Evidence of increased parathyroid activity on discontinuation of high-aluminum dialysate in patients undergoing hemodialysis
High-aluminum dialysate exposure has been incriminated in the pathogenesis of vitamin D-resistant osteomalacia in patients undergoing long-term hemodialysis. Parathyroid-mediated osteitis fibrosa is rare in these patients. Thirteen patients undergoing long-term hemodialysis were transferred from a c...
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| Veröffentlicht in: | The American journal of medicine 1984-08, Vol.77 (2), p.229-232 |
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| creator | O'Hare, James A. Murnaghan, Dermot J. |
| description | High-aluminum dialysate exposure has been incriminated in the pathogenesis of vitamin D-resistant osteomalacia in patients undergoing long-term hemodialysis. Parathyroid-mediated osteitis fibrosa is rare in these patients. Thirteen patients undergoing long-term hemodialysis were transferred from a center (Unit A) where water used to prepare dialysate was high in aluminum (100 to 450 μg/liter) to a new center (Unit B) where dialysate was highly purified (aluminum concentration less than 10 μg/liter), and changes in calcium metabolism were studied over a 12-month period. After transfer of patients to Unit B, serum aluminum levels fell (p < 0.01), whereas serum immunoreactive parathyroid hormone levels rose (p < 0.01) over 10 months. Over this time, predialysis serum calcium levels did not alter significantly, whereas postdialysls serum calcium levels declined slightly (p < 0.05). Serum phosphate levels did not alter. Serum alkaline phosphatase levels rose progressively in Unit B (p < 0.001). Discontinuation of dialysate high in aluminum in patients undergoing long-term hemodialysis may facilitate a rise in parathyroid activity. |
| doi_str_mv | 10.1016/0002-9343(84)90696-X |
| format | Article |
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Parathyroid-mediated osteitis fibrosa is rare in these patients. Thirteen patients undergoing long-term hemodialysis were transferred from a center (Unit A) where water used to prepare dialysate was high in aluminum (100 to 450 μg/liter) to a new center (Unit B) where dialysate was highly purified (aluminum concentration less than 10 μg/liter), and changes in calcium metabolism were studied over a 12-month period. After transfer of patients to Unit B, serum aluminum levels fell (p < 0.01), whereas serum immunoreactive parathyroid hormone levels rose (p < 0.01) over 10 months. Over this time, predialysis serum calcium levels did not alter significantly, whereas postdialysls serum calcium levels declined slightly (p < 0.05). Serum phosphate levels did not alter. Serum alkaline phosphatase levels rose progressively in Unit B (p < 0.001). Discontinuation of dialysate high in aluminum in patients undergoing long-term hemodialysis may facilitate a rise in parathyroid activity.</description><identifier>ISSN: 0002-9343</identifier><identifier>EISSN: 1555-7162</identifier><identifier>DOI: 10.1016/0002-9343(84)90696-X</identifier><identifier>PMID: 6431809</identifier><identifier>CODEN: AJMEAZ</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Alkaline Phosphatase - blood ; Aluminum - blood ; Aluminum - pharmacology ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Calcium - blood ; Emergency and intensive care: renal failure. Dialysis management ; Humans ; Intensive care medicine ; Kidney Failure, Chronic - enzymology ; Kidney Failure, Chronic - therapy ; Long-Term Care ; Medical sciences ; Middle Aged ; Parathyroid Glands - drug effects ; Parathyroid Glands - physiopathology ; Parathyroid Hormone - blood ; Phosphates - blood ; Renal Dialysis ; Time Factors</subject><ispartof>The American journal of medicine, 1984-08, Vol.77 (2), p.229-232</ispartof><rights>1984</rights><rights>1985 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c386t-8ab46032a6d6e5d14320212ffb6f4d3fd99539f737b24971740060488f79434c3</citedby><cites>FETCH-LOGICAL-c386t-8ab46032a6d6e5d14320212ffb6f4d3fd99539f737b24971740060488f79434c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/000293438490696X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=8919905$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/6431809$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>O'Hare, James A.</creatorcontrib><creatorcontrib>Murnaghan, Dermot J.</creatorcontrib><title>Evidence of increased parathyroid activity on discontinuation of high-aluminum dialysate in patients undergoing hemodialysis</title><title>The American journal of medicine</title><addtitle>Am J Med</addtitle><description>High-aluminum dialysate exposure has been incriminated in the pathogenesis of vitamin D-resistant osteomalacia in patients undergoing long-term hemodialysis. Parathyroid-mediated osteitis fibrosa is rare in these patients. Thirteen patients undergoing long-term hemodialysis were transferred from a center (Unit A) where water used to prepare dialysate was high in aluminum (100 to 450 μg/liter) to a new center (Unit B) where dialysate was highly purified (aluminum concentration less than 10 μg/liter), and changes in calcium metabolism were studied over a 12-month period. After transfer of patients to Unit B, serum aluminum levels fell (p < 0.01), whereas serum immunoreactive parathyroid hormone levels rose (p < 0.01) over 10 months. Over this time, predialysis serum calcium levels did not alter significantly, whereas postdialysls serum calcium levels declined slightly (p < 0.05). Serum phosphate levels did not alter. Serum alkaline phosphatase levels rose progressively in Unit B (p < 0.001). Discontinuation of dialysate high in aluminum in patients undergoing long-term hemodialysis may facilitate a rise in parathyroid activity.</description><subject>Adult</subject><subject>Alkaline Phosphatase - blood</subject><subject>Aluminum - blood</subject><subject>Aluminum - pharmacology</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Calcium - blood</subject><subject>Emergency and intensive care: renal failure. Dialysis management</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Kidney Failure, Chronic - enzymology</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Long-Term Care</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Parathyroid Glands - drug effects</subject><subject>Parathyroid Glands - physiopathology</subject><subject>Parathyroid Hormone - blood</subject><subject>Phosphates - blood</subject><subject>Renal Dialysis</subject><subject>Time Factors</subject><issn>0002-9343</issn><issn>1555-7162</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1984</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1rGzEQhkVJSZy0_6CFPYSSHLaVVlqtdCmUkKSFQC8t5CZkfdhTdiVH0hoM_fGVa-NjTmI0z7yMHiH0geDPBBP-BWPctZIyeiPYrcRc8vb5DVqQvu_bgfDuDC1OyAW6zPlPLbHs-Tk654wSgeUC_b3fgnXBuCb6BoJJTmdnm41Ouqx3KYJttCmwhbJrYmgsZBNDgTDrArWuQ2tYrVs9zlO9nCqgx13WxdWwmlLAhZKbOViXVhHCqlm7KR4gyO_QW6_H7N4fzyv0--H-19339unn44-7b0-toYKXVugl45h2mlvueksY7XBHOu-X3DNLvZWyp9IPdFh2TA5kYBhzzITwg2SUGXqFPh1yNym-zC4XNdV3uHHUwcU5K0GIZJ2QFWQH0KSYc3JebRJMOu0UwWovXe2Nqr1RJZj6L10917GPx_x5OTl7Gjparv3rY19no0efdDCQT5iQRErcV-zrAXPVxRZcUtnA_m8sJGeKshFe3-MfMauf3Q</recordid><startdate>198408</startdate><enddate>198408</enddate><creator>O'Hare, James A.</creator><creator>Murnaghan, Dermot J.</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>198408</creationdate><title>Evidence of increased parathyroid activity on discontinuation of high-aluminum dialysate in patients undergoing hemodialysis</title><author>O'Hare, James A. ; Murnaghan, Dermot J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c386t-8ab46032a6d6e5d14320212ffb6f4d3fd99539f737b24971740060488f79434c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1984</creationdate><topic>Adult</topic><topic>Alkaline Phosphatase - blood</topic><topic>Aluminum - blood</topic><topic>Aluminum - pharmacology</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Calcium - blood</topic><topic>Emergency and intensive care: renal failure. Dialysis management</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Kidney Failure, Chronic - enzymology</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Long-Term Care</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Parathyroid Glands - drug effects</topic><topic>Parathyroid Glands - physiopathology</topic><topic>Parathyroid Hormone - blood</topic><topic>Phosphates - blood</topic><topic>Renal Dialysis</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>O'Hare, James A.</creatorcontrib><creatorcontrib>Murnaghan, Dermot J.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>O'Hare, James A.</au><au>Murnaghan, Dermot J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evidence of increased parathyroid activity on discontinuation of high-aluminum dialysate in patients undergoing hemodialysis</atitle><jtitle>The American journal of medicine</jtitle><addtitle>Am J Med</addtitle><date>1984-08</date><risdate>1984</risdate><volume>77</volume><issue>2</issue><spage>229</spage><epage>232</epage><pages>229-232</pages><issn>0002-9343</issn><eissn>1555-7162</eissn><coden>AJMEAZ</coden><abstract>High-aluminum dialysate exposure has been incriminated in the pathogenesis of vitamin D-resistant osteomalacia in patients undergoing long-term hemodialysis. Parathyroid-mediated osteitis fibrosa is rare in these patients. Thirteen patients undergoing long-term hemodialysis were transferred from a center (Unit A) where water used to prepare dialysate was high in aluminum (100 to 450 μg/liter) to a new center (Unit B) where dialysate was highly purified (aluminum concentration less than 10 μg/liter), and changes in calcium metabolism were studied over a 12-month period. After transfer of patients to Unit B, serum aluminum levels fell (p < 0.01), whereas serum immunoreactive parathyroid hormone levels rose (p < 0.01) over 10 months. Over this time, predialysis serum calcium levels did not alter significantly, whereas postdialysls serum calcium levels declined slightly (p < 0.05). Serum phosphate levels did not alter. Serum alkaline phosphatase levels rose progressively in Unit B (p < 0.001). Discontinuation of dialysate high in aluminum in patients undergoing long-term hemodialysis may facilitate a rise in parathyroid activity.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>6431809</pmid><doi>10.1016/0002-9343(84)90696-X</doi><tpages>4</tpages></addata></record> |
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| subjects | Adult Alkaline Phosphatase - blood Aluminum - blood Aluminum - pharmacology Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Calcium - blood Emergency and intensive care: renal failure. Dialysis management Humans Intensive care medicine Kidney Failure, Chronic - enzymology Kidney Failure, Chronic - therapy Long-Term Care Medical sciences Middle Aged Parathyroid Glands - drug effects Parathyroid Glands - physiopathology Parathyroid Hormone - blood Phosphates - blood Renal Dialysis Time Factors |
| title | Evidence of increased parathyroid activity on discontinuation of high-aluminum dialysate in patients undergoing hemodialysis |
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