Evaluation of oxidant-antioxidant balance in patients on maintenance haemodialysis: a comparative study of dialyzers membranes.

BACKGROUND: Haemodialysis (HD) exacerbates oxidative stress (OS). The polymethyl-methacrylate (PMMA)-BK-F membrane ameliorates OS and inflammation markers compared to polyacrylonitrile (PAN/AN69) and cellulose membranes. This may be due to the size of pore radius, high flux or other specific properties of PMMA membranes. AIM: To compare OS and inflammatory status in HD-treated end stage renal disease patients with membranes of different pore size radius and flux. METHODS: 47 patients of both sexes were studied. The HD membranes with which the patients were normally treated were changed to BK-P or B-3 membranes for 6 months. Intracellular and extracellular components of the oxidant-antioxidant balance (OAB), C-reactive protein (CRP), beta2-micro-globulin (beta2mu-globulin), albumin and transferrin were measured. RESULTS: A significant decrease in red cell membrane thiobarbituric acid reacting substances and an increase in cytosolic superoxide dismutase (SOD) and plasma total antioxidant substances were observed in all patients after 6 months of treatment with BK-P and B-3 membranes except SOD and CRP in patients previously dialysed with triacetate cellulose membranes. Albumin and transferrin remained unmodified. beta2mu-globulin significantly decreased after treatment with PMMA membranes. CONCLUSION: BK-P and B-3 HD membranes improved the OAB, beta2mu-globulin and CRP compared to PAN/AN69 and cellulose diacetate membranes.

[Heparin immune thrombocytopenia in a hemodialysis patient. A case report. Literature review]. / Trombopenia inmune inducida por heparina en hemodiálisis a propósito de un caso. Revisión de la literatura.

Heparin-induced thrombocytopenia (HIT) is an important side effect of heparin therapy associated with significant morbidity and mortality if unrecognized. The platelet count typically falls below 150,000/ll 5-14 days after heparin is started. Thrombosis is the major clinical complication. We present the case gives a patient that develops a deep vein thrombosis ilio-femoral left, with trombocytopenia, one week after beginning treatment with haemodialysis in which Ac anti heparin is detected by test PaGIA (Particle Gel Inmuno Assay.

Renal function impairment caused by intravenous urography. A prospective study.

Renal function was evaluated before and after intravenous urography (IVU) in 124 randomly selected patients. In cases with renal insufficiency (RI) (serum creatinine level, greater than or equal to 2 mg/dL), the incidence of renal impairment was higher (11 of 20 patients, 55%) than in the group without RI (16 of 104 patients, 15%). In the latter group, high blood pressure (BP) was associated with a higher frequency of renal impairment (28.6% vs 10.5%). Advanced age, mild proteinuria, and a single functioning kidney were not risk factors. The IVU preparation contributed to renal function impairment in ten cases, while in the other 17 cases, the iodinated contrast material was the only factor apparently involved. Renal function returned to its previous level in a mean period of 12 days. One patient suffered progressive and irreversible renal failure, and two others had a slight, persistent impairment of renal function. It was concluded that the incidence of renal function impairment is high, but cases are usually mild and reversible. The most important predisposing factors are RI and high BP.

[Selective IgA deficiency in systemic lupus erythematosus (author's transl)]. / Deficiencia selectiva de IgA en el lupus eritematoso sistémico.

The case of a 23 year-old female with a diagnosis of systemic lupus erythematosus associated to selective IgA deficiency is reported. The patient persistently had serum IgA levels below 0.05 mg/dl, while the remaining serum immunoglobulins were normal. No salivary IgA was detected, and the karyotype disclosed no abnormalities of the chromosome 18. In the in vitro immunological study a normal number of B and T lymphocytes was found, and decreased production of all surface immunoglobulins was observed.