Natural History of Uremic Polyneuropathy and Effects of Dialysis

Jebsen, R H; Tenckhoff, Heinrich; Honet, Joseph C.

doi:10.1056/nejm196708172770702

Cited by 173 publications

(74 citation statements)

References 12 publications

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“…Many of the abnormalities present in patients with chronic renal disease such as anemia (32), hypertension (33), glucose intolerance (34), thrombocytopenia (35), encephalopathy (36), and polyneuropathy (37) (33,38). These observations are consistent with our findings that hemodialysis (T.D., Tables I, II, III, V) in contrast to homotransplantation (J. P. and C.M., Tables I, II, III, V) was ineffectual in altering the deranged metabolism of vitamin D,.…”

Section: Resultsmentioning

confidence: 99%

The metabolic fate of vitamin D3-3H in chronic renal failure

Avioli¹,

Birge²,

Lee³

et al. 1968

J. Clin. Invest.

161

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A B S TRA CT The absorption and metabolism of vitamin D3-3H was studied in eight patients with chronic renal failure. Although the intestinal absorption of vitamin D8-3H was normal, the metabolic fate of the vitamin was abnormal as characterized by a twofold increase in fractional turnover rate, an abnormal accumulation of biologically inactive lipid-soluble metabolites, and the urinary excretion of both vitamin D3-3H and biologically inactive metabolites. Neither alterations in watersoluble vitamin D. metabolites nor qualitative abnormalities in protein-binding of vitamin D.were observed in the uremic subjects. Although hemodialysis proved ineffectual in reversing the observed abnormalities in vitamin D, metabolism and excretion, renal homotransplantation was completely successful in this regard, These experiments support the conclusion that the resistance to therapeutic doses of vitamin D often seen in patients with chronic renal failure and renal osteodystrophy results from an acquired defect in the metabolism and excretion of vitamin D. INTRODUCTIONThe occurrence of skeletal abnormalities in patients with chronic renal disease (renal osteodystrophy) and the destructive effects of secondary hyperparathyroidism and chronic acidosis on bone in uremia have been well established (1-5). Recent observations by Dent, Harper, and Philpot (2) and Stanbury and Lumb (3,4) suggest that renal

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Section: Resultsmentioning

confidence: 99%

The metabolic fate of vitamin D3-3H in chronic renal failure

Avioli¹,

Birge²,

Lee³

et al. 1968

J. Clin. Invest.

161

View full text Add to dashboard Cite

show abstract

“…Then, their maximum respiratory pressures were taken, a procedure that, depending on their changes in the volume and biochemical composition of body fluids, which may adversely affect respiratory muscle function. 6,7 Maximum inspiratory (PImax) and expiratory (PEmax) mouth pressures produced during static efforts are considered a reflex of the strength of the respiratory muscles. The relations of those maximum static pressures to age, sex, and general muscle development have been described by some authors 8,9 , as has been the influence of the lung volume in which the measurements were taken.…”

Section: Methodsmentioning

confidence: 99%

Avaliação das pressões respiratórias máximas em pacientes renais crônicos nos momentos pré e pós-hemodiálise

Rocha

Araújo

2010

J. Bras. Nefrol.

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Introduction and Objective: Maximal inspiratory and expiratory pressures (PI max and PE max ) are used to assess the integrity of respiratory muscles by measuring their strength. The aim of this study was to assess the immediate influence of hemodialysis (HD) on respiratory muscle strength by measuring PI max and PE max , investigating the integrity of that musculature and/or the presence of muscular weakness. Method: A prospective, crosssectional study was carried out on a convenience sample of 35 patients with chronic kidney disease (26 men and 9 women; mean age, 51.7 ± 14.7 years) at the Nephrology Division of the Hospital Universitário Alzira Vellano, in the city of Alfenas, in the state of Minas Gerais, Brazil. Patients had their PI max and PE max taken in the seated position (at 90°) by using a digital manovacuometer (MVD 300®) attached to a notebook for reading and recording data obtained before and after the HD session. Results: Both PI max and PE max were lower than the values predicted for pre-and post-HD (p < 0.0001). Comparing the values obtained pre-HD and post-HD, PImax showed a slight improvement (p = 0.0420), evidenced only in patients with pre-HD values below 60 cmH 2 O (Wilcoxon; p = 0.0480). Post-HD PE max did not differ from the pre-HD measure (p = 0.4987). Conclusion: The CKD patients showed a serious impairment of their respiratory muscle function, and only one isolated HD session could not significantly improve their maximum respiratory pressures. A slight improvement in the inspiratory strength was observed in patients whose PI max was lower than 60 cm-H 2 O before the procedure.

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“…The following technique was used tor measurement of MNCV (8). Using a stainless steel intramuscular electrode, the sciatic nerve was stimulated supramaximally (rectangular pulse of 0.1 ms at 1 Hz frequency) at the level of the sciatic notch (proximal) and the popliteal fossa (distal).…”

Section: Methodsmentioning

confidence: 99%