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Bone Histology and Mineral Balance in the Early Stage of Renal Osteodystrophy

Year 1982, Volume: 35 Issue: 1, 157 - 166, 31.03.1982

Necmiye Tümer

Abstract

This study investigates bone histological changes and mineral balance in the early stages of chronic renal failure—before radiological signs of renal osteodystrophy appear. Bone biopsies from 11 pediatric patients without radiological evidence revealed thinning of bone lamellae, atrophy, and reduced osteogenesis. A significant reduction in calcium and hydroxyproline concentrations was found in bone tissue, while phosphorus, magnesium, zinc, copper, and alkaline phosphatase levels remained within normal ranges. Slightly low serum and urine calcium levels were observed, along with a notable decline in hydroxyproline. The findings demonstrate a positive correlation between decreased bone formation and lowered hydroxyproline and calcium, likely linked to vitamin D deficiency and inadequate protein intake. The study emphasizes the importance of initiating treatment before radiological signs of osteodystrophy manifest.

Keywords

renal kemik mineral

References

  • 1 - Beale MG ve ark.: Renal osteodystrophy. Pediat Clin North Am 23: 873, 1976.
  • 2 - Bengman I, Laxley R: Two improved and simplified methods for the spectrophotometric determination of hydroxyprolin. Anal Chem 35: 1961, 1963.
  • 3 - Casey CE ve ark.: Zinc, copper and vitamin A in pediatric dialysis. J Pediatr 98: 434, 1981.
  • 4 - Chan JCM: Renal osteodystrophy in children: Progress in its management. Clin Pediatr 15: 996, 1976.
  • 5 - Chan JCM, Kodroff MB, Landwehr DM: Effects of 1.25-dihydroxy-vitamin-D on renal function, mineral balance, and growth in children with severe chronic renal failure. Pediatrics 68: 559, 1981.
  • 6 - Coburn JW: Renal osteodystrophy. Kidney Int 17: 677, 1980.
  • 7 - Coburn JW ve ark.: Lefective skeletal mineralization in uremia without relation to vitamin D, serum Ca. or P. Kidney Int 12: 455, 1977.
  • 8 - Coburn JW, Hartenbower DL, Brickman AS: Advances in vitamin D metabolism as they pertain to chronic renal disease. Am J Clin Nutr 29: 1283, 1978.
  • 9 - Colowick SP, Kaplan ND: Methods in enzymology. Academic Press Inc., New York, 1957. Vol II, Section VII.
  • 10 - Evans GW, Johnson EG: Zinc absorption in rats fed a low protein diet and a low protein supplemented with tryptophan or picolinic acid. J Nutr 110: 1076, 1980.
  • 11 - Favus MR: Vitamin D physiology and some aspects of the vitamin D endocrine system. Med Clin North Am 62: 1291, 1978.
  • 12 - Gordon EF, Gordon RC, Passal DB: Zinc metabolism. J Pediatr 99: 341, 1981.
  • 13 - Hanley DA, Sherwood LM: Sekonder hyperparathyroidism in chronic renal failure: Pathophysiology and treatment. Med Clin North Am 62: 1319, 1978.
  • 14 - Heller RM ve ark.: Skeletal changes of copper deficiency in infants receiving prolonged total parenteral nutrition. J Pediatr 92: 947, 1978.
  • 15 - Hodsman ve ark.: Bone aluminium in osteomalacic renal osteodystrophy correlation with excess osteoid. Kidney Int 19: 127, 1981.
  • 16 - Hsieh HS, Navia JM: Zinc deficiency and bone formation in guinea pig alveolar implants. J Nutr 110: 1581, 1980.
  • 17 - Koo SI, Fullmer CS, Wasserman RH: Effects of cholecalciferol and 1.25 dihydroxycholecalciferol on the intestinal absorption of zinc in the chick. J Nutr 110: 1813, 1980.
  • 18 - Latorzeff S ve ark.: Quantitative study of bone biopsy in 81 uremic patients. Kidney Int 9: 522, 1976.
  • 19 - Lindman RD ve ark.: Serum concentrations and urinary excretions of zinc in cirrhosis, nephrotic syndrome and renal insufficiency. Am J Med Sci 275: 17, 1978.
  • 20 - Mahajan SK ve ark.: Zinc deficiency in uremia. Kidney Int 19: 153, 1981.
  • 21 - Malluche HH ve ark.: Bone histology in incipient and advanced renal failure. Kidney Int 9: 355, 1976.
  • 22 - Mankin HJ: Rickets, osteomalacia and renal osteodystrophy. J Bone Joint Surg 56A: 352, 1974.
  • 23 - Mansouri K, Halsted JA, Gombos EA: Zinc, copper, magnesium and calcium in dialyzed and non-dialyzed uremic patients. Arch Intern Med 125: 88, 1970.
  • 24 - Norman ME ve ark.: Early diagnosis of juvenile renal osteodystrophy. J Pediatr 97: 226, 1980.
  • 25 - Oreopoulos DG ve ark.: Plasma hydroxyproline: An accurate index of bone resorption in renal failure. Kidney Int 12: 459, 1977.
  • 26 - Perkin-Elmer: Clinical methods for atomic absorption spectroscopy. AA-Cu-1.1 & AA-Zn-1.1, Norwalk, Connecticut, 1971.
  • 27 - Prasad AS: Trace elements and iron in human metabolism. John Wiley & Sons Ltd., 1978, p: 315.
  • 28 - Reimold EW: Changes in zinc metabolism during the course of the nephrotic syndrome. Am J Dis Child 134: 46, 1980.
  • 29 - Riordan JF: Biochemistry of zinc. Med Clin North Am 60: 661, 1976.
  • 30 - Royer P ve ark.: Renal osteopathy. Pediatric Nephrology, W.B. Saunders Co, 1974, p: 395.
  • 31 - Rubin MI, Baratt TM: Pediatric Nephrology, The Williams and Wilkins Co, Baltimore, 1975, p: 740.
  • 32 - Stanbury SW: Bone disease in uremia. Am J Med 44: 714, 1968.
  • 33 - Starcher BC, Hill CH, Modaras JG: Effect of zinc deficiency on bone collagenase and collagen turnover. J Nutr 110: 2095, 1980.
  • 34 - Teitelbaum SL: Morphological effects of vitamin D and its analogs on bone. Am J Clin Nutr 29: 1300, 1976.
  • 35 - Vaughan JM: The physiology of bone. JW Arrowsmith Ltd, England, 1970, p: 61, 91.
  • 36 - Wizemann V ve ark.: Intestinal Mg absorption: Effect of chronic uremia, calcium, and calcitrol. Kidney Int 20: 169, 1981.

Renal Osteodistrofinin Erken Evresinde Kemik Histolojisi ve Mineral Dengesi

Year 1982, Volume: 35 Issue: 1, 157 - 166, 31.03.1982

Necmiye Tümer

Abstract

Bu çalışma, kronik böbrek yetmezliğinin radyolojik bulguları ortaya çıkmadan önceki erken evresinde kemik dokusundaki histolojik değişiklikleri ve mineral dengesini incelemektedir. Radyolojik olarak renal osteodistrofi bulgusu olmayan 11 çocuk hastadan alınan kemik biyopsilerinde, lamellerde incelme, atrofi ve kemik yapımında azalma gözlenmiştir. Kemik dokusunda anlamlı şekilde azalmış kalsiyum ve hidroksiprolin düzeyleri saptanırken; fosfor, magnezyum, çinko, bakır ve alkalen fosfataz düzeyleri normal bulunmuştur. Serum ve idrarda kalsiyum değerleri hafif düşük olup, hidroksiprolin ise anlamlı düzeyde azalmıştır. Sonuçlar, kemik yapımındaki azalma ile düşük hidroksiprolin ve kalsiyum düzeyleri arasında pozitif bir ilişki olduğunu ve bu metabolik bozuklukların vitamin D yetersizliği ile yetersiz protein alımına bağlı gelişebileceğini göstermektedir. Radyolojik bulgular oluşmadan önce tanı ve tedaviye başlanmasının önemi vurgulanmaktadır.

Keywords

renal kemik mineral

References

  • 1 - Beale MG ve ark.: Renal osteodystrophy. Pediat Clin North Am 23: 873, 1976.
  • 2 - Bengman I, Laxley R: Two improved and simplified methods for the spectrophotometric determination of hydroxyprolin. Anal Chem 35: 1961, 1963.
  • 3 - Casey CE ve ark.: Zinc, copper and vitamin A in pediatric dialysis. J Pediatr 98: 434, 1981.
  • 4 - Chan JCM: Renal osteodystrophy in children: Progress in its management. Clin Pediatr 15: 996, 1976.
  • 5 - Chan JCM, Kodroff MB, Landwehr DM: Effects of 1.25-dihydroxy-vitamin-D on renal function, mineral balance, and growth in children with severe chronic renal failure. Pediatrics 68: 559, 1981.
  • 6 - Coburn JW: Renal osteodystrophy. Kidney Int 17: 677, 1980.
  • 7 - Coburn JW ve ark.: Lefective skeletal mineralization in uremia without relation to vitamin D, serum Ca. or P. Kidney Int 12: 455, 1977.
  • 8 - Coburn JW, Hartenbower DL, Brickman AS: Advances in vitamin D metabolism as they pertain to chronic renal disease. Am J Clin Nutr 29: 1283, 1978.
  • 9 - Colowick SP, Kaplan ND: Methods in enzymology. Academic Press Inc., New York, 1957. Vol II, Section VII.
  • 10 - Evans GW, Johnson EG: Zinc absorption in rats fed a low protein diet and a low protein supplemented with tryptophan or picolinic acid. J Nutr 110: 1076, 1980.
  • 11 - Favus MR: Vitamin D physiology and some aspects of the vitamin D endocrine system. Med Clin North Am 62: 1291, 1978.
  • 12 - Gordon EF, Gordon RC, Passal DB: Zinc metabolism. J Pediatr 99: 341, 1981.
  • 13 - Hanley DA, Sherwood LM: Sekonder hyperparathyroidism in chronic renal failure: Pathophysiology and treatment. Med Clin North Am 62: 1319, 1978.
  • 14 - Heller RM ve ark.: Skeletal changes of copper deficiency in infants receiving prolonged total parenteral nutrition. J Pediatr 92: 947, 1978.
  • 15 - Hodsman ve ark.: Bone aluminium in osteomalacic renal osteodystrophy correlation with excess osteoid. Kidney Int 19: 127, 1981.
  • 16 - Hsieh HS, Navia JM: Zinc deficiency and bone formation in guinea pig alveolar implants. J Nutr 110: 1581, 1980.
  • 17 - Koo SI, Fullmer CS, Wasserman RH: Effects of cholecalciferol and 1.25 dihydroxycholecalciferol on the intestinal absorption of zinc in the chick. J Nutr 110: 1813, 1980.
  • 18 - Latorzeff S ve ark.: Quantitative study of bone biopsy in 81 uremic patients. Kidney Int 9: 522, 1976.
  • 19 - Lindman RD ve ark.: Serum concentrations and urinary excretions of zinc in cirrhosis, nephrotic syndrome and renal insufficiency. Am J Med Sci 275: 17, 1978.
  • 20 - Mahajan SK ve ark.: Zinc deficiency in uremia. Kidney Int 19: 153, 1981.
  • 21 - Malluche HH ve ark.: Bone histology in incipient and advanced renal failure. Kidney Int 9: 355, 1976.
  • 22 - Mankin HJ: Rickets, osteomalacia and renal osteodystrophy. J Bone Joint Surg 56A: 352, 1974.
  • 23 - Mansouri K, Halsted JA, Gombos EA: Zinc, copper, magnesium and calcium in dialyzed and non-dialyzed uremic patients. Arch Intern Med 125: 88, 1970.
  • 24 - Norman ME ve ark.: Early diagnosis of juvenile renal osteodystrophy. J Pediatr 97: 226, 1980.
  • 25 - Oreopoulos DG ve ark.: Plasma hydroxyproline: An accurate index of bone resorption in renal failure. Kidney Int 12: 459, 1977.
  • 26 - Perkin-Elmer: Clinical methods for atomic absorption spectroscopy. AA-Cu-1.1 & AA-Zn-1.1, Norwalk, Connecticut, 1971.
  • 27 - Prasad AS: Trace elements and iron in human metabolism. John Wiley & Sons Ltd., 1978, p: 315.
  • 28 - Reimold EW: Changes in zinc metabolism during the course of the nephrotic syndrome. Am J Dis Child 134: 46, 1980.
  • 29 - Riordan JF: Biochemistry of zinc. Med Clin North Am 60: 661, 1976.
  • 30 - Royer P ve ark.: Renal osteopathy. Pediatric Nephrology, W.B. Saunders Co, 1974, p: 395.
  • 31 - Rubin MI, Baratt TM: Pediatric Nephrology, The Williams and Wilkins Co, Baltimore, 1975, p: 740.
  • 32 - Stanbury SW: Bone disease in uremia. Am J Med 44: 714, 1968.
  • 33 - Starcher BC, Hill CH, Modaras JG: Effect of zinc deficiency on bone collagenase and collagen turnover. J Nutr 110: 2095, 1980.
  • 34 - Teitelbaum SL: Morphological effects of vitamin D and its analogs on bone. Am J Clin Nutr 29: 1300, 1976.
  • 35 - Vaughan JM: The physiology of bone. JW Arrowsmith Ltd, England, 1970, p: 61, 91.
  • 36 - Wizemann V ve ark.: Intestinal Mg absorption: Effect of chronic uremia, calcium, and calcitrol. Kidney Int 20: 169, 1981.
There are 36 citations in total.

Details

Primary Language Turkish
Subjects Infant and Child Health
Journal Section Research Article
Authors

Necmiye Tümer This is me

Publication Date March 31, 1982
Published in Issue Year 1982 Volume: 35 Issue: 1

Cite

APA Tümer, N. (1982). Renal Osteodistrofinin Erken Evresinde Kemik Histolojisi ve Mineral Dengesi. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 35(1), 157-166.
AMA Tümer N. Renal Osteodistrofinin Erken Evresinde Kemik Histolojisi ve Mineral Dengesi. Ankara Üniversitesi Tıp Fakültesi Mecmuası. March 1982;35(1):157-166.
Chicago Tümer, Necmiye. “Renal Osteodistrofinin Erken Evresinde Kemik Histolojisi Ve Mineral Dengesi”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 35, no. 1 (March 1982): 157-66.
EndNote Tümer N (March 1, 1982) Renal Osteodistrofinin Erken Evresinde Kemik Histolojisi ve Mineral Dengesi. Ankara Üniversitesi Tıp Fakültesi Mecmuası 35 1 157–166.
IEEE N. Tümer, “Renal Osteodistrofinin Erken Evresinde Kemik Histolojisi ve Mineral Dengesi”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 35, no. 1, pp. 157–166, 1982.
ISNAD Tümer, Necmiye. “Renal Osteodistrofinin Erken Evresinde Kemik Histolojisi Ve Mineral Dengesi”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 35/1 (March1982), 157-166.
JAMA Tümer N. Renal Osteodistrofinin Erken Evresinde Kemik Histolojisi ve Mineral Dengesi. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 1982;35:157–166.
MLA Tümer, Necmiye. “Renal Osteodistrofinin Erken Evresinde Kemik Histolojisi Ve Mineral Dengesi”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 35, no. 1, 1982, pp. 157-66.
Vancouver Tümer N. Renal Osteodistrofinin Erken Evresinde Kemik Histolojisi ve Mineral Dengesi. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 1982;35(1):157-66.