In recent years most of the interest in musculoskeletal problems secondary to renal disease has focused on problems occurring in patients with chronic renal failure and specifically in patients on long-term hemodialysis. The musculoskeletal involvement in long-term hemodialysis may involve the joints, soft tissues, or both, and there is presently no good classification to which authors may refer when they report musculoskeletal problems in these patients. There has been intense interest in the past few years in the amyloidosis associated with long-term hemodialysis, and now, apparently, also with peritoneal dialysis. This type of amyloidosis is due to a specific type of amyloid, namely beta 2-microglobulin amyloid. Debate is ongoing about the role of both aluminum toxicity and iron deposition as cofactors affecting the location and extent of amyloid deposits. Debate is also unresolved about the role of specific dialysis membranes in lessening the incidence of dialysis-related amyloid. I review some of these areas as well as interesting new developments in localization of amyloid deposits in patients with chronic renal failure who are on hemodialysis.
Glomerular uptake of intravenously administered aggregated albumen or immune complexes in mice appears to be inversely related to the activity of the reticuloendothelial system (RES). Stimulation of RES activity diminishes the amount of material appearing in the glomerulus whereas RES blockade enhances glomerular uptake. The possible relevance of these observations to experimental models of immune complex disease is discussed.
A six week, double-blind, randomized, parallel group, multicentre study was conducted in 85 patients with osteoarthritis of the knee and hip to compare the efficacy, tolerability, and safety of Flurbiprofen-SR 200 mg with Diclofenac Sodium-SR 100 mg. Between group comparisons, based on change scores from baseline, we detected no significant differences between the two drugs with respect to efficacy for the majority of outcome measures. There was no significant difference between the groups in the proportion of patients experiencing at least one adverse medical event or in terminations from treatment. We conclude that Flurbiprofen-SR 200 mg is similar in efficacy, tolerability, and safety to Diclofenac Sodium-SR in this trial.
Rheumatoid factor (RF) is found in the circulation in several human disorders associated with glomerular immune complex deposition and glomerulonephritis. RF has also been found in the involved glomeruli of several of these diseases. In several experimental systems RF has been shown to bind in situ to glomerular bound complexes and to subsequently act as an immunoabsorbent. The implications of these observations in terms of chronicity of immune complex associated glomerular lesions are discussed.
This paper reports a study of the importance of vasoactive amines in glomerular localization of passively administered immune complexes in the mouse. Two strains of mice were investigated, one sensitive and the other relatively resistant to the anaphylactogenic effect of intravenously administered immune complexes. The effect on glomerular deposition immune complexes in animals of both strains treated with either vasoactive amine depletors or antagonists leads to the conclusion that in this experimental system vasoactive amines do not play a major part in the glomerular localization of immune complexes.
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