Serum and lymphocyte, aluminum and nickel in chronic renal failure

Wills, M. R.; Brown, Catherine S.; Bertholf, Roger L.; Ross, Richard; Savory, John

doi:10.1016/0009-8981(85)90286-4

Cited by 26 publications

(13 citation statements)

References 8 publications

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“…These patients had taken routine medications, in dialysis units for at least 3 months, such as phosphate binding agents CaCO 3 (500 mg/tab Ca 0.2g, 10 mEq) 2 to 3 tablets 3 times with a meal per day, Ca acetate (667 mg/tab Ca 169 mg) 2 to 3 tablets 3 times with a meal per day, Sucralfate (basic aluminum sucrose sulfate 1,000 mg, Al 210 mg/sachet, Taiwan Tung Yang Chemical Ind. Co., Ltd., Taipei, Taiwan) 1 sachet 3 times with a meal per day, or Al (OH) 3 (324 mg/tab, Al 136 mg/tab) 2 tablets 3 times with a meal per day. Patients with high iPTH greater than 200 pg/ml or hypocalcemia received daily Rocaltrol (0.25 ∼ 0.5 g, Roche Products Ltd., Basel, Switzerland) or Alfarol (1-␣(OH)D 3 , Chugai Pharmaceutical Co., Ltd., Tokyo, Japan) 0.5 to 1.0 g. Medication compliance was checked by questionnaires and reenforced at each dialysis visit.…”

Section: Methodssupporting

confidence: 93%

“…The possibility of trace metal contamination of various medications and the effects of medications on the metabolism of trace metals are still unknown. We conducted a multicenter collaborative cross-sectional study to investigate the prevalence of abnormal blood contents of 6 trace metals, copper (Cu), zinc (Zn), aluminum (Al), lead (Pb), cadmium (Cd) and mercury (Hg), in HD patients and their relation with frequently used drugs such as erythropoietin (EPO), CaCO 3 , Ca acetate, Sucralfate (basic Al sucrose sulfate), Al hydroxide, Rocaltrol (1,25-(OH) 2 vitD 3 ), and Alfarol (1-OH vitD 3 ). Age and sex matched healthy persons were recruited as the control group.…”

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confidence: 94%

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Trace Metals' Abnormalities in Hemodialysis Patients: Relationship with Medications

et al. 2000

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A multicenter collaborative study was performed to investigate the prevalence of abnormal blood contents of 6 trace metals, copper (Cu), zinc (Zn), aluminum (Al), lead (Pb), cadmium (Cd), and mercury (Hg), in hemodialysis (HD) patients and to analyze their relationship with the medications, such as CaCO3, Ca acetate, Al containing phosphate-binding agents, 1,25-dihydroxy vitD3, 1-hydroxy vitD3, and erythropoietin (EPO), as well as hematocrit level, by chi-square statistics. From 6 medical centers in Taiwan, we included 456 patients in maintenance HD for more than 4 months for this study, and they had continued the previously mentioned medications for at least 3 months. Blood samples were collected before initiating HD, and atomic absorption spectrophotometry was used to measure plasma levels of Cu, Zn, and Al as well as whole blood levels of Pb, Cd, and Hg. Three hundred seventy-five (78%) of the HD patients had low plasma Zn levels, that is, <800 microg/L, and the mean (+/-SD) concentration was 705.8 (+/-128.23) microg/L in all subjects. One hundred forty-one (31%) of the HD patients had high plasma Al, that is, >50 microg/L, and the mean (+/-SD) was 44.30 (+/-28.28) microg/L in all subjects. Three hundred thirty-three (73%) of the dialysis patients had high Cd levels, that is, >2.5 microg/L, and the mean (+/-SD) was 3.32 (+/-1.49) microg/L in all subjects. The majority of HD patients had normal blood levels of Cu, PB, and Hg. Only 21 (4. 6%), 5 (1.1%), and 3 (0.06%) patients had elevated blood levels of Cu, Pb, and Hg, respectively. Their mean (+/-SD) blood concentration of Cu, Pb, and Hg were 1,049.78 (+/-233.25) microg/L, 7.45 (+/-3.95) microg/dL, and 3.17 (+/-25.56) microg/L, respectively. Three patients had elevated plasma Hg concentrations, that is, 546, 12.6, and 24.0 microg/L, respectively. In the 152 normal healthy age and sex matched control group, the blood levels of Al, Cd, and Pb were all significantly lower than the HD patients. However, the levels of Cu and Zn were higher in the control group. The Hg level was not significantly different in both groups. There was no statistical difference between patients with normal and abnormal blood levels of trace metals in various medications except Al containing phosphate binder. The Al containing phosphate binder users had significantly higher plasma Al levels (54.71 +/- 26.70 versus 41.15 +/- 28.03 microg/L, p < 0.001) and hematocrit levels (29.61 +/- 4.61 versus 27. 81 +/- 3.91, p < 0.0005). There was no statistical correlation between erythropoietin (EPO) dose and hematocrit level in these patients. In conclusion, the blood level of trace metals of these HD patients except Al was not related to their medications. However, caution must be exercised in interpreting this result as dose and duration of medication; efficiency of HD and water treatment may play an important role. Otherwise, environmental factors, diet, and the aging process may contribute to the trace metal burden in uremia. Thus, Zn and Cu are abundant in seafood, and Cd is abundant in contam...

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Section: Methodssupporting

confidence: 93%

mentioning

confidence: 94%

Trace Metals' Abnormalities in Hemodialysis Patients: Relationship with Medications

et al. 2000

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“…Results are reported using an appropriate correction factor based on the cell count and reported as fg Cu or Zn/cell. For the estimation of Cu and Zn in mononuclear WBCs a method by Wills et al [11], as modified by McGregor (personal communica tion) in our laboratories, was used.…”

Section: Methodsmentioning

confidence: 99%

Effect of clopamide, a thiazide diuretic, on copper and zinc levels in hypertensive patients.

Preez

Lockett

1991

Journal of the American College of Nutrition

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Thiazide diuretics, which are often prescribed to treat mild to moderate hypertension, commonly cause an increase in urinary zinc (Zn) excretion. Metabolic interrelationships between Zn and copper (Cu) are known to exist; consequently, Zn might influence Cu levels. This study aims to determine whether or not Cu and Zn levels in hypertensive patients were influenced by treatment with clopamide, a thiazide diuretic. Eight male patients, aged 36-59 and with an average supine diastolic pressure of 95-115 mm Hg, were treated with single daily doses of clopamide 5 mg as monotherapy for 16 weeks. Plasma, erythrocyte (RBC), and mononuclear leukocyte (WBC) levels of Cu and Zn were determined immediately before therapy (week 0) and again at weeks 8 and 16. There was a significant fall in Cu in mononuclear WBCs from 13.25 (SEM = 0.86) to 1.9 fg/cell (SEM = 0.56) (p less than 0.001) and an increase in Zn from 33.87 (SEM = 3.7) to 70.8 fg/cell (SEM = 11.7) (p less than 0.001), with no change in either cell count or measurable cell volume. Plasma Cu levels increased significantly (p less than 0.001), but the Zn levels decreased only slightly (p less than 0.03). Changes in RBC Cu levels during the treatment period were not significantly altered (p less than 0.1). Zn levels in RBCs were significantly (p less than 0.04) lower. It is concluded that treatment with clopamide may induce some changes in Cu and Zn levels in normal hypertensives, particularly in WBCs. Further investigation is needed to determine the extent of this influence.

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“…Aluminium in plasma or serum was determined using mainly GFAAS, giving a range of mean values from 2.0-10.2 pg L-' in groups of less than 50 subjects, with little data given concerning the age or gender of the subjects. In two studies where large reference groups were described, mean plasma aluminium concentrations were 7.3 pg L-' (range 2-1 5 pg L-') in 46 subjects (1 5 m/31 f) with an age range of 18-56 years [I31 and 6.1 k2.7 pg L-' in 50 unspecified control subjects [14].…”

Section: Discussionmentioning

confidence: 99%

Plasma aluminium in a reference population: the effects of antacid consumption and its influence on biochemical indices of bone formation

Sharp¹,

Perks²,

Worsfold³

et al. 1993

Eur J Clin Investigation

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Abstract. Aluminium is involved in the etiology of several complications of chronic renal failure and has been firmly established as having toxic effects on bone tissue. We have measured plasma aluminium together with serum osteocalcin, procollagen I C-terminal peptide and total alkaline phosphatase activity in healthy subjects and in a group of subjects who consumed aluminium-containing and non-aluminium containing antacid preparations, with normal renal function. Age-related healthy reference ranges for plasma aluminium are presented and the effects of chronic antacid consumption on plasma aluminium and biochemical markers of bone formation investigated.In 172 healthy subjects the mean plasma aluminium concentration was 4.4k2.9 p g L-', men having a significantly greater circulating aluminium load than women (5-4k2.8 p g L-' vs. 4.0f2.8 p g L-' respectively (P = 0.0039)). Older men were found to have significantly higher plasma aluminium levels than younger men. Increased plasma aluminium was seen in subjects taking antacids although this was not associated with significant changes in most indices of bone formation.

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Serum and lymphocyte, aluminum and nickel in chronic renal failure

Cited by 26 publications

References 8 publications

Trace Metals' Abnormalities in Hemodialysis Patients: Relationship with Medications

Trace Metals' Abnormalities in Hemodialysis Patients: Relationship with Medications

Effect of clopamide, a thiazide diuretic, on copper and zinc levels in hypertensive patients.

Plasma aluminium in a reference population: the effects of antacid consumption and its influence on biochemical indices of bone formation

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