Thursday, February 24, 2011

Implications of Ion Toxicity on the kidneys (Questions that must be answered.)

Those of you follow this blog know I have been wrestling with the questions surrounding the potential harmful effects the ion toxicity levels may have on kidneys since I have only one remaining.  Tomorrow, I have an appointment with a nephrologist (kidney specialist) to shed some light on these questions. I thought I might share them with you.
Questions for my consults (in no particular order):
1)      What is the cancer risk in  the kidney given the statistically significant results found in the Sweden study?
2)      What is the risk of a trivalent chromium being a carcinogen with the primary target being the kidney?
3)      Kidney epithelial cells are 10x more sensitive towards Cr 6 than the same liver cells. Humm hepatoxic issues as well ?
4)      Can non toxic Cr3 be oxidized to Cr 6 under certain conditions and what are they? (very important question/studies indicate yes.)
5)      What is the toxic range for Cr and Co in the kidney?
6)      What are the signs for this?
7)      What are the tests for measuring the accumulation of these metals in the kidneys?
8)      What is my risk given I have only one left?
9)      What is the risk differentiator with metal implants vs inhaled or oral exposure? Studies seem to be focused on the latter not the former?
10)   What are the genotoxic effects for a trivalent Cr to the kidney?
11)   What oxidation is this metal exposed to in the body once it is in there?
12)   What solubility issues should be considered?
13)   Once absorbed, Cr 6 IS QUICKLY REDUCED TO THE TIRVALENT FORM WHICH ACCOUNTS FOR ALL OF THIE ELEMENT PRESENT IN THE BLOOD STREAM OR TAKEN UP BY THE TISSUE?  What??  Then how is CR 6 responsible for cancer and other things if it is non toxic?
14)   How is this absorbed by the kidney?
15)   Two main features of kidney damage re metals: (Is this correct overall?)
a.       Lack of dose-effect/response relationships or progression toward more severe impairment when the exposure intensity increases
b.      The recent absorption rate more than the cumulated does is responsible for the observed nephrotoxic effects.
16)   What is renal oligio anuric deficiency?  How is it caused?
17)    There is good evidence that Cr 6 is the ion responsible for MOST of the toxic actions although much of the underlying molecular damage may be due to the intracellular reduction to the even more highly reactive and short-lived Cr3 and Cr6. ??
18)   What about Cobalt?  “Patients with impaired renal function may experience Co poisoning without the presence of pain despite a well positioned implant because the cobalt released by normal implant wear is not adequately cleared by their kidneys? (2010/Alaska epidemiology)
19)   In short term tests, the hexavalent Cr demonstrated genotoxic effects 4 times more frequently than did the trivalent Cr compounds.  Well this is not comforting. This tells me that there are geneotoxic effects with trivalent as well.  So what are they?

4 comments:

  1. Connie,

    Did you get the answers to these questions and, if so, can you please print them with the questions? I am new to this sight and haven't had the opportunity to read everything, but I am very concerned about the cancer risks. I am a bilateral Depuy recipient and have had both revisions done this year. Before surgery my Cr level was 32 ng/ml and my Co was 100.3 ng/ml, the highest of any patient in my surgeon's practice. From what I've read on the web about conversions, and please correct me if I'm wrong, my Co was over 5000 times normal based upon a formula provided by an online doctor. Four months post-op from the first revision (right hip), the level dropped significantly from Cr 11 ng/ml and Co 13 ng/ml, still toxic. Another blood test will be ordered after six months post-op from the second revision (left hip)which will be January 2012. My primary right hip arthroplasty was performed in April 2007 and I was never pain free having gone back to my surgeon multiple times only to be told to go to pain management. It wasn't until the recall came out that I discovered the reason for my chronic pain. It is my belief that I have permanent damage to the right hip based upon the continuance of the chronic pain and the damaged soft tissue that was removed during revision as a result of metallosis.

    I'd be really curious to see the answers to those questions if you don't mind.

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  2. HI,

    Unfortunately, the nephrologist said that there are little or no studies done on this subject matter. However, right after she said that, a study was conducted by Sanford which you can find a summary of by typing this into the search box on the page:

    Nine-Year Incidence of Kidney Disease in Patients Who Have had Total Hip Arthroplasty

    If it is cancer you are concerned about, I have a whole cancer section on this blog. Go to the upper left hand cornor of the home page in the blog and click on medical studies. they are all listed. The cancer studies are all listed if you just scroll down the page.

    In terms of metal levels, just type metal levels or toxic levels of metals in the search box on my blog and you will get a list of the information pertaining to that subject.

    Unfortunately, there are no definitive indicators of what is really toxic and not in terms of these tests. there are high and low ranges but I have never seen something that indicated that the metal level was toxic.

    If you have an orthopedic surgeon who was not listening to your pain issues, I would consider getting a new surgeon.

    One thing you will find in reviewing this information is that you have to dig very deep to find any information on these topics. There is not much factual information which is circultated likely due to litigation.

    Have you hired a lawyer? If not, I have a list of them contained in the litigation section who are experts in this subject matter if you think you have permanent damage. If you can;t find that list, LMK. I would be happy to direct you to it.

    Regards,

    Connie.

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  3. Hi,

    thanks for your comments:

    1. Most of the questions where not answerable by the nephrologist because there is not a lot of history with this problem. you can however, find the most recent study done on Kidney issues which was just completed in April of this year. You can type in this on the blog search box:

    Nine-Year Incidence of Kidney Disease in Patients Who Have had Total Hip Arthroplasty


    2. If you would like to read the cancer implications of this, go up to the upper left hand side of the blog home page and click on Medical studies and then scroll down. You will see all of the cancer studies listed. There are a lot of them. I typically reprint the abstract in my notes.

    3. If you would like information on the ion toxicity levels, enter this in the search page and it will take you to a series of overview topics from a 5 part lecture series that will provide you with the background information you need:

    Continuing Medical Education Panel sponsored by the American Orthopedics Association for Surgeons: Total hip Atheroplasty: Is there a MOM bearings controversy? Part One of Five

    Please let me know if I can help further.

    Sorry to hear of the issues with your surgeries.

    Regards,

    connie

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  4. sorry but I seem to be having problems posting comments. I will check back tomorrow to see if anything posted. I have answered twice but the comments haven't posted.

    Apologies!

    ReplyDelete