ABSTRACT
We evaluated the course of severe aluminum-related bone disease (ARBD) after the first year of a successful renal transplantation (RTx) in 11 adult patients. Bone pain and muscle weakness, presented in all patients previously to RTx, subsided, and all were able to walk, even the ones who were confined to wheelchairs. Bone necrosis developed in 6 patients, but none required surgical repair. Serum alkaline phosphatase activity increased 2.5 times the upper normal level, up to the 5th month and then declined to normal levels up the 12th month (p < 0.05). The inverse profile was observed in both serum calcium and phosphorus levels. In bone biopsies, there was a significant decrease in all of the following histomorphometric static parameters: osteoid volume, thickness and surface and also in aluminum surface. Also, there was a significant increase in all the dynamic parameters of mineralization: mineral apposition rate, mineralization surface, bone formation rate and adjusted apposition rate. In conclusion, ARBD remarkably improves after 1 year of successful RTx.
Subject(s)
Aluminum/metabolism , Bone and Bones/metabolism , Chronic Kidney Disease-Mineral and Bone Disorder/metabolism , Kidney Transplantation , Osteomalacia/metabolism , Adult , Bone Density , Bone and Bones/pathology , Bone and Bones/physiopathology , Calcification, Physiologic , Calcium/blood , Chronic Kidney Disease-Mineral and Bone Disorder/pathology , Chronic Kidney Disease-Mineral and Bone Disorder/physiopathology , Creatinine/blood , Female , Humans , Male , Middle Aged , Osteogenesis , Osteomalacia/pathology , Osteomalacia/physiopathology , Phosphorus/blood , Postoperative Period , Prospective StudiesSubject(s)
Graft Rejection/radiation effects , Immunosuppression Therapy/methods , Kidney Transplantation , Adolescent , Adult , Female , Humans , Injections, Intralymphatic , Iodine Radioisotopes/administration & dosage , Iodine Radioisotopes/therapeutic use , Iodized Oil/therapeutic use , Male , Middle Aged , Prognosis , Radiotherapy DosageABSTRACT
A case of renal transplantation is presented in which the donor had idiopathic hypercalciuria. The hypercalciuria persisted in the donor, but was not observed in the recipient. This fact suggests that, in this case, the cause of the hypercalciuria is the intestinal hyperabsorption of calcium ions.
Subject(s)
Calcium/urine , Kidney Transplantation , Tissue Donors , Adolescent , Calcium/blood , Creatinine/blood , Female , Graft Rejection , Humans , Kidney Function Tests , Male , Middle Aged , Phosphorus/blood , Postoperative Complications/diagnosis , Sodium/blood , Transplantation, HomologousABSTRACT
The effect of intra-lymphatic administration of Lipiodol-l131 on the number of T and B lymphocytes, and on the in vivo response to common antigens and to DNCB, was investigated in uremic patients in the pre-transplant period. T lymphocytes have been detected by rosette formation with sheep erythrocytes (E) and B lymphocytes by rosette formation with erythrocytes sensitized with antibody and complement (EAC). After irradiation it was observed a lymphopenia due to a statistically significant decrease in the number of both T and B peripheral blood lymphocytes and a depletion of these cells in the irradiated lymph nodes. Their ability to give delayed hypersensitivity response to common antigens in vivo was lost after intralymphatic irradiation. Two patients were able to develop sensitization to DNCB and this reaction was supressed in one of them by irradiation. These effects of intralymphatic irradiation on the immune system favours further study of this method in clinical renal transplantation.