lördag 13 juli 2019

Hypersulfatemia ilmenee ennen hyperfosfatemiaa - Onkonormaali plastinen sulfur kehon "havaitsematonta plasmaa"?

 Talletin vuonna 2002  artikkelin :Fernandes I et al. Sulfate homeostasis, NaSi-1 cotransporter, and SAT-1 exhancer expression in chronic renal failure in rats.  Kidney Int 2001 Jan ; 59(1):210-21.  Jouduin K-vitamiinityöni yhteydessä katsomaan rikkiaineenvaihduntaa, koska osa K-vitamiinifunktioista  toimi sillä alueella ( sulfotransferaasien ja arylsulfataasien tarvitsemana cofaktorina ja lipidisynteesien alueella  myös  sulfatidien synteesin varhaisvaihe vaati Kvitamiinia kuten päätösvaihekien.  samoin myös B6-vitamiini. Rikistä oli varsin vähän tietoa ravinto-opin kirjoissa ja kuitenkin sen osuus proteiineissa on yhtä konventionelli kuin typen niin että niillä on proteiinistruktuurissa  tietty normaali suhteensa N:S. Tässä artikkelissa jonka säästin, mainittiin viime lauseessa, että "kroonisessa munuaisviassa  hypersulfatemia aiemmin kuin hyperfosfatemia". Kirjoitin joskus paperin reunaan:  "Katso tämä asia!".
 Tänään etsin PubMed  hakulaitella  sanalla Hypersulfatemia ja saan 8 vastausta, joisa on  juuri tämä artikkeli numero 2.
Katson näitä nyt.

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Items: 8

1.
Pelham RW, Alcorn H Jr, Cleveland Mv.
J Clin Pharmacol. 2010 Mar;50(3):350-4. doi: 10.1177/0091270009339741. Epub 2010 Jan 12.
The pharmacokinetics (PK) of an oral sulfate solution (OSS) for bowel cleansing preparation was studied. OSS (30 g of sulfate) was split between 2 doses, 12 hours apart. Safety measures included electrocardiography, vital signs, adverse events, hematology, blood chemistry, and urinalysis. Six adult patients with moderate renal disease (MRD), 6 with mild-moderate hepatic disease (M/MHD), and 6 normal healthy volunteers (NHVs) completed the study. Adverse events were mild to moderate in severity and were mainly limited to headache and expected gastrointestinal symptoms. Serum sulfate levels were highly variable at all times, even after adjusting for baseline. Sulfate was higher in MRD in comparison to the other groups. The C(max) and AUC were higher in the patients, but no statistically significant differences emerged.
 Sulfate levels returned to predose values within 54 hours after dosing. No electrolyte disturbances occurred. Urinary sulfate excretion was approximately 20% of the dose. OSS was well tolerated. The types and severity of adverse events were similar to those seen in large phase III trials. While patients with MRD had elevated sulfate, the levels were less than those in renal failure and did not alter biochemical parameters that are associated with hypersulfatemia.
2.
Fernandes I, Laouari D, Tutt P, Hampson G, Friedlander G, Silve C.
Kidney Int. 2001 Jan;59(1):210-21.
It is known that hypersulfatemia, like hyperphosphatemia, occurs in chronic renal failure (CRF). The aim of this study was to assess the effects of CRF on sulfate homeostasis and on sodium sulfate cotransport (NaSi-1) and sulfate/oxalate-bicarbonate exchanger (Sat-1) expression in the kidney. In addition, sulfate homeostasis was compared with phosphate homeostasis...Free Article
 
3.
Cole DE, Evrovski J.
Crit Rev Clin Lab Sci. 2000 Aug;37(4):299-344. Review.
Although inorganic sulfate  is an essential and ubiquitous anion in human biology, it is infrequently assayed in clinical chemistry today.
 Serum sulfate is difficult to measure accurately without resorting to physicochemical methods, such as ion chromatography, although many other techniques have been described.
 It is strongly influenced by a variety of physiological factors, including age, diet, pregnancy, and drug ingestion.
 Urinary excretion is the principal mechanism of disposal for the excess sulfate produced by sulfur amino acid oxidation, and the kidney is the primary site of regulation
In renal failure, sulfoesters accumulate and hypersulfatemia contributes directly to the unmeasured anion gap characteristic of the condition. 
In contrast, sulfate in urine is readily assayed by a number of means, particularly nephelometry after precipitation as a barium salt
Sulfate is most commonly assayed today as part of the clinical workup for nephrolithiasis, because sulfate is a major contributor to the ionic strength of urine and alters the equilibrium constants governing saturation and precipitation of calcium salts.
 Total sulfate deficiency has hitherto not been described, although genetic defects in sulfate transporters have been associated recently with congenital osteochondrodystrophies that may be lethal.
 New insights into sulfate transport and its hormonal regulation may lead to new clinical applications of sulfate analysis 
 in the future.
4.
Kirschbaum B.
ASAIO J. 1998 Jul-Aug;44(4):314-8.
Concentrations of sulfate can increase eightfold in the blood of patients with severe reductions in glomerular filtration rate. Sulfate enters the body almost exclusively as the amino acids cysteine and methionine, and leaves in the urine predominantly as inorganic sulfate. Concentrations in plasma may exceed 2.5 mol/L in renal failure, and raise the anion gap by 5 mEq/L.
 In studies by the author and colleagues, hemodialysis using large dialyzers and brisk blood flow rates effectively lowered the concentrations of sulfate in plasma to normal in the immediate post dialysis period; the sulfate reduction ratio actually exceeded the urea reduction ratio. 
Significant correlation was observed between the two ratios.
 Concentrations of sulfate, in conjunction with other data, may prove useful for estimating dietary intake of protein and monitoring control of acid-base balance.
5.
Martínez-Piñeiro L, Mateos Antón F, Martínez-Piñeiro JA.
Arch Esp Urol. 1992 Nov;45(9):875-89. Review. Spanish.
PMID:
1337244
6.
Ricci J, Oster JR, Gutierrez R, Schlessinger FB, Rietberg B, O'Sullivan MJ, Clerch AR, Vaamonde CA.
Am J Nephrol. 1990;10(5):409-11.
Although hypermagnesemia purportedly lowers the anion gap (AG), we have shown previously that increases in the serum concentration of the unmeasured cation (UC) Mg due to therapeutic infusion of MgSO4 are not associated with AG reduction. To assess our hypothesis that increases in serum SO4 (unmeasured anion, UA) offset the effect of elevated serum Mg on the AG, we prospectively studied 11 patients receiving MgSO4 intravenously for toxemia of pregnancy. After 6 h of MgSO4 infusion, serum Mg increased by 2.1 +/- 0.2 (SE) mEq/l (p less than 0.001) without a significant decrease in the AG. Concomitantly, serum SO4 increased by 1.4 +/- 0.2 mEq/l. Comparison of the renal handling of SO4 versus Mg showed a higher fractional excretion of the former, probably accounting in part for the smaller increment of serum SO4 than of Mg. Comparison of the change in serum SO4 minus that of Mg indicated that, on the average, 70% of the observed 1.0 +/- 0.7 mEq/l reduction in AG was accounted for by the observed changes in the two pertinent unmeasured ions. A small decrement in serum Ca probably was a quantitatively minor factor tending to obviate a greater decrease in AG. We conclude that hypersulfatemia attenuates the reduction in AG that would otherwise accompany MgSO4-induced hypermagnesemia.
7.
Friedlander MA, Lemke JH, Johnston MJ, Freeman RM.
Am J Kidney Dis. 1983 May;2(6):660-3.
Serum sulfate concentrations may reach five to ten times normal in renal failure patients dialyzed on a sorbent cartridge system, and these patients have elevated alkaline phosphatase levels suggesting an increased incidence of renal oseodystrophy. We studied the effect of adding sulfate on ionized calcium (Ca2+) in human serum in vitro and in rat serum in vivo. K2SO4 or Na2SO4:NaCl mixtures were added to aliquots of serum from normal subjects to reproduce the observed biologic range of sulfate concentrations up to 10 mmol. Serum Ca2+ concentration was found to decrease linearly as serum sulfate concentration increased, for each subject. The weighted mean slope estimates of the effect of sulfate on ionized calcium in two experiments were -.0197 and -.0181. Rats were infused through the inferior vena cava with 2 mL of either 200 mmol NaCl (N = 5) or 100 mmol Na2SO4 (N = 6), after ligation of the renal arteries and veins and withdrawal of 2 mL blood for baseline studies. The animals were killed by exsanguination from the aorta after a five-minute equilibration period. In rats administered NaCl, no difference in Ca2+ or sulfate concentration was found between pre- and postinfusion sera. In the Na2SO4 treated rats, however, a significant mean increase of 0.635 mmol (p less than .005) in serum sulfate concentration was associated with a significant mean decrease of -0.062 mmol (p less than .01) in serum Ca2+ concentration. We conclude that the acute in vitro and in vivo addition of sulfate results in a decrease in serum Ca2+ concentration. Thus, hypersulfatemia, which is present chronically in patients on sorbent dialysis systems, may contribute to elevated alkaline phosphatase levels in these patients.
8.
LESTRADET H, FREDERICH A, RODRIGUEZ-SORIANO J.
Presse Med. 1962 Jan 27;70:211-2. French. No abstract available.
PMID:
14464375
 
jatko: haen näsitä entsyymeistä tietoa NaSi1-cotransporter, SAT-1 exhancer  jos löytyy ortologit ihmisestä. 

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