01 00:00:00
abstract::Thales was born into a noble family of Phoenician origin at the time of the 25th Olympiad (floruit 585 bc; he was 40 in the year of the solar eclipse. He had no teachers but had occasion to learn from Egyptian priests. He developed into a scholar and politician very much appreciated by Heraclitus, Herodotus and Democr...
journal_title:Journal of nephrology
pub_type: 传,历史文章,杂志文章
doi:
更新日期:2009-11-01 00:00:00
abstract::Hemolytic uremic syndrome (HUS) is a rare disease characterized by microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure. It is usually secondary to infections by strains of Escherichia coli (STEC) that produce Shiga-like toxin. In about 10% of patients, no STEC infections are reported. In these ...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.5301/jn.5000146
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Accurate assessment of kidney function level is the key to the identification and management of chronic kidney disease (CKD). Glomerular filtration rate (GFR) is the best measure of overall kidney function in health and disease. There is no consensus about the method to be used routinely to measure and/or es...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2006-03-01 00:00:00
abstract::Percutaneous transluminal angioplasty of the renal artery (PTRA) has been increasingly used over the past 20 years for treating renovascular hypertension (RVH). From the experience gathered so far it is justified to state that this technique is the first choice for patients with fibromuscular renal artery stenosis (RA...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND:Proteinuria results from increased glomerular permeability and is associated with retraction and effacement of the highly specialized interdigitating podocyte foot processes. In podocytes (glomerular epithelial cells [GECs]), p130Cas localizes diffusely to the cytoplasm and connects focal adhesion proteins a...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.5301/jn.5000261
更新日期:2013-09-01 00:00:00
abstract::Inherited distal renal tubular acidosis (dRTA) is caused by impaired urinary acid excretion resulting in hyperchloremic metabolic acidosis. Although the glomerular filtration rate (GFR) is usually preserved, and hypertension and overt proteinuria are absent, it has to be considered that patients with dRTA also suffer ...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.1007/s40620-016-0370-x
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Contrast-induced nephropathy (CI-AKI) is a complication of diagnostic/therapeutic hemodynamic procedures in cardiology, which may also cause renal cholesterolinic atheroembolism. Despite the severe clinical impact of these complications, there is no optimal therapy for preventing and treating them. We sugge...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.5301/jn.5000266
更新日期:2013-05-01 00:00:00
abstract::Recently, two independent teams detected presumed hepatitis agents, which were designated HGV and hepatitis GB virus C; they represent a new genus in the family Flaviviridae. The most accurate way to assess the epidemiology of GBV-C/HGV infection remains the combination of RT-PCR and anti-GBV-C/HGV E2 techniques, to d...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:1999-05-01 00:00:00
abstract:INTRODUCTION:End stage renal disease (ESRD) is associated with a high incidence of cardiovascular disease and cancer. Patients undergoing hemodialysis show a reduced number and an impaired function of endothelial progenitor cells (EPCs), which in physiological conditions contribute to repair the vascular damage. In pat...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:The regulation of renal hemodynamics is closely related to the L-arginine (L-Arg)/nitric oxide (NO) pathway. NO - metabolized from L-Arg - is capable of improving renal function in ischemic and toxic acute renal failure (ARF), while NO synthase (NOS) inhibition induces deterioration in renal function. The mo...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2005-07-01 00:00:00
abstract::Influenza is a commonly encountered and serious pathogen. Patients with end-stage renal disease are more susceptible to serious morbidity and mortality associated with influenza infection. Proper management of patients includes: vaccination, monitoring for symptoms and isolation of potentially infected patients as wel...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.1007/s40620-017-0407-9
更新日期:2018-04-01 00:00:00
abstract::Cutaneous periarteritis nodosa (PAN) is a clinical feature characterized by chronic, benign course; its pathogenesis is unknown. In patients submitted to renal transplantation cutaneous PAN is a rare complication. We report a case of cutaneous PAN associated with the reappearance of hepatitis B antigen 16 years after ...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2001-09-01 00:00:00
abstract::Structural and functional alterations affecting the aging kidney predispose to an increased risk of acute renal failure (ARF) in the elderly. This is a common problem becoming more relevant because of an increase in life expectancy. The epidemiology of ARF in the elderly is far from being well assessed, because of the...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.5301/jn.5000141
更新日期:2012-01-01 00:00:00
abstract::Kidney remodeling is a response to intrinsic or extrinsic triggers of kidney injury. Injury initiates a set of universal response programs that were positively selected through evolution to control potentially life-threatening dangers and to regain homeostasis, including tissue repair. These danger control programs ar...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.5301/jn.5000247
更新日期:2013-05-01 00:00:00
abstract::Patients with type 2 diabetes run a high risk for progressive renal function loss. Many interventions have been tested to reduce the risk, but we are nowadays still confronted with a high unmet need. To improve on this unmet need, we will have to change the current strategies in drug discovery, clinical trials and cli...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.1007/s40620-020-00820-2
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:No study has evaluated the efficacy of non-calcium-containing phosphate binders in slowing progression of cardiac valve calcification or deterioration of kidney function in patients with chronic kidney disease not on dialysis. This study addressed these issues. METHODS:Outpatients (n = 170) with stage 3-4 c...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.5301/jn.5000290
更新日期:2013-07-01 00:00:00
abstract::The attitude of 19th century (and even of 20th century) scholars toward medieval and, particularly, Anglo-Saxon medicine has been of severe criticism. According to them it was filled with superstition and stupidities. However, in these last fifty years research has proved that, compared with the Continent, Anglo-Saxon...
journal_title:Journal of nephrology
pub_type: 历史文章,杂志文章
doi:
更新日期:2009-11-01 00:00:00
abstract::The collecting duct is responsible for the final secretion or reabsorption of protons and bicarbonate, respectively. Approximately 2% of the total filtered bicarbonate is reabsorbed in this segment. At least two different types of cells are involved in the transport of protons and bicarbonate, namely, type A and B int...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:Chronotropic incompetence (CI) is an independent predictor of cardiovascular events and overall mortality. The prevalence and significance of CI in renal transplant patient has not been examined. METHODS:38 non-heart failure renal transplant recipients were recruited for a transthoracic echocardiogram and t...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.1007/s40620-014-0091-y
更新日期:2014-08-01 00:00:00
abstract::Ferumoxytol is a new product approved for intravenous use by the US Food and Drug Administration (FDA) in the treatment of iron deficiency anemia in adults with chronic kidney disease. This approval was based on data from 3 open-label, randomized, controlled clinical trials. In all of these trials, ferumoxytol was wel...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.5301/jn.5000025
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:Functional failure of the peritoneal membrane is the most serious problem in long-term continuous ambulatory peritoneal dialysis (CAPD). Transforming growth factor-beta (TGF-ss) is one of the key mediators of fibrosis in some organs, and is thought to be involved in peritoneal alterations. In this study, we ...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Uromodulin (Tamm-Horsfall protein) is the most abundant urinary protein in healthy individuals. Despite 60 years of research, its physiological role remains rather elusive. Familial juvenile hyperuricemic nephropathy and medullary cystic kidney disease Type 2 are autosomal dominant tubulointerstitial nephrop...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.1007/s40620-014-0079-7
更新日期:2014-06-01 00:00:00
abstract:INTRODUCTION:Post-transplant malignancies are among the most important complications in organ transplantation. Hemangioblastoma (HB) is especially prevalent in the cerebellum. CASE REPORT:A 20-year-old male who first started dialysis therapy, and then underwent kidney transplantation from a living-relative donor. Five...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:Mesangial proliferative glomerulonephritis (MePGN) is characterized by excessive mesangial cell proliferation and mesangial matrix expansion, which lead to glomerular sclerosis and obliteration and, in turn, to deteriorating renal function. To identify and quantify the total proteins in renal tissues of MePG...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.5301/jn.5000124
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Chronic kidney disease (CKD) is an established risk factor for cardiovascular disease (CVD). In addition, patients with renal disease are exposed to a myriad of risk factors that increase their risk even further. The treatment of risk factors in these patients is paramount to reducing cardiovascular risk and...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2005-01-01 00:00:00