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Kronik Böbrek Yetersizliğinde Dipiridamol Kullanımı PTH Direncini Artırabilir

Dipyridamole Can Augment the Resistance to Parathormone in Chronic Renal Failure

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2005

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Dipyridamole which is used for vasodilatation might enhance renal tubular reabsorption of phosphate. In this study, we aimed to investigate the effect of dipyridamole on Ca, P metabolism, PTH, renal functions and electrolytes in pre-dialysis patients with stable renal function. Thirty pre-dialysis patients with stable renal function were treated with dipyridamole for 4 weeks without their treatment and diet being changed. Baseline (I) serum levels of BUN, creatinine, sodium, potassi¬ um, chlorur, Ca, P, magnesium, PTH, Vitamin D3, creatinine clearance and urinary BUN, Cr, Na, FENa, Ca, P, total phosphate reabsorption were measured. These parameters were repeated at the end of the therapy (II) and 4 weeks after withdrawal of dipyridamole (III). There was no difference for all parameters for 3 measurements, except PTH. The mean values of PTH for I, II and III measurements were 152.2±124.1, 230.7±196.6, 210.9±163.2 pg/mL, respectively. The differences between I-II and I-III for PTH were significant (p<0.05). But, the difference betwe¬ en II and III was not significant. Consequently, dipyridamole increased serum PTH levels without any effect on renal functions, serum Ca-P and Vitamin D3 levels and this effect continued for 4 weeks after withdrawal of dipyridamole in pre-dialysis patients . But, this effect of dipyridamole on PTH should be investigated in patients with secondary hyperparathyroidism and we recommend being cautious in using of dipyridamole in predialysis patients.
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Abstract (Original Language): 
Vazodilatör olarak kullanılan dipiridamol renal fosfat geri emilimini artırabilir. Bu çalışmada, stabil renal fonksiyonlu prediyaliz dönemindeki hastalarda dipiridamolün Ca, P metabolizması, PTH, renal fonksiyonlar ve elektrolitler üzerindeki etkilerini araştırmayı amaçladık. Stabil renal fonksiyonlu, prediyaliz dönemindeki 30 olgu aldıkları ilaçlar ve diyetleri değiştirilmeden çalışmaya dahil edildi. Olguların tedavi öncesi (I) serum BUN, kreatinin, sodyum, potasyum, klor, Ca, P, magnezyum, PTH, Vitamin D3, kreatinin klirensi, idrar BUN, Cr, Na, FENa, Ca, P ve total fosfat reabsorpsiyonu değerlendirildi. Bu parametrelere 4 haftalık dipiridamol tedavisi sonrası (II) ve ilaç kesildikten 4 hafta sonra (III) tekrar bakıldı. Her 3 ölçümde PTH dışındaki parametrelerde farklılık yoktu. PTH için I, II ve III. ölçümlerde ortalama değerler sırası ile 152.2±124.1, 230.7±196.6, 210.9±163.2 pg/mL idi. PTH I-II ve I-III arasındaki farklılıklar anlamlı idi (p<0.05). Fakat, II ve III. ölçümler arasındaki farklılık anlamlı de¬ ğildi. Sonuç olarak, dipiridamol renal fonksiyonlar, serum Ca, P ve Vitamin D3 düzeylerini değiştirmeden serum PTH düzeylerini artırmıştır. Bu etki dipiridamol kesildikten sonraki 4 hafta süresince devam etmiştir. Dipiridamolün PTH üzerindeki bu etkisi sekonder hiperparatiroidili olgularda incelenmeli ve prediyaliz dönemdeki has¬ talarda dikkatli kullanılmalıdır.
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  • 1
14-17
  • Turkish

REFERENCES

References: 

1. National Kidney Foundation. K/DOQI Clinical Practice Guidelines for Bone Metabolism and Disease in Chronic Kidney Disease. Am J Kidney Dis 2003 (suppl 3);42:S1-S202.
2. Prie D, Blanchet FB, Essing M, Jourdain JP, Friedlander G. Dipyridamole decreases renal phosphate leak and augments
patients with renal phosphate threshold. J Am Soc Nephrol 1998;9:1264-1269.
3. Michaut P, Friedlander G. Dipyridamole for renal phosphate leak? N Engl J Med 1994;331:58-59.
4. Brossard JH, Yamamoto LN, D'Amour P. PTH metabolites in renal failure: Bioactivity and clinical implications. Seminars in Dialysis 2002;15:196-201.
5. Disthabanchong S, Hassan H, McConkey CL, Martin KJ, Gon¬zalez EA. Regulation of PTH1 receptor expression by uremic ultrafiltrate in UMR 106-01 osteoblast-like cells. Kidney Int 2004; 65(3):897-903.
6. Gao H, Bodine PVN, Murillis R, Bex FJ, Bilezikian JP, Morris SA. PTH-depended adenylyl cyclase activation in SaOS-2 cells: Passage depended effects on G protein interactions. Jo¬urnal of Cellular Physiology 2002;193:10-18.
7. Seikaly MG, Quigley R, Baum M. Effect of dipyridamole on serum and urinary phosphate in X-linked hypophosphate-
mia. Pediatr Nephrol 2000;15:57-59.
8. Anfossi G, Russo I, Massucco P, Mattiello L, Cavalot F, Bal-bo A, Trovati M. Adenosine increases human platelet levels of cGMP through nitric oxide: possible role in its antiagg-regating effect. Thrombosis Research 2002;105:71-78.

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