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Titolo:
Rubidium deficiency in dialysis patients
Autore:
Canavese, C; DeCostanzi, E; Branciforte, L; Caropreso, A; Nonnato, A; Pietra, R; Fortaner, S; Jacono, F; Angelini, G; Gallieni, M; Fop, F; Sabbioni, E;
Indirizzi:
Univ Turin, Dept Internal Med, Nephrol Sect, Turin, Italy Univ Turin Turin Italy n, Dept Internal Med, Nephrol Sect, Turin, Italy Univ Turin, Dept Internal Med, Neurosci Sect, Turin, Italy Univ Turin Turin Italy , Dept Internal Med, Neurosci Sect, Turin, Italy S Giovanni Molinette Hosp, Dept Analyt Chem, Turin, Italy S Giovanni Molinette Hosp Turin Italy p, Dept Analyt Chem, Turin, Italy S Paolo Hosp, Renal Unit, Milan, Italy S Paolo Hosp Milan ItalyS Paolo Hosp, Renal Unit, Milan, Italy Asti Hosp, Renal Unit, Milan, Italy Asti Hosp Milan ItalyAsti Hosp, Renal Unit, Milan, Italy Joint Res Ctr Ispra, European Commiss, Varese, Italy Joint Res Ctr Ispra Varese Italy Ispra, European Commiss, Varese, Italy
Titolo Testata:
JOURNAL OF NEPHROLOGY
fascicolo: 3, volume: 14, anno: 2001,
pagine: 169 - 175
SICI:
1121-8428(200105/06)14:3<169:RDIDP>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRACE-ELEMENT CONCENTRATIONS; CHRONIC-RENAL-FAILURE; HEMODIALYSIS-PATIENTS; MAJOR DEPRESSION; DISEASE; PLASMA; UREMIA; HEMOFILTRATION; DIAGNOSIS; CHLORIDE;
Keywords:
rubidium; dialysis; depression; trace elements; quality of life;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
46
Recensione:
Indirizzi per estratti:
Indirizzo: Canavese, C S Giovanni Molinette Hosp, Dept Nephrol, Corso Bramante 88, I-10126 Turin,Italy S Giovanni Molinette Hosp Corso Bramante 88 Turin Italy I-10126
Citazione:
C. Canavese et al., "Rubidium deficiency in dialysis patients", J NEPHROL, 14(3), 2001, pp. 169-175

Abstract

Background. Since dialysis has brought long-term survival to uremic patients, we can now speculate on more subtle problems derived from imbalance or sub-optimal regulation of some elements such as trace metals. We focused onthe rubidium (Rb) status in dialysis patients (HD), as concerns about its possible deficiency have been raised. Methods. Rb in uremic patients was evaluated by: A) serum concentration (graphite furnace atomic absorption spectroscopy) from blood samples of 70 patients on chronic hemodialysis (HD) incomparison with 75 controls; B) tissue concentration (neutron activation analysis) from autopsy or biopsy samples (20) of HD patients in comparison with 21 controls; C) in vivo intradialytic mass balance during standard bicarbonate dialysis in 8 HD patients. Results. A) Serum Rb concentrations in HD patients significantly were lower than in normal controls (304 +/- 81 mug/L versus 350 +/- 74 mug/L p <0.001, log-transformed 5.68 +/- 0.28 versus 5.84 +/- 0.20, p <0.001). Univariate logistic regression analysis found a significantly higher risk of serum Rb < 250-300 and 350 mug/L in uremic patients than in controls (Odd ratios or 12.6, 95% CI 2.77 - 57.04; 4.0, 95% CI 1.92 - 8.4; 2.08, 95% CI 1.02 - 4.25, respectively). B) Rb was significantly lower in tissues of HD patients, including brain (2250 +/- 1520 ng/g versus 5490 +/- 1250 ng/g, p=0.0002) than normal controls. C) Rb was transferred from the patients' blood to the dialysis bath during a standard bicarbonate dialysis session, giving mean intradialytic Rb removal of 4.0 +/-1.1 mg/session. Conclusions. These results confirm that Rb deficiency may arise in uremic patients, and indicate that diffusive dialysis treatments allow Rb removal which, however, with a standard bicarbonate schedule does not seem to be any greater than that expected with normal urine output (20 mg/week). Furtherstudies are needed to clarify the roles of many factors in this Rb deficiency, including the effects of uremia by itself, pre-dialysis factors (diet,impaired renal function and drugs), dialysis procedures (frequency, hours,diffusive/convective components) or other biochemical/clinical parameters (hemoglobin, body mass index, age). The finding of a Rb deficiency in uremia is important as it has a role in neurobehavioural functions, mainly as anantidepressant. As Rb deficiency may be implicated in central nervous system alterations which strongly influence the quality of life, we believe that monitoring serum Rb in uremic patients and clarifying the causal mechanisms of deficiency will facilitate future therapeutic approaches.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 18/01/20 alle ore 07:23:38