RESUMEN
BACKGROUND: It is now recognized that long-term exposure to even low levels of lead may increase bone lead content. Lead can then be released in toxicologically significant amounts during critical states of increased bone turnover. METHODS: Two patients with end-stage renal failure, one on haemodialysis and the other on continuous ambulatory peritoneal dialysis (CAPD), had been exposed to lead and developed secondary hyperparathyroidism. An edetate calcium disodium (EDTA) test was performed in combination with haemofiltration or CAPD before and after parathyroidectomy. RESULTS: Before parathyroidectomy, both patients had low delta aminolaevulinic acid dehydrase (ALA-D) and high concentrations of chelated lead. After parathyroidectomy, there was a dramatic decrease in chelated lead and the ALA-D returned to normal. CONCLUSION: Secondary hyperparathyroidism increases mobilization of bone lead in dialysis patients with an elevated lead burden. This may cause toxic effects.
Asunto(s)
Huesos/metabolismo , Hiperparatiroidismo Secundario/complicaciones , Fallo Renal Crónico/complicaciones , Fallo Renal Crónico/metabolismo , Plomo/metabolismo , Anciano , Transporte Biológico , Femenino , Humanos , Fallo Renal Crónico/terapia , Masculino , Persona de Mediana Edad , Diálisis Peritoneal Ambulatoria Continua , Diálisis RenalAsunto(s)
Aspirina/metabolismo , Membrana Sinovial/metabolismo , Sinovitis/tratamiento farmacológico , Adolescente , Adulto , Anciano , Aspirina/sangre , Femenino , Humanos , Cinética , Articulación de la Rodilla , Masculino , Persona de Mediana Edad , Proteínas/metabolismo , Líquido Sinovial/metabolismo , Sinovitis/metabolismoRESUMEN
Recently, respiratory acidemia has been shown to be associated with an altered volume of distribution (Vd) of theophylline in patients during an acute exacerbation of chronic obstructive pulmonary disease. However, many factors other than acidemia could have altered the pharmacokinetics. Our purpose was to study the effects of respiratory acidemia alone. Six awake dogs had normocapnia and hypercapnia induced in a conditioned chamber. After intravenous injection (8 mg/kg), plasma theophylline concentrations were measured for 8 hours by means of quantitative enzyme immunoassay technique. There were no statistically significant effects of respiratory acidosis on Vd and total theophylline clearance. There was no significant correlation between these variables and pH, PCO2, PO2. We conclude that respiratory acidosis, per se, does not effect theophylline pharmacokinetics in dogs.