Partially reversible renal tubular damage in patients with obstructive jaundice
Φόρτωση...
Ημερομηνία
Συγγραφείς
Bairaktari, E.
Liamis, G.
Tsolas, O.
Elisaf, M. S.
Τίτλος Εφημερίδας
Περιοδικό ISSN
Τίτλος τόμου
Εκδότης
Περίληψη
Τύπος
Είδος δημοσίευσης σε συνέδριο
Είδος περιοδικού
peer-reviewed
Είδος εκπαιδευτικού υλικού
Όνομα συνεδρίου
Όνομα περιοδικού
Hepatology
Όνομα βιβλίου
Σειρά βιβλίου
Έκδοση βιβλίου
Συμπληρωματικός/δευτερεύων τίτλος
Περιγραφή
Decreased serum uric acid levels resulting from renal urate wasting have been occasionally encountered in jaundiced patients. However, in these cases, there are no data concerning the underlying renal tubular defects. In the present study, we investigated the renal tubular function in 35 patients with obstructive jaundice of various severity and causes (11 with lithiasis, 17 with carcinoma, and 7 with intrahepatic cholestasis). A detailed study of the renal tubular function was performed. Beyond the conventional methods, (1)H-NMR spectroscopy of urine was used to evaluate noninvasively renal damage by the characteristic perturbation in the excretion pattern of low-molecular weight endogenous metabolites. On admission, patients with obstructive jaundice had significantly lower serum uric acid and phosphate levels and higher bile acid concentrations compared with 40 age- and sex-matched controls. Serum uric acid levels presented a negative correlation with the total and direct bilirubin as well as the fractional excretion of uric acid. Furthermore, a great number of the patients studied developed one or more proximal tubular dysfunction manifestations beyond uricosuria, such as renal glucosuria, phosphaturia, and increased excretion of alpha(1)-microglobulin. (1)H-NMR spectroscopy of the urine showed decreased levels of citrate and hippurate and increased levels of 3-hydroxybutyrate and acetate. In 12 patients partial or complete remission of jaundice was followed by an improvement of the proximal renal tubular damage. In conclusion, obstructive jaundice can cause a partially reversible generalized proximal tubular dysfunction.
Περιγραφή
Λέξεις-κλειδιά
Adult, Bile Acids and Salts/blood, Cholestasis/blood/*pathology/physiopathology/urine, Female, Humans, Kidney Tubules, Proximal/*pathology/physiopathology, Magnetic Resonance Spectroscopy, Male, Middle Aged, Phosphates/blood/urine, Prospective Studies, Reference Values, Uric Acid/blood/urine
Θεματική κατηγορία
Παραπομπή
Σύνδεσμος
http://www.ncbi.nlm.nih.gov/pubmed/11391524
http://onlinelibrary.wiley.com/store/10.1053/jhep.2001.25089/asset/510330605_ftp.pdf?v=1&t=h0ak7jbo&s=35f02d78b8a9e3ceba632901179dddc788d8c016
http://onlinelibrary.wiley.com/store/10.1053/jhep.2001.25089/asset/510330605_ftp.pdf?v=1&t=h0ak7jbo&s=35f02d78b8a9e3ceba632901179dddc788d8c016
Γλώσσα
en
Εκδίδον τμήμα/τομέας
Όνομα επιβλέποντος
Εξεταστική επιτροπή
Γενική Περιγραφή / Σχόλια
Ίδρυμα και Σχολή/Τμήμα του υποβάλλοντος
Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής