[Hyperuricemia. VII. Hyperuricemic substances].
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Biomedical subjects
Publications and source records attributed to D Kuntz.
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Distributions and correlations of serum uric acid (SUA) were studied in 13,885 men and 6,861 women who were between the ages of 20 and 90. In men and women the distribution of SUA is unimodal. The average SUA value is 6,28 mg/100 ml SD: 1,19) in men and 5,05 mg/100 ml (SD: 1,10) in women, 27% of the men and 4% of the women have a SUA level above 7 mg/100 ml. In men and in women correlations of SUA with an obesity index is strong (r = 0,272; r = 0,311). In men partial correlations between SUA and age, blood pressure, cholesterolemia, glycemia and hemoglobinemia diminish when obesity index is fixed. In women these correlations are stronger and do not vary when obesity index is fixed. In men and women the correlation between SUA and creatininemia is strong and do not vary when obesity index is fixed.
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The occurrence of rheumatic disorders in patients treated by long-term haemodialysis (HD) has been emphasized for several years. Complications include carpal tunnel syndrome and various arthropathies. Together with renal osteodystrophy, they are the main limiting factors for the quality of long-term survivals. The pathophysiology is still poorly understood but apatite crystal deposition, aluminum or iron overload and the articular deposition of a new type of amyloid may play a part. We will attempt here to review the available data on these rheumatic disorders in dialysis patients.
Quantitative vertebral CT scan imaging is a method developed to provide direct measurements of mineralization of vertebral body spongy tissue, and is presently the most precise procedure for the early detection of spinal osteoporosis. A fracture threshold has been defined below which are found 95% of patients with a crushed vertebra: it is situated at 70% of the value for mineralization normal for the age of patients. Patients with marked reductions in their level of mineralization can be kept under surveillance before the onset of fracture. In patients with vertebral collapses the density is correlated significantly with the number of crush fractures. In addition, measurement of vertebral spongy bone density has allowed the importance of the vertebral lesion to be determined in various osteoporotic disorders, including those with only cortical fractures, and in this way to differentiate them.
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vitamin compounds to the basic dialytic treatment of renal osteodystrophy is of contestable interest. Because 1) optimum conditions of dialysis without D vitamin addition prevent efficiently the progress of severe gyperparathyroidism and osteomalacia 2) the D vitamin compunds could render the phosphatemia control more difficult thus contributing to aggravate the histologic lesions of hyperparathyroidism.
Stimulation of bone resorption by local factors, the cytokines, is key to the development of hypercalcemia in multiple myeloma patients. Parathyroid hormone-related peptide, the systemic factor found in humoral hypercalcemia, has rarely been incriminated in myeloma. We report a case of myeloma with hypercalcemia and elevated serum level of parathyroid hormone-related peptide. Bisphosphonate therapy was rapidly effective in correcting serum calcium levels despite persistent high levels of the peptide. Seven other cases of myeloma with hypercalcemia and high serum parathyroid hormone-related peptide levels have been reported. Expression by myeloma plasmocytes of the messenger RNA for this peptide has also been demonstrated. These data suggest that parathyroid hormone-related peptide may contribute to the development of hypercalcemia in some myeloma patients.