pyrophosphate and Kidney-Diseases

Pyrophosphate and diphosphonates produce striking results on calcium metabolism in experimental animals and man. Compounds containing P-O-P- bonds (e.g. inorganic pyrophosphate [PP-ii1 or P-C-P bonds (diphosponates) inhibit both the formation and dissolution of calcium phosphate crystals in vitro. PP-i may have a physiological function in regulating calcification and bone turnover, and obnormalities in its metabolism may occur in some human diseases notably hypophosphatasia and pseudogout. Diphosphonates inhibit ectopic calcification, and slow down resorption and bone turnover in several experimental systems in vivo. They have helped in studies of various aspects of the regulation of calcium metabolism. The diphosphonate, disodium ethane-1-hydroxy-1,1-diphosphonate (EHDP) has been shown in clinical studies to be effective against ectopic calcification particularly in myositis ossificans progressiva and in disorders of increased bone resorption such as Paget's diseases and some types of osteoporosis. -99mTechnetium complexes of EHDP, PP-i and other polyphosphates have also recently been used successfully as bone scanning agents.

Topics: Animals; Bone and Bones; Bone Resorption; Calcification, Physiologic; Calcinosis; Calcium; Calcium Metabolism Disorders; Cartilage; Chemical Phenomena; Chemistry; Culture Techniques; Depression, Chemical; Diphosphates; Etidronic Acid; Humans; Hydroxyapatites; Kidney Diseases; Methylene Chloride; Organophosphonates; Organophosphorus Compounds; Osteoporosis; Urinary Bladder Calculi; Vitamin D

The purpose of this study was to examine the diagnostic value of planar. PYP images of 109 consecutive patients with suspected ATTR-CA were retrospectively reviewed. The myocardial PYP uptake was visually graded on a scale of 0 to 3 and quantified with the heart-to-contralateral (H/CL) ratio in accordance with the current expert consensus recommendations. The diagnostic value of planar images for identifying positive PYP SPECT was assessed by a receiver-operating characteristic curve analysis with the area under the curve (AUC). The uptake ratios of the ascending and descending aorta, left atrium, and trapezius muscle divided by the liver uptake were measured on SPECT images and compared to the renal function.. A total of 41 patients (38%) had myocardial PYP uptake on SPECT images. In comparison with the visual scores on 1-h anterior planar images, those on 3-h anterior planar images had lower sensitivity (80.5% vs. 97.6%) and higher specificity (86.8% vs. 55.9%) for identifying positive PYP SPECT. The ROC analysis showed that the combination of visual scores on both 1-h and 3-h anterior planar images had significantly higher AUC values in comparison with 1-h anterior planar images alone (0.90 [95% CI 0.83-0.94] vs. 0.83 [95% CI 0.75-0.88]; P < 0.001), which was comparable to the AUC values on 3-h anterior planar images alone (0.88 [95% CI 0.80-0.92]; P = 0.071). In comparison with visual scores on 1-h or 3-h anterior planar images alone, the combination of visual scores and H/CL ratio did not significantly improve the diagnostic value for identifying positive PYP SPECT (P = 0.73 and P = 0.50, respectively). The uptake ratios of ascending aorta/liver, descending aorta/liver, left atrium/liver, and trapezius muscle/liver were not significantly associated with the serum creatinine level or estimated glomerular filtration rate (P > 0.05 for all).. In the assessment of ATTR-CA using PYP imaging, visual scores on 3-h anterior planar images for identifying positive PYP SPECT had lower sensitivity and higher specificity in comparison with those on 1-h anterior planar images. The diagnostic value of the visual scores on 1-h and 3-h anterior planar images was not improved by adding the H/CL ratio. Blood pool activity of PYP was not significantly associated with renal dysfunction.

Topics: Amyloidosis; Cardiomyopathies; Diphosphates; Humans; Kidney Diseases; Prealbumin; Radionuclide Imaging; Radiopharmaceuticals; Retrospective Studies; Technetium Tc 99m Pyrophosphate; Tomography, Emission-Computed, Single-Photon

Topics: Adenosine Triphosphate; Diphosphates; Humans; Kidney Diseases; Tenofovir

Pyrophosphate (PPi) is a potent inhibitor of vascular calcification and may be deficient in renal failure. We sought to determine whether plasma PPi is affected by dialysis or the mode of dialysis and whether it correlates with vascular calcification.. PPi was measured in plasma samples stored from a recent study of vascular calcification in 54 HD patients, 23 peritoneal dialysis (PD) patients and 38 patients with stage 4 chronic kidney disease (CKD). Calcification was quantified in a standardized section of the superficial femoral artery using computed tomography, and PPi was measured by enzyme assay, at both baseline and 1 year.. Baseline plasma PPi was weakly correlated with age and serum phosphate, but not with alkaline phosphatase activity or other biochemical parameters, and did not differ between HD, PD and CKD patients. Both baseline calcification score and change in the calcification score at 1 year decreased with increasing quartiles of plasma PPi. In a multivariate analysis, plasma PPi was independently correlated with baseline calcification (P = 0.039) and the change in calcification (P = 0.029).. Plasma PPi is negatively associated with vascular calcification in end-stage renal disease (ESRD) and CKD but is not affected by dialysis, the mode of dialysis or nutritional or inflammatory status. Although these data are consistent with an inhibitory effect of PPi on vascular calcification, further studies are needed to establish a causal role.

Topics: Aged; Calcinosis; Chronic Disease; Diphosphates; Female; Femoral Artery; Humans; Kidney Diseases; Kidney Failure, Chronic; Male; Middle Aged; Multivariate Analysis; Peritoneal Dialysis; Renal Dialysis; Tomography, X-Ray Computed

Topics: Alkaline Phosphatase; Calcinosis; Carrier Proteins; Chronic Disease; Diphosphates; Diphosphonates; Disease Progression; Femoral Artery; Humans; Kidney Diseases; Phosphoric Diester Hydrolases; Pyrophosphatases

The proposed method of sequential scintigraphy of the kidneys and joints in a single administration of 99mTc-pyrophosphate permits obtaining objective information on function and topography of the kidneys and pyodestructive processes in the joints. Dynamic scintigraphy helps to assess visually renal hemodynamics and the antomotopographic position of the kidney and to obtain exhaustive information on accumulative-evacuatory function of each kidney individually. Scintigraphy also helps to investigate all the joints and to detect pyoinflammatory changes in them. The proposed method considerably reduces the time of investigation and lessens radiation exposure of patients, permitting repeated investigations to assess and correct the treatment of patients with rheumatic arthritis.

Topics: Adult; Arthritis, Rheumatoid; Diphosphates; Evaluation Studies as Topic; Female; Humans; Joint Diseases; Joints; Kidney; Kidney Diseases; Male; Middle Aged; Radionuclide Imaging; Suppuration; Technetium; Technetium Tc 99m Pyrophosphate

10 patients with chronic renal failure (6 women, 4 men), 19 to 59 years of age, duration of the disease form 3 up to 21 years, treated by hemodialysis from 2 to 5 years, were examined. The scintigraphic examination of the bones with 99mTc pyrophosphate (166.5.10(6) MBq) on the third hour after the i.v. application of the radiocolloid, registered by the scanning device SELO-DS-2, allows the discovery of the initial changes of the so called renal osteodystrophy (bone disease in patients on chronic hemodialysis). The coefficient bones/soft tissues may be used as a quantitative index of the renal osteodystrophy in these patients whereas the coefficient calvaria/sternum has not the same diagnostic value.

Topics: Adolescent; Adult; Bone and Bones; Chronic Kidney Disease-Mineral and Bone Disorder; Diphosphates; Female; Humans; Kidney Diseases; Kidney Failure, Chronic; Male; Middle Aged; Radionuclide Imaging; Renal Dialysis; Technetium; Technetium Tc 99m Pyrophosphate

Topics: Bone Neoplasms; Diagnosis, Differential; Diphosphates; False Negative Reactions; Humans; Kidney Diseases; Radionuclide Imaging; Retrospective Studies; Technetium

Topics: Absorptiometry, Photon; Acidosis, Renal Tubular; Adolescent; Bone and Bones; Bone Diseases; Child; Child, Preschool; Diphosphates; Fanconi Syndrome; Humans; Kidney Diseases; Osteomalacia; Phosphorus Metabolism Disorders; Radionuclide Imaging; Renal Tubular Transport, Inborn Errors; Technetium

A gallium-67/technetium-99m subtraction technique was used with a variable weighting factor. That is, each image was separately set to 100%. Varying amounts of the Tc-99m images were subtracted from those of Ga-67. A total of 95 patients who had radiogallium scanning for suspected inflammatory disease were studied by the subtraction technique. Thirty of these patients had abnormal Tc-99m pyrophosphate bone scans, while 20 had abnormal radiogallium abdominal foci; 45 had defects in liver, spleen, or kidney images. The subtraction technique with variable weighting was highly successful in enhancing hot-spot visibility, and in providing information as to the anatomic location of the defect.

Topics: Abscess; Adult; Arthritis, Infectious; Citrates; Computers; Diphosphates; Female; Gallium Radioisotopes; Humans; Inflammation; Kidney Diseases; Liver Abscess; Male; Middle Aged; Osteomyelitis; Radionuclide Imaging; Splenic Diseases; Technetium

Myocardial scinitgrams, using 99mTc-stannous pyrophosphate, showed an acute posterior infarction and an abnormally placed left kidney in a 24-year-old hypertensive man; Further study revealed that the kidney was displaced by a mass later proven to be a pheochromocytoma. The latter was the cause of his hypertension and probably instigated the acute myocardial infarction.

Topics: Adult; Diphosphates; Humans; Hypertension; Kidney Diseases; Male; Myocardial Infarction; Pheochromocytoma; Radionuclide Imaging; Technetium

A retrospective study of 795 consecutive bone scans employing either 18F or 99mTc-pyrophosphate to evaluate the diagnostic value of renal asymmetry in such scans has been carried out. It is concluded that asymmetric renal images in bone scans convey relatively specific information regarding renal pathology, especially in the 99mTc-pyrophosphate studies.

Topics: Adenocarcinoma; Adult; Aged; Bone Neoplasms; Carcinoma, Bronchogenic; Diphosphates; Female; Fluorine; Humans; Kidney; Kidney Diseases; Kidney Neoplasms; Male; Melanoma; Radioisotopes; Radionuclide Imaging; Retrospective Studies; Technetium; Ureteral Obstruction

Type I hyperoxaluria results from reduced activity of alpha-ketoglutarate: glyoxylate carboligase, which is necessary for the synergistic decarboxylation of glyoxylate and alpha-ketoglutarate to alpha-hydroxy-beta-keto-adipate. Since thiamine pyrophosphate is a cofactor in the reaction, thiamine deficiency might be expected to result in tissue oxalosis. However, there was no significant increase in the incidence of renal oxalosis in 15 patients with Wernicke's encephalopathy at necropsy compared with controls. It is possible that hyperoxaluria was present in these thiamine-deficient patients but at a urine concentration below that necessary for calcium oxalate deposition. It is also possible that the severity of the thiamine deficit required for hyperoxaluria exceeds that for the neuronal and cardiac manifestations.

Topics: Acute Kidney Injury; Adipates; Adult; Carboxy-Lyases; Diphosphates; Glyoxylates; Humans; Ketoglutaric Acids; Kidney Diseases; Metabolic Diseases; Middle Aged; Oxalates; Thiamine; Thiamine Deficiency; Wernicke Encephalopathy

Topics: Allopurinol; Arthritis; Calcium Phosphates; Cartilage, Articular; Chondrocalcinosis; Crystallization; Diphosphates; Gout; Humans; Kidney Diseases; Kidney Tubules; Leukocytes; Macrophages; Myeloproliferative Disorders; Synovial Fluid; Uric Acid