No tissue level abnormality of vitamin A concentration despite elevated serum vitamin A of uremic patients.

In 57 patients with chronic renal failure (CRF) [44 patients on regular dialysis treatment (RDT), 33 renal transplant patients (RT) and 26 normal patients (NP)] and in a further 11 patients with CRF (8 patients on RDT and 17 patients without any renal disease in the post mortem) the vitamin A content of the serum obtained from the tissue of the liver, the stomach, the subcutaneous adipose tissue and the bone were analyzed. The vitamin A content of the serum was increased significantly for all groups of patients in comparison with the control group, but hypervitaminotic ranges were not reached in any case. The vitamin A content decreased depending on the time of dialysis treatment and the period after kidney transplantation. The retinol-binding protein accumulated even more than vitamin A in CRF and RDT. This statement is not in conformity with that of a hypervitaminosis A, of which normal respectively decreased RBP levels are characteristic. The serum prealbumin concentration was near the upper limit of the normal range in all groups of patients. The serum content of beta-carotene in patients with CRF and RDT was raised in comparison with NP and RT patients. As to the vitamin A content of the organs, a distinctive decrease appeared in the liver, so that a marginal supply must be assumed. In the stomach and the subcutaneous adipose tissue no changes, in comparison with the control patients, resulted. Due to renal insufficiency the results indicated an unphysiological situation in the vitamin A metabolism. Connections with disturbances of the fat-household could not be set up.(ABSTRACT TRUNCATED AT 250 WORDS)