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Biomedical subjects

C Feletti

Publications and source records attributed to C Feletti.

43 records · Page 3Linked to original sources

Effect of calcitonin on bone lesions in chronic dialysis patients.

The effects of synthetic salmon CT, administered subcutaneously and intermittently (1 MRC U/kg/day for 15 days/month over 6 months) were investigated in 15 uremic patients on regular dialysis treatment (RDT), all presenting various degrees of osteodystrophy. Clinically, osteoarticular pain disappeared in 8 out of 10 cases; 1 patient with rib fractures had a rapid calcification of the bone fracture repair tissue. No significant changes were found in serum calcium and PTH levels. Phosphotemia showed a significant decrease within the first 20 days. The varying individual hypophosphatemic response proved to be related to the initial level of phosphatemia. The alkaline phosphatase, when increased, showed a decrease to the normal range. A significant decrease in osteoclastic hyperactivity (active resorption surface, osteoclast index) and a slight increase in osteoblastic pool (active osteoid surface) were documented. No change was noted when osteomalacia predominated. Side effects included: anorexia, nausea, vomiting, face flushing. Our data suggest that salmon CT may be usefully employed in chronic uremic patients on RDT, when secondary hyperparathyroidism predominates.

Adult↗

Serial histomorphometric and histochemical bone biopsy studies in dialysis and transplantation.

A serial bone biopsy longitudinal study has been undertaken to asses the effects of Dialysis and Transplantation on uremic osteodystrophy. The clinical material consists of: normal (24 cases, 61 biopsies), patients with moderate renal failure on free diet (50 c., 61 b.), patients on Low Protein Diet (146 c., 251 b.), patients on Regular Dialysis Treatment (114 c., 256 b.), patients submitted to Transplantation (50 c., 84 b.). A significant correlation has been documented between duration of low protein diet and bone changes. In long-term dialysis patients remarkable differences have been found in "late" dialysis starting time (mean value of creatinine clearance at the beginning of treatment 2.04 +/- 1.7) in respect to "early" starting-time (mean value 13.1 +/- 3.9). In late group bone histomorphometry showed quite evident signs of secondary hyperparathyroidism and hyperosteoidism which remarkably worsened 3-4 years after dialysis. The aminoacids composition of the bone showed an increase in the total amount of aminoacids during dialysis, expecially for proline, hydroxyproline and glycine. In early group both basic values and progression rate of bone lesions were less severe. In transplanted patients with good renal function (serum creatinine less than 1.4 mg%) bone histomorphometric analysis showed a rather rapid disappearance of uremic bone lesions. A significant correlation was found between serum PTH, renal function and bone histology. On some occasions signs of secondary hyperparathyroidism were documented even after 16 months. A good correlation between inactive bone surfaces and immunosuppressive regimen was found.

Adolescent↗

[Pre-dialysis arteriovenous fistula results in better patency rate].

BACKGROUND: The timing of creation of the first permanent vascular access is crucial to the clinical history of haemodialysis patients. Our strategy is to create vascular access early enough to allow its maturation before the start of the treatment. METHODS: Aim of the study is to evaluate patency of primary A-V fistulas in patients treated between 1985 and 2000 in our dialysis unit. One hundred and thirty A-V fistulas created before haemodialysis treatment (range 10-540 days) and used at its beginning (pre-HD group) are compared with 74 A-V fistulas created and/or used after the start of the haemodialysis treatment (post-HD group). RESULTS: Pre-HD group fistulas resulted in higher patency rate than the post-HD group, immediately at the start of the treatment (94.6% vs. 86.5%, p<0.05), at 6 months (89.2% vs. 75.6%, p<0.025), at 12 months (84.5% vs. 64.6%, p< 0.005), at 24 months (77.2% vs. 54.8%, p< 0.005). CONCLUSIONS: A-V fistula is to be preferred in the choice of primary vascular access for chronic haemodialysis patients. It should be created early enough before the beginning of the treatment (when serum creatinine reaches 6 to 7 mg/dL). This planning avoids central venous catheter placement, preserves vessels and the choice of the best surgical option thus resulting in a better fistula survival.

Aged↗