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Vitamin A and hyperparathyroid bone disease in uremia
The American Journal of Clinical Nutrition
|December 1, 1983
Summary
Elevated vitamin A in uremia is linked to increased retinol-binding protein (RBP), not excess vitamin A. This finding suggests hypervitaminosis A does not significantly contribute to bone disease in kidney failure patients.
Area of Science:
- Nephrology
- Endocrinology
- Bone Metabolism
Background:
- Uremia, or kidney failure, is associated with complex metabolic disturbances.
- Bone disease, or renal osteodystrophy, is a common complication in patients with chronic kidney disease.
- The role of vitamin A in the bone disease of uremia has been previously debated.
Purpose of the Study:
- To investigate the potential contribution of hypervitaminosis A to bone disease in dialysis-treated patients with end-stage chronic renal failure.
- To determine the relationship between plasma vitamin A levels, retinol-binding protein (RBP), and indices of bone disease in uremic patients.
Main Methods:
- Studied 50 dialysis patients with end-stage chronic renal failure, none receiving vitamin A supplements.
- Measured plasma concentrations of total vitamin A and RBP.
- Assessed biochemical, radiographic, and histological markers of hyperparathyroidism and bone resorption.
Main Results:
- Patients exhibited increased plasma vitamin A and RBP concentrations, but a lower molar ratio of vitamin A to RBP compared to controls.
- A significant correlation was observed between plasma vitamin A and RBP levels.
- No significant relationship was found between vitamin A status and indicators of hyperparathyroidism or bone resorption.
Conclusions:
- Elevated plasma vitamin A in uremia is primarily due to high RBP levels.
- Hypervitaminosis A does not appear to be a significant factor in the development of renal osteodystrophy.