Administration Of EDTA Research Articles

Evaluation of Dissolution of Pulp by Sodium Hypochlorite when Mixed with Tetrasodic Etidronate and Disodic Ethylenediamine Tetraacetate under Controlled Flow.

Sodium hypochlorite serves as the most efficient root canal irrigating fluid. This study's goal was to assess the replenished NaOCl's capacity to dissolve the tissue of pulp when combined with 9% tetrasodic etidronate (Na4HEBP), 18% tetrasodic etidronate (Na4HEBP), and 17% disodic ethylenediaminetetraacetate (Na2EDTA) under continuous controlled administration. Hundred and twenty complete undamaged teeth of the anterior mandible extracted due to periodontal problems within forty-eight hours were taken as a source of the pulp tissue. It was found that there was a decrease in the weight of pulp tissue in all groups except negative control. NaOCl's potential to dissolve tissue with chelating agents like EDTA and HEBP inside the root canal was unaffected when there was controlled administration of EDTA and HEBP.

Specific detection of Cu2+ by a pH-independent colorimetric rhodamine based chemosensor

A new colorimetric “off-on” rhodamine based chemosensor for metal ions (2,4,6-trihydroxybenzaldehyde rhodamine B hydrazone, THB ) was synthesized via Schiff base chemistry between rhodamine B hydrazide and 2,4,6-trihydroxybenzaldehyde. Of all the metal ions tested, it selectively turned pink in the presence of Cu 2+ , and its sensitivity was evaluated. Coordination with Cu 2+ was accompanied by a binding constant of 5.95 × 10 3 M −1 whilst its detection limit is remarkably low (0.48 μM; WHO acceptable limit = 31.5 μM). Moreover, detection of Cu 2+ with THB was independent of pH as pinkish mixture with high absorbance was observed in a wide range from pH 4–12. Consequently, a 1:1 binding ratio of THB to Cu 2+ was verified. Additionally, THB can be reversibly used for up to three times with administration of EDTA and the coordination of THB with Cu 2+ was corroborated by the shifting of carbonyl amide peak in the FT-IR spectra. Then, the prototype of THB as an on-site test kit for detection of Cu 2+ in 100% aqueous condition was also successfully demonstrated. However, THB is weakly cytotoxic against the colorectal adenocarcinoma cell line HT-29 albeit non-toxic towards the non-cancerous colon cell line CCD-18Co (IC 50 via MTT: HT-29 = 39.24 ± 1.59 μM; CCD-18Co > 50.62 μM). Nonetheless, these findings proposed the potential of THB as a simple and feasible sensor in multiple practical applications. • Excellent selectivity of THB towards copper ions. • Wide pH detection range for Cu 2+ . • Versatile application of THB in both acidic and alkaline conditions. • Detection limit of 0.48 μM, well below WHO acceptable levels (31.5 μM). • Application of THB as an on-site testing kit.

Determination by ICP-MS and multivariate data analysis of elemental urine excretion profile during the EDTA chelation therapy: A case study

BackgroundBased on the medical history and laboratory analytical tests, a patient presenting symptoms compatible with Chronic Fatigue Syndrome was suspected of metal intoxication; therefore, a chelating therapy was attempted. In parallel, the profile of elemental excretion in urine was determined. MethodsChelation therapy by CaNa2EDTA was administered every two weeks and urine samples were routinely collected for 17 months. The samples were mineralized with HNO3 69 % and analyzed by Inductively-Coupled Plasma – Mass Spectrometry. Data were processed by multivariate statistical methods. ResultsMost of the toxic elements showed a peak of excretion in 12−24 h after EDTA administration, which returned to basal level by 24−36 h after the treatment. Yet, the excretion of some trace elements persisted in the urine collected 26 h after the treatment. ConclusionsThe analysis of excreted metals following the CaNa2EDTA infusion allowed to monitor dynamically the chelation therapy. The chelation therapy was effective in mobilizing and eliminating the principal heavy metals present from the body. However, since such clearance almost vanished 24 h after the treatment, a protocol with more frequent and low-dose administrations is advisable to improve the metal excretion.

Effect of Ferric Sodium EDTA administration, in combination with vitamin C, folic acid, copper gluconate, zinc gluconate and selenomethionine, on cardiovascular risk evaluation: exploration of the HRV frequency domain

Background: Anaemia is a frequent co-morbidity in old patients affected by chronic heart failure and/or respiratory diseases. Using the Heart Rate Variability (HRV) analysis is possible to provide an evaluation of the safety and the effectiveness of intervention. Objective: To evaluate the efficacy and safety of Ferric Sodium EDTA in combination with vitamin C, folic acid, copper gluconate, zinc gluconate and selenomethionine (Ferachel forte®) 2 tabs/day for 24 days in elderly patients with secondary anaemia, by exploring the HRV frequency domain. Methods: In 45 elderly patients with secondary anaemia and/or low-moderate kidney failure, laboratory values after administration of Ferric Sodium EDTA, 2 tabs a day, in combination with vitamin C, folic acid, copper gluconate, zinc gluconate and selenomethionine (Ferachel forte®) for 24 days (N=16 patients) or ferrous gluconate 63 mg/day added to saline solution administered using intravenous access during the hospitalization period of 15+5 days (N=29 patients) were evaluated. Also, ECG signals and bioelectrical impedance (BIA) were measured. Results: Oral iron supplementation with Ferric Sodium EDTA, in combination with vitamin C, folic acid, copper gluconate, zinc gluconate and selenomethionine (Ferachel forte®) confirmed to be effective and safe about the cardiovascular risk in old patients. This study showed the real superiority of the oral administration about the cardiovascular risk in elderly patients in comparison with intravenous administration of ferrous gluconate. Conclusion: This study confirms that Ferric Sodium EDTA combination (Ferachel forte®) can be a valid alternative to ferrous gluconate intravenous therapy (gold standard) in the treatment of secondary anaemia in elderly patients. In fact, during the treatment, efficacy results have been maintained without statistically significant variations about cardiovascular risk, evaluated by exploring the HRV frequency domain.

In-VITRo effect of Ficus deltoidea on the contraction of isolated rat's uteri is mediated via multiple receptors binding and is dependent on extracellular calcium.

BackgroundFicus deltoidea, is a perennial herb that is used to assist labor, firm the uterus post-delivery and to prevent postpartum bleeding. In view of its claimed uterotonic action, the mechanisms underlying plant’s effect on uterine contraction were investigated.MethodsAdult female SD rats were injected with 2 mg/kg 17β-oestradiol (E2) to synchronize their oestrous cycle. A day after injection, uteri were removed for in-vitro contraction studies. The dose dependent effect of Ficus deltoidea aqeous extract (FDA) on the tension produced by the isolated rat’s uteri was determined. The effects of atropine (2×10-8 M), atosiban (0.5 IU), THG113.31 (10 μM), oxodipine (0.25 mM), EDTA (1 mM), 2-amino-ethoxy-diphenylborate (2-APB) (40 mM) and thapsigargin (1 mM) on the maximum force of contraction (Emax) achieved following 2 mg/ml FDA administration were also investigated.ResultsFDA induced in-vitro contraction of the isolated rat’s uteri in a dose-dependent manner. Administration of atropine, atosiban and THG113.31 reduced the Emax with atosiban having the greatest effect. The Emax was also reduced following oxodipine and EDTA administration. There was no significant change observed following 2-APB administration. Thapsigargin, however, augmented Emax.ConclusionsFDA-induced contraction of the isolated rat’s uteri is mediated via multiple uterotonin receptors (muscarinic, oxytocin and prostaglandin F2α) and was dependent on the extracellular Ca2+. Contraction, however, was not dependent on the Ca2+ release from the internal stores. This in-vitro study provides the first scientific evidence on the claimed effect of Ficus Deltoidea on uterine contraction.

Lead toxicosis of captive vultures: case description and responses to chelation therapy

BackgroundLead, a serious threat for raptors, can hamper the success of their conservation. This study reports on experience with accidental lead intoxication and responses to chelation therapy in captive Cinereous (Aegypius monachus) and Egyptian (Neophron percnopterus) Vultures.ResultsSoil contamination by lead-based paint sanded off the steel aviary resulted in poisoning of eight Cinereous and two Egyptian Vultures. A male Egyptian Vulture developed signs of apathy, polydipsia, polyuria, regurgitation, and stupor, and died on the next day. Liver, kidney and blood lead concentrations were 12.2, 8.16 and 2.66 μg/g, respectively. Laboratory analyses confirmed severe liver and kidney damage and anaemia. Blood Pb levels of Pb-exposed Cinereous Vultures were 1.571 ± 0.510 μg/g shortly after intoxication, decreased to 0.530 ± 0.165 μg/g without any therapy in a month and to 0.254 ± 0.097 μg/g one month after CaNa2EDTA administration. Eight months later, blood lead levels decreased to close to the background of the control group. Blood parameters of healthy Pb-non-exposed Cinereous Vultures were compared with those of the exposed group prior to and after chelation therapy. Iron levels in the lead-exposed pre-treatment birds significantly decreased after chelation. Haematocrit levels in Pb-exposed birds were significantly lower than those of the controls and improved one month after chelation. Creatine kinase was higher in pre-treatment birds than in the controls but normalised after therapy. Alkaline phosphatase increased after chelation. A marked increase in the level of lipid peroxidation measured as thiobarbituric acid reactive species was demonstrated in birds both prior to and after chelation. The ferric reducing antioxidant power was significantly lower in pre-treatment vultures and returned to normal following chelation therapy. Blood metallothionein levels in lead-exposed birds were higher than in controls. Reduced glutathione dropped after CaNa2EDTA therapy, while oxidised glutathione was significantly lower in both pre- and post-treatment birds. A chick in an egg produced by a Cinereous Vulture female two months after lead toxicosis died on day 40 of artificial incubation. Lead concentrations in foetal tissues were consistent with levels causing avian mortality.ConclusionsThe reported blood parameters and reproduction impairment in captive birds may have implications for professionals dealing with lead exposure in wild birds.

EDTA chelation reappraisal following new clinical trials and regular use in millions of patients: review of preliminary findings and risk/benefit assessment

EDTA chelation therapy is regularly used in thousands of patients worldwide. An FDA approval of more than 50 years ago for heavy metal detoxification prompted many physicians to use EDTA as an alternative medicine for many categories of patients. Recently, NIH initiated the so-called Trial to Assess Chelation Therapy (TACT), which has been designed to evaluate whether EDTA and high dose oral vitamins and mineral therapy could offer clinical, quality of life, and economic benefits for patients with a previous myocardial infraction. A 50% reduction of urinary Pb and improvement of systolic blood pressure was observed in 33 cardiovascular patients following 20 iv administrations. In another study involving 15 patients of different categories, EDTA also has been shown to be an effective and nontoxic chelator for the removal of xenobiotic metals such as Pb, Cd, Ni and Al. Administration of iv EDTA on weekly basis appears to be a sufficient and nontoxic protocol for treating patients with suspected overload and toxicity of xenobiotic metals especially Pb and Cd. The causative effect of xenobiotic metals in cancer, cardiovascular, neurodegenerative, renal and other diseases needs further investigation. Similarly, the use of EDTA chelation therapy in other conditions, which are not related to xenobiotic metal toxicity needs further investigation and confirmation of therapeutic use from controlled randomized clinical trials. Metal balance and drug interaction studies are required to clarify the risk/benefit assessment for the long term use of EDTA in patients with excess xenobiotic metal toxicity and in other conditions.

Effectiveness of treatment of calcific tendinitis of the shoulder by disodium EDTA

To evaluate the effectiveness of disodium EDTA administration in the treatment of calcific tendinitis of the shoulder. Eighty patients with radiographically verified calcific tendinitis of the shoulder were enrolled between September 2001 and October 2003. Patients were randomly assigned to either a study group (n = 40) or a control group (n = 40). Pain and functional level were evaluated before and after treatment and at 1-year followup. Radiographic modifications in calcifications were evaluated before and after treatment. Disodium EDTA was administered through single needle mesotherapy and 15 minutes of pulsed-mode 1 MHz-ultrasound. The study group displayed improvement in all of the parameters analyzed after treatment and at the 1-year followup. Calcifications disappeared completely in 62.5% of the patients in the study group and partially in 22.5%; calcifications partially disappeared in only 15% of the patients in the control group, and none displayed a complete disappearance. Our results suggest that the use of disodium EDTA for the management of calcific tendinitis of the shoulder is safe and effective, leading to a significant reduction in pain, improvement in shoulder function, and disappearance of calcifications after 4 weeks, without adverse effects.

Parathyroid hormone secretion in women in late menopause submitted to EDTA-induced hypocalcemia

Objective The physiological role of parathormone (PTH) in the maintenance of bone mass in humans has not been fully defined. The main objective of the present study was to evaluate basal and EDTA-stimulated PTH levels in young women (Group Y = 30.9 years, N = 7) and in women in late menopause (Group M = 64.7 years, N = 7) and their relationship to bone mineral density. Methods The PTH secretion test was performed by induction of hypocalcemia through intravenous administration of EDTA for 2 h. Blood samples were collected every 10 min and used for ionic calcium and PTH measurements. During the basal period, an additional sample was collected for the determination of osteocalcin, FSH, and estradiol. A sample of early morning second voided urine was collected for analysis of deoxypiridinoline and creatinine as well as bone mass density (BMD) was determined by dual X-ray energy absorptiometry (DEXA). Results The aged patients presented lower femoral BMD (Y = 0.860 g/cm 2 vs. M = 0.690 g/cm 2, p < 0.01), with four of them having a T score lower than −2.5 S.D. Basal, and during the EDTA infusion, PTH values were similar in both groups. However, among aged volunteers, the rise in PTH levels was higher for subjects with normal bone mass (NM: peak = 236 pg/ml) than for subjects with osteoporosis (OM: peak = 134.4 pg/ml). Conclusions The present results suggest that PTH can have a modulating effect on the rate of bone loss during late menopause.

EDTA‐induced urothelial cell shedding for the treatment of superficial bladder cancer in the mouse

The aim of this study was to determine the effect of intravesical EDTA instillation on the development of intravesically implanted tumor cells in normal mice. The mouse bladder tumor (MBT-2) model was used in female C3H/eb mice to evaluate the amount of normal urothelial cell shedding, and the degree of tumor growth inhibition following intravesical EDTA instillation in comparison with phosphate-buffered saline (PBS) instillation. At 1 h after instillation, the number of urothelial cells aspirated was 500-1000 per PBS-treated mouse and 10,000-20,000 per EDTA-treated mouse (P < 0.00001). The bladder weight, which reflected the effect of the agent on the tumor, was similar in the untreated and PBS-treated mice (105.46 +/- 46 mg and 106.2 +/- 50 mg, respectively). It was significantly lower in the EDTA-treated mice (80.4 +/- 42 mg) (P = 0.0045). Intravesical administration of EDTA results in significant normal and neoplastic urothelial cell shedding. Intravesical irrigation with EDTA may prevent adherence of the malignant cells to the bladder wall following tumor resection.

Effect of Oral Calcium Disodium EDTA on Iron Absorption in a Human Model of Iron Overdose

Objective. Anecdotal case reports and animal models have suggested that the administration of CaNa2 EDTA (EDTA) may be effective in reducing the absorption of iron after an oral iron overdose. We designed this study to determine the effect of orally administrated EDTA with or without activated charcoal (AC) on iron absorption after a mild iron ingestion in healthy human volunteers. Methods. A randomized, crossover study was conducted in eight healthy human volunteers. All subjects ingested 5 mg/kg of elemental iron in the form of ferrous sulfate. One hour post ingestion, subjects were randomized to receive 35 mg/kg EDTA, EDTA plus 50 grams of AC, or water. Serial iron levels were obtained at baseline and every hour for the first 6 hours, then at 8, 12, and 24 hours. A 2-week washout was used between study arms. The Kruskal-Wallis test was used for the following comparisons between treatment groups: baseline serum iron levels, area under time-concentration curves (AUCs) from baseline to 12 hours and baseline to 24 hours, and peak iron levels. Results. Baseline serum iron levels did not differ among the three treatment groups (p = 0.844). AUCs were not different among groups (p = 0.746 for 12 hr, p = 0.925 for 24 hr). AUC medians (with 95% binomial confidence bounds) for control, EDTA, EDTA + AC groups, respectively, for 12 hr were: 2813 (2298, 3561), 2570 (1669, 3476), and 2654 (2125, 3600); and for 24 hr were: 4083 (3488,5314), 4139 (2666, 5547), and 4274 (3336, 5577). Peak serum iron levels did not differ among treatment groups (p = 0.481). Peak iron level medians in µg/dL (with 95% binomial confidence bounds) were for control: 329 (253, 382), for EDTA: 271 (184, 375), and for EDTA + AC: 285 (229, 352). Conclusion. Orally administered EDTA did not significantly reduce iron absorption when administered 1 hour post iron ingestion during the 12 or 24-hour period following the ingestion of 5 mg/kg of elemental iron in healthy human volunteers.

Effect of iron bioavailability on performance, feed digestibility, blood parameters, and carcass characteristics at slaughter of grain-fed veal calves

The effects of the iron chelator, EDTA, on performance, feed digestibility, blood parameters, and carcass quality were investigated in 48 veal calves (52 ± 4 kg BW) allocated to five treatment groups: a control, 5 mg EDTA mg-1 Fe in the feed for the last 8 or 18 wk before slaughter, or 15 mg EDTA mg-1 Fe in the feed for the last 8 or 18 wk before slaughter. Calves were fed a diet of whole corn and protein supplement (grain: supplement ratio of 2:1, 3.5:1 and 5:1 for starter, grower, and finisher production phases, respectively, resulting in crude protein levels of 21, 18 and 15%, respectively). The effects of both dose and duration of EDTA administration were analysed using a randomised complete block design in a factorial model. Daily DMI and ADG decreased linearly with an increasing dose of EDTA (P &lt; 0.001). ADG declined linearly with increasing dose and duration of EDTA administration (P &lt; 0.05). Blood iron, haemoglobin and haematocrit levels decreased linearly with increasing EDTA dose (P &lt; 0.001) and duration of administration (P &lt; 0.05). Carcass weight (kg) and yield (%) decreased linearly with both increasing EDTA dose (P &lt; 0.001) and duration of EDTA administration (P &lt; 0.05). Carcass classification improved linearly with increasing EDTA dose (P &lt; 0.01). When EDTA is used as a dietary supplement for veal calves, there may be beneficial effects on carcass classification, but the dose and duration of administration need to be chosen judiciously to avoid deleterious effects on the well-being of the calves. Key words: Veal, iron bioavailability, EDTA, digestibility, haemoglobin

Rectifying effect of exercise on hypertension in spontaneously hypertensive rats via a calcium-dependent dopamine synthesizing system in the brain

The effect of exercise on blood pressure in spontaneously hypertensive rats (SHR) was investigated assuming a mechanism involving calcium-dependent dopamine synthesis in the brain. Male SHR (13 weeks of age) were forced to run for 1 h at a speed of 10 m/min using a programmed motor-driven wheel cage. Systolic blood pressure was reduced after running, and this effect of exercise was decreased by prior intracerebroventricular administration of EDTA (1 nmol/rat), α-methyltyrosine (inhibitor of tyrosine hydroxylase, 1 mg/rat), sulpiride (D 2 receptor antagonist, 50 μg/rat) or eticlopride (D 2 receptor antagonist, 100 μg/rat), but was not changed by administration of SCH 23390 (D 1 receptor antagonist, 30 μg/rat). Also, the calcium levels in the serum and brain were increased by exercise. Combining these results with our previous reports, it is suggested that exercise leads to an increase in the serum calcium level and subsequently an increase in the brain calcium level. This, in turn, leads to increased brain dopamine synthesis through a calmodulin-dependent system, with the increased dopamine levels inhibiting sympathetic nerve activity via the dopamine D 2 receptor in the brain and causing a reduction in blood pressure.

Time course of gastrointestinal tract permeability to chromium 51-labeled ethylenediaminetetraacetate in healthy dogs

Abstract Objectives To establish values for gastrointestinal tract permeation by chromium 51-labeled ethylenediaminetetraacetate (51Cr-labeled EDTA) in healthy adult dogs, and to evaluate the time course for 51Cr-labeled EDTA absorption over a 24-hour period after its administration, in an effort to define a shorter, more practical collection method. Animals 6 healthy adult mixed-breed dogs. Procedure After an 18-hour nonfeeding period, each dog was given a solution containing 50 μCi of 51Cr-labeled EDTA in deionized water (10 ml/kg of body weight) by stomach tube. Complete urine collection was done at 2, 4, 6, and 24 hours after 51Cr-labeled EDTA administration. Five-milliliter samples of urine were counted for 15 minutes in a gamma counter, and radioactivity in urine was expressed as a percentage of the orally administered dose. Results Median (range) 24-hour urinary recovery of 51Cr-labeled EDTA after 24 hours was 15.1 (12.7 to 20.3)%. Urine collected at 2, 4, and 6 hours contained 1.0 (0.2 to 3.5)%, 6.5 (2.2 to 8.7)%, and 10.0 (8.1 to 11.7)% of the administered 51Cr-labeled EDTA, respectively. Urine passed during the first 6 hours contained, on average, 67 (54 to 77)% of the total 24-hour urine recovery. Conclusions 6-hour urinary recovery of 51Cr-EDTA provides a potential alternative to 24-hour recovery. This shorter collection period may more specifically reflect small intestinal permeability. (Am J Vet Res 1998; 59:1113-1115)

Effect of chronic poisoning with aluminum on the renal handling of phosphate in the rat

The effects of aluminum on renal function and phosphate handling were studied using clearance techniques in chronically-intoxicated rats. Rats were given aluminum hydroxide (80 mg/kg b.w., i.p.), three times per week during 6 months. The phosphate tubular transport capacity was evaluated by determining the maximum tubular transport (TmRPi) and the fractional excretion of phosphate (FE% Pi) during the infusion of phosphate solutions with increasing concentrations (0, 9, 18, 33 mM). Parathyroid gland function was studied using indirect methods: calcemia recovery after EDTA administration and the nephrogenic excretion of cAMP as indicative of renal PTH actions, by RIA. The systemic acid base status was determined and food intake and rat growth were controlled in both groups. No changes were observed in the renal function. Pi reabsorption values per ml glomerular filtration rate (TRPi/GFR μg/ml) for different Pi plasmatic concentrations were distributed following a saturation curve compatible with a saturation kinetics. Aluminum increased TmRPi/GFR in treated animals (T) 76±4 as compared with control animals (C) 57±7 μg/ml, without a statistical modification in the apparent affinity. The FE% Pi and FE% Na were significantly lower in treated animals than in control animals. There were neither systemic variations in the acid-base balance nor in the Ca and Pi concentrations in plasma. The calcemia recovery following a hypocalcemic stimulus and the nephrogenic excretion of cAMP (T: 44±4; C: 91±7 pmol/min) were diminished. Considering all these facts, it can be postulated that the aluminum renal effect is associated from a decrease in PTH phosphaturic capacity. Nevertheless, other associated factors like minor phosphate intestinal absorption rate may not be disregarded, even though there were no significant intake variations.

Chelation therapy for peripheral arterial occlusive disease: a systematic review.

Chelation therapy is viewed, promoted, and practiced as a form of complementary/alternative medicine (see References 1 and 21 2 ). It uses repeated intravenous administration of EDTA, usually in combination with vitamins, trace elements, and iron supplements as a treatment for a variety of diseases.3 4 5 Oral chelation therapy also has been advocated (see Reference 66 ) but will be excluded from this review. Among others, chelation therapy is claimed to be effective in reversing the arteriosclerotic disease process,7 8 in particular peripheral arterial occlusive disease (PAOD). Proponents claim that it can be an alternative for amputation in severe cases.8 This goes back to an observation made in the 1950s, when it was noted that patients undergoing EDTA therapy for lead poisoning felt a relief of angina pectoris after this therapy.9 While various authors9 10 11 12 13 14 15 have subsequently reported promising results in uncontrolled studies, others have been unable to confirm these in similarly designed trials.16 17 The debate of whether or not it is a useful form of therapy for PAOD therefore continues.18 19 20 21 22 23 24 25 Meanwhile, numerous clinics have been set up in Europe, the United States, and elsewhere using and promoting chelation therapy for PAOD. In the light of recent trial data, it is therefore timely to systematically review the evidence from randomized, placebo-controlled, double-blind trials and ask whether chelation therapy for PAOD is safe and effective. Computerized literature searches were performed (Medline 1966 to 1996; CISCOM 1996, a database specialized in complementary/alternative medicine) to identify all studies on the subjects. Publications thus found were screened for further …

The Protocol for the Safe and Effective Administration of EDTA and Other Chelating Agents for Vascular Disease, Degenerative Disease, and Metal Toxicity

The Protocol for the Safe and Effective Administration of EDTA and Other Chelating Agents for Vascular Disease, Degenerative Disease, and Metal Toxicity

Elevated body lead burden from drinking water in end-stage chronic renal failure

Delta aminolaevulinic acid dehydratase (ALA-D) who assayed in 66 patients with end-stage renal failure who live in a region where there is a high risk of lead poisoning from drinking water (Vosges mountains). Sixty patients received dialysis and six underwent renal transplantation. Results were compared to those obtained in 366 control subjects with normal renal function hospitalized in a department of Internal Medicine and living in the same geographical area. The ALA-D level was significantly lower in dialysed patients (0.40 +/- 20) than in controls (0.57 +/- 0.31) (P = 0.0014). Transplant recipients had ALA-D levels comparable to subjects with normal renal function (0.59 +/- 0.37). In this high-risk population an EDTA test was performed in 74 subjects (with normal renal function and 17 dialysis patients in combination with haemofiltration for the latter patients. In the two study groups a negative correlation was found between ALA-D and the amount of lead chelated during the 24 h following administration of EDTA (r = -0.77 and -0.88 respectively). In subjects who live in an area of endemic lead poisoning, the incidence of elevated body lead burden from drinking water was similar in the group with normal renal function and in the group of dialysed patients (18.6 and 8.3% respectively). This study shows (i) that in dialysis patients, measurement of ALA-D represents an accurate screening test for lead overload, provided that the lower threshold of normal is lowered from 0.40 to 0.20, and (ii) that diagnosis and treatment are possible by administering EDTA in conjunction with haemofiltration or CAPD.

Toxic effects of cholelitholytic solvents on gallbladder and liver. A piglet model study.

We evaluated the toxic effects of four currently used chemolytic solvents--dimethyl sulfoxide (DMSO, 99%), ethyl propionate (EP, 99%), tetrasodium ethyl-dimethyl tetraacetate (4Na-EDTA, 2%, pH 11), and methyl tert-butyl ether (MTBE, purity = 99.5%) in an animal model. Each solvent was tested in nine farm piglets (Landrace), weighing between 20 and 25 kg. A solvent-resistant catheter was inserted transhepatically into the gallbladder (GB) using sonographic guidance 24 hr prior to each experiment. Seventy-five milliliters of each solvent was infused over 3 hr into the gallbladder. The following day, a laparotomy was performed in order to assess for possible damage to the liver, GB, bile ducts (BD), or intestines. The GB and liver were resected and their histology examined. The following pathologic grades were assigned to GB, BD, and liver specimens to describe the tissue damage: normal (0), mild (1), moderate (2), and severe (3). We found that DMSO had the highest score on gallbladder and bile duct injury (49, 3), followed by EP (36, 2), EDTA (14, 1) and MTBE (16, 0), respectively; the difference in gallbladder damage was statistically significant. Very mild hepatocyte damage was present in the DMSO (2) and MTBE (2) groups. The administration of EP and EDTA resulted in no liver injury at all. Piglets within each treatment group suffered from varying degrees of tissue injury. No deaths were attributed to the administered solvents. We concluded that DMSO, EP, EDTA, and MTBE do not have serious local toxic effect on the GB, BD, and intestine; nor do they lead to severe hepatotoxicity.(ABSTRACT TRUNCATED AT 250 WORDS)

Involvement of the cervical sympathetic nervous system in the changes of calcium homeostasis during turpentine oil-induced stress in rats.

Hypocalcemia is a common finding during stress. The objective of this study was to examine: (a) the changes in circulating calcium, parathyroid hormone (PTH) and calcitonin (CT) concentration in rats stressed by being given a subcutaneous injection of turpentine oil, and (b) the involvement of the sympathetic cervical pathway in stress-induced changes of calcium homeostasis. Four hours after receiving turpentine oil or vehicle, rats were subjected either to hypocalcemia, by being given EDTA intraperitoneally, or to hypercalcemia, by being injected CaCl2 intraperitoneally. Significant changes in serum calcium (10% decrease), serum PTH (28% increase) and CT levels (40% decrease) were observed in stressed rats. EDTA administration brought about a significantly greater hypocalcemia, and a higher PTH secretory response in turpentine oil-stressed rats. During stress, the increase of serum calcium after CaCl2 was significantly smaller, and the rise of CT was greater than in controls. In the case of CT the changes were still observed in rats subjected to superior cervical ganglionectomy (SCGx) 14 days earlier. In the case of PTH, the increase found in stressed rats, but not the augmented response after EDTA, was blunted by SCGx. The potentiation of hypocalcemia brought about by turpentine oil was no longer observed in SCGx rats. In vehicle-treated controls, SCGx delayed PTH response to hypocalcemia, but did not affect the increased response of CT to CaCl2 challenge. The results indicate that a number of changes in calcium homeostasis arise during turpentine oil stress in rats. SCGx was effective to modify the set point for PTH release, but played a minor role in affecting the augmentation of CT release during stress.