SVIBOR - Project code: 3-01-483

MINISTRY OF SCIENCE AND TECHNOLOGY

Strossmayerov trg 4, HR - 10000 ZAGREB
tel.: +385 1 459 44 44, fax: +385 1 459 44 69
E-mail: ured@znanost.hr

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Project code: 3-01-483


Influence of mineral metabolism disturbance in uremia on heart morphology and function


Main researcher: KRPAN, DALIBOR (122301)


Assistants
Type of research: applied
Duration from: 02/01/93. to 02/01/96.
Papers on project (total): 14
Papers on project quoted in Current Contents: 4
Institution name: Bolnica "Sveti duh", Zagreb (129)
Department/Institute: Nephrology departmant of Internal Clinic, General Hospital "Sveti Duh"
Address: 10000 Zagreb, Hrvatska, Sveti Duh 64
City: 10000 - Zagreb, Croatia
Communication
Phone: 385 (1) 219 408
Fax: 385 (1) 2334 619
Summary: Transiliac bone biopsy and subsequent histomorphometric analysis of undecalcified bone specimen were performed to 150 uremic patients on maintenance dialysis until August 31th 1995. To all patients we also performed echocardiography, polycardiography, echophonocardiography and dinamic electrocardiography. At the same time blood samples was taken for blood testing of:WBC,RBC, Htc, Hgb, Tr,Fe/UIBC,osmolality, ASTRUP, BUN, Kreatinin, Glucose,Ca,P,Mg,K,Na,iPTH,Alkaline phosphatase,Cl,lipids,proteins,and to all patients ocular fundus,blood pressure and heart rate were checked. Based on such data, using the statistic's program SPSS/PC, we will try to obtain more information about heart morphology and function in uremic patients and to see if there are any differences in such characteristics between the patients with different types of renal osteodystrophy: dominant hyperparathyroidism, Mixed uremic osteodystrophy, Adynamic uremic bone disease and Low turnover osteomalacia. We will also correlate particular haemodynamic parameters of heart cycle with bone volume, osteoid volume, osteoid thickness, fibrosis, osteoid surface, osteoblast interface, osteoclast interface, and mineralization rate.

Keywords: Renal osteodystrophy, Secundary hyperparathyroidism, Aluminum induced osteomalacia in severe chronic renal failure.

Research goals: Renal osteodystrophy is considered to be abnormalities due to disturbance of mineral metabolism characterized by multifactorial ethiopathogenesis which could influence on various organs, not only on bone. How it could influence on heart morphology and function is still a matter of investigation.Such investigation are complicated with the fact that not only mineral mertabolism disturbance influence on heart in uremia. Hypertension, anemia, presence of uremic toxins etc. are common in uremic patients, so it is very difficult to differ theirs impact on heart from those due to mineral metabolism disturbance. Furthermore, according to the ethiopathogenesis there are several types of Renal osteodystrophy (RO). So, heart abnormalities we should consider separatly for each type of RO. Therefore, if we evaluate heart abnormalities in uremia we should clearly distinguish a type of RO. It could be achived on the best way by bone histomorphometry. So, transiliac bone biopsy and histomorphometry are preformed to each patients. Bone volume, Osteoid volume, Fibrosis, Osteoid surface, Osteoid thickness, Osteoblast interface, Osteoclast interface, Mineralization rate, Double tetracycline labelling and presence of Aluminum at the mineralization front are quantitatively evaluated, and according to that patients would be selected to the certain type of RO: Predominant Hyperparathyreoidism, Mixed Uremic Osteodystrophy, Low-Turnover Osteomalacia and Adynamic Uremic Bone Disease. By means of Echocardiography,Polycardiography, Phonocardiography and Dinamic-electrocardiography heart morphology and function are evaluated and correlated with bone histomorphometric parameters.The intention of this researching project is to see if there are any particular heart abnormalities characteristic for certein type of RO and what kind of abnormalities are they. It could be important from the clinical point of view particulary for decision which therapeutic modalites in treatment of RO would be applied and when. If we found for example that Predominant Hyperparathyreoidism have greater risk of cardio-vascular complication, parathyreoidectomy would be advised earlier. Until August 31th 1995. 150 patients were examined and included in the project.The result will be evaluated after we completed investigation in all 200 patients, which is our goal planed in the project.

COOPERATION - PROJECTS


  1. Name of project: 6-06-146 Kibernetički model ličnosti
    Name of institution: Filozofski fakultet, Humanističke i društvene znanosti
    City: 10000 - Zagreb, Croatia

  2. Name of project: 5-10-114 Programiranje kinezioloških transformacijskih procesa
    Name of institution: Fakultet za fizičku kulturu
    City: 10000 - Zagreb, Croatia

  3. Name of project: 3-01-203 Patofiziologija i terapija uremije
    Name of institution: O.B."Sveti Duh" Zagreb, Interna klinika
    City: 10000 - Zagreb, Croatia

COOPERATION - INSTITUTIONS


  1. Name of institution: Nova bolnica Zagreb
    Type of institution: University/Faculty
    Type of cooperation: Joint project
    City: 10000 - Zagreb, Croatia

  2. Name of institution: Filozofski fakultet
    Type of institution: University/Faculty
    Type of cooperation: Joint publishing of scientific papers
    City: 10000 - Zagreb, Croatia

  3. Name of institution: Fakultet za fizičku kulturu
    Type of institution: University/Faculty
    Type of cooperation: Joint publishing of scientific papers
    City: 10000 - Zagreb, Croatia

  4. Name of institution: Institut za anatomiju Medicinskog fakulteta "Drago Perović"
    Type of institution: University/Faculty
    Type of cooperation: Joint publishing of scientific papers
    City: 10000 - Zagreb, Croatia

  5. Name of institution: KLINIČKI BOLNIČKI CENTAR REBRO, CENTRALNI LABORATORIJ
    Type of institution: University/Faculty
    Type of cooperation: Systematic exchange of information
    City: 10000 - ZAGREB, HRVATSKA

  6. Name of institution: Dartmouth-Hitchcock Medical Center
    Type of institution: University/Faculty
    Type of cooperation: Systematic exchange of experts
    City: Lebanon, USA, New Hemshire

OTHER ACHIEVEMENTS


  1. Name: Tko je tko u Hrvatskoj
    Type of achievement: Catalogues, address books,

  2. Name: Dialyse Journal, Hrvatsko izdanje
    Type of achievement: Other
    Authors: Dr.sc.Dalibor Krpan, imenovan je glavnim urednikom Hrvatskog izdanja međunarodnog časopisa Dialyse Journala
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