[Use of "active" vitamin D in uremic osteodystrophy].
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Biomedical subjects
Publications and source records attributed to V Mioli.
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Chronic Renal Failure is a generalized functional impairment, due to Kidneys inability to maintain volume and composition of body fluids and solutes within normal conditions. In the attempt to point out the pathophysiology of Bright's syndrome, the Authors review the "intact nephron hypothesis" and his functional reserve. The uraemic clinical appearance is a very wide field of investigations and beside their own experience, the Authors present some datas and theories to explain the coming out and the evolution of poliuria and oliguria, hypertension, heart pathology, anemia and bleedings, hormonal and metabolic pathways alterations, calcium and bone diseases and central and peripheral uraemic neuropathy.
A multicentric study was carried out to investigate the safety and effectiveness of long-term treatment of chronic uremic patients by a regular combination of hemodialysis and charcoal hemoperfusion. 39 RDT patients from five dialysis centers were treated for up to 12 months. The combined treatment proved to be safe, well tolerated and effective in improving certain dialysis-resistant uremic signs, mainly severe peripheral neuropathy, asthenia, anorexia, nausea, lack of well-being and relapsing pericarditis. There was also a marked decrease, after several weeks of combined treatment, in plasma values of urea, uric acid and creatinine.
Thyroid function was explored in 27 CAPD patients and 25 HD patients. Dialysis was associated with low T3 and T4 levels, increased rT3 concentrations, normal T4 : T3 and reduced T4 : rT3 ratios, normal FT3 and Thyroglobulin concentrations. TSH levels increased during dialysis but still fell within normal limits. The data rule out a condition of primary hypothyroidism and point out to increased thyroidal dismission associated with the block T4-T3 in peripheral cells. Also the increased FT4 levels in CAPD patients could be due to de novo dismission of thyroidal T4.
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