pyrophosphate and Hyperparathyroidism--Secondary

Topics: Animals; Bone Diseases; Bone Resorption; Calcinosis; Calcium; Diphosphates; Homeostasis; Humans; Hydroxyapatites; Hyperparathyroidism, Secondary; Kidney Failure, Chronic; Organophosphonates; Osteogenesis; Osteomalacia; Rats; Renal Dialysis; Uremia

Hypophosphatemia complicating parathyroidectomy for secondary hyperparathyroidism in renal failure is usually corrected by the oral or intravenous routes. We present a case in which those methods of treatment were not possible, and the phosphate was administered intraperitoneally. Phosphate was added as one molar sodium diphosphate solution to the dialysis fluid. In our case the procedure was well tolerated, phosphate blood levels were rapidly corrected, no alterations in calcium, magnesium or other parameters were detected and the patient was discharged in good condition. In selected cases of hungry bone syndrome after parathyroidectomy, intraperitoneal phosphate can be used safely.

Topics: Adult; Chronic Kidney Disease-Mineral and Bone Disorder; Dialysis Solutions; Diphosphates; Female; Humans; Hyperparathyroidism, Secondary; Kidney Failure, Chronic; Parathyroidectomy; Peritoneal Dialysis; Phosphates

In a series of 28 long-term dialysis patients with musculoskeletal complaints, the radiologic findings in six cases resembled those occurring in the arthropathy of idiopathic calcium pyrophosphate dihydrate deposition (CPPD) disease. These findings included osteophytes, subchondral cysts, and cartilage loss in the metacarpophalangeal joints, patellofemoral joints, wrists, and shoulders. Chondrocalcinosis was present in three of the six cases. There were no significant differences in renal function or levels of serum calcium, phosphorus, iron, ferritin, aluminum, or parathormone between these patients and a control group matched for sex and age. Long-term dialysis may be associated with a metabolic arthritis similar to the arthritis which occurs in CPPD deposition disease. The etiology may include deposition of CPPD crystals, hydroxyapatite, or other calcium-containing substances in joints, or it may be related to a number of dialysis-induced metabolic abnormalities.

Topics: Arthritis; Arthrography; Calcinosis; Calcium Pyrophosphate; Cartilage, Articular; Cysts; Diphosphates; Hemochromatosis; Humans; Hyperparathyroidism, Secondary; Iron; Kidney Failure, Chronic; Renal Dialysis

Most patients with primary hyperparathyroidism have normal 5-hr bone-to-soft-tissue ratios for 99MTc-pyrophosphate. In contrast, all five patients with advanced secondary hyperparathyroidism in this study showed significant (p less than 0.001) increases of bone uptake. In the early period after parathyroidectomy, there was no quantitative or qualitative change in uptake. A limited decrease of bone uptake was observed only after prolonged periods of observation. In itself, parathyroid activity seems to have little direct influence on bone uptake of 99MTc-pyrophosphate.

Topics: Adolescent; Adult; Aged; Alkaline Phosphatase; Bone and Bones; Bone Resorption; Diphosphates; Female; Humans; Hyperparathyroidism; Hyperparathyroidism, Secondary; Male; Middle Aged; Parathyroid Hormone; Radionuclide Imaging; Technetium

Topics: Bone Diseases; Bone Resorption; Diphosphates; Humans; Hyperparathyroidism; Hyperparathyroidism, Secondary; Parathyroid Diseases; Parathyroid Glands; Parathyroid Hormone; Pseudohypoparathyroidism; Radionuclide Imaging; Technetium

The effects of the long term ingestion of Solanum Glaucophyllum leaves (SG) by the rat was investigated in two series of experiments; the animals were fed a normal (for 8 weeks) or a low Ca diet (for 5 weeks). With both diets, the intestinal absorption of Ca was increased and the endogenous fecal Ca excretion was decreased by SG treatment. Added to a normal Ca diet, SG increased the urinary excretion of Ca, Mg and P and reduced the excretion of hydroxyproline and pyrophosphate. At the histological level, SG induced a higher rate of bone tissue synthesis on trabecular and endosteal surfaces. The bone content of hydroxyproline and citrate increased significantly. The total alkaline phosphatase activity of plasma decreased as a function of SG intake due to a decreased in the activity of the intestinal isoenzyme, which was not compensated by the increase in the bone isoenzyme activity. The Mg absorption was decreased by SG inducing lower Mg balances and lower plasma Mg levels. Added to a low Ca diet, SG increased the severity of the secondary hyperparathyroidism induced by the diet. The urinary excretion of hydroxyproline and the plasma alkaline phosphatase activity (both isoenzymes) were significantly increased. The Na and K content of bone decreased as a function of SG intake. 45Ca kinetic experiments revealed that SG increased the rate of Ca resorption and the rate constant of the fast exchangeable Ca pool, in both diets.

Topics: Alkaline Phosphatase; Alkaloids; Animal Feed; Animals; Bone and Bones; Calcium; Calcium, Dietary; Dihydroxycholecalciferols; Diphosphates; Female; Growth; Hydroxyproline; Hyperparathyroidism, Secondary; Kinetics; Magnesium; Male; Phosphorus; Plants; Rats

A study was undertaken to investigate the behavior of 99mTc-Sn-pyrophosphate complex in metabolic bone disease. Of clinical importance was the generalized increased periarticular bone accumulation of the radiopharmaceutical in osteomalacia and in combined osteomalacia and osteitis fibrosa as found in patients with chronic renal failure. The pattern in primary hyperparathyroidism was variable. There was no correlation between the initial rates of accumulation of the radiophosphate complex or its bone to soft-tissue uptake ratio at 5 hr when compared with the degree of osteomalacia and osteitis fibrosa. It is postulated that the 99mTc-Sn-pyrophosphate complex has greater affinity for immature collagen than the crystal surface.

Topics: Adenocarcinoma; Adult; Aged; Anorexia Nervosa; Bone Diseases; Diphosphates; Female; Humans; Hyperparathyroidism; Hyperparathyroidism, Secondary; Middle Aged; Osteitis Deformans; Osteitis Fibrosa Cystica; Osteomalacia; Parathyroid Neoplasms; Radionuclide Imaging; Renal Dialysis; Technetium