RESUMO
The biofiltration with bicarbonate as dialysate buffer (BiBF) was used in 10 patients on RDT: the patients were treated for 10 months on standard BF and for 10 months on BiBF. The amount of fluid infused varied between 3 and 5 liters and Na-bicarbonate (100 mEq/h) was infused during BF. The dialytic protocol was 3 hours every other day. Cardiovascular stability, waste molecules and acid-base balance were investigated. No differences in vascular stability and no significant changes in the waste-molecules concentrations were found. Both protocols correct the metabolic acidosis; however, in standard BF 50% of patients showed acute hypocapnia at the end of dialysis.
Assuntos
Bicarbonatos/administração & dosagem , Sangue , Sódio/administração & dosagem , Ultrafiltração/métodos , Equilíbrio Ácido-Base , Acidose/sangue , Soluções Tampão , Dióxido de Carbono/sangue , Humanos , Hipotensão/sangue , Diálise Renal , Bicarbonato de Sódio , Cloreto de Sódio/administração & dosagemRESUMO
Biofiltration (BF) was performed on 60 patients from 12 dialytic centers in Puglia. The protocol was 9-10.5 hours a week with 1.2 m2 PAN dialyzers. A dialysate with 140 Na+, 2-2.5 K+, 3.5-4 Ca++, 38 mEq/l acetate was used in 49 patients; the acetate was replaced by bicarbonate (35-40 mEq/l) in 11 patients. The same patients were treated for 1 year with standard acetate dialysis (49 patients) and standard bicarbonate dialysis (11 patients). The two protocols were compared on the basis of the clinical state, BUN and serum creatinine, acid-base balance, PTH, anemia, and nerve conduction velocity (NCV). Favourable effects were achieved in 55 patients. Four patients left the program because of progressive hyperhydration. BUN and serum creatinine levels showed a moderate, but insignificant increase. PTH, anemia and NCV did not worsen. BF gave better correction of metabolic acidosis in the patients undergoing acetate dialysis.
Assuntos
Sangue , Ultrafiltração/métodos , Acetatos/administração & dosagem , Acidose/prevenção & controle , Adulto , Idoso , Bicarbonatos/administração & dosagem , Feminino , Humanos , Hipotensão/prevenção & controle , Itália , Cinética , Masculino , Pessoa de Meia-Idade , Diálise Renal , Ultrafiltração/instrumentação , Ureia/sangueAssuntos
Bicarbonatos , Diálise Renal/métodos , Acetatos/efeitos adversos , Acidose/terapia , Peso Corporal , Eletrocardiografia , Feminino , Humanos , Hipotensão/induzido quimicamente , Masculino , Pessoa de Meia-Idade , Potássio/intoxicação , Diálise Renal/efeitos adversos , Uremia/fisiopatologia , Uremia/terapia , Resistência VascularAssuntos
Rejeição de Enxerto/terapia , Antígenos HLA/imunologia , Imunoglobulina G/sangue , Isoanticorpos/sangue , Transplante de Rim/imunologia , Proteína Estafilocócica A , Adulto , Formação de Anticorpos , Cromatografia de Afinidade , Rejeição de Enxerto/imunologia , Rejeição de Enxerto/patologia , Humanos , Imunoglobulina G/isolamento & purificação , Técnicas de Imunoadsorção , Isoanticorpos/isolamento & purificação , Transplante de Rim/patologia , Transplante de Rim/fisiologia , Pessoa de Meia-Idade , Falha de Tratamento , Resultado do TratamentoAssuntos
Infecções Bacterianas/tratamento farmacológico , Nefropatias/tratamento farmacológico , Falência Renal Crônica/complicações , Penicilinas/uso terapêutico , Infecções Urinárias/tratamento farmacológico , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Mezlocilina , Pessoa de Meia-IdadeAssuntos
Injúria Renal Aguda/complicações , Antibacterianos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Falência Renal Crônica/complicações , Rim/efeitos dos fármacos , Adulto , Idoso , Antibacterianos/administração & dosagem , Antibacterianos/efeitos adversos , Antibacterianos/metabolismo , Interações Medicamentosas , Feminino , Humanos , Fígado/metabolismo , Masculino , Pessoa de Meia-Idade , Diálise Renal/efeitos adversos , Sisomicina/administração & dosagem , Sisomicina/efeitos adversos , Sisomicina/uso terapêutico , Infecções Urinárias/tratamento farmacológicoRESUMO
Bone densitometry using I125 is a very easy method of investigation; it may be used repeatedly and simultaneously at different bone levels without distress to patients. The problems involved were those of the value, semeiological significance and possible limitations of this method in the investigation of uraemic osteopathy. These problems were solved successfully in tests carried out on 87 patients of both sexes suffering from various degrees of chronic nephropathy and on chronic haemodialysis patients. The method is reliable: reproducibility tests in normal and uraemic subjects were satisfactory; the indexes remain constant, usually in normal subjects. The parameters are "Bone Mineral Content" and "Bone Index". Trabecular bone is more sensitive than cortical bone, although comparisons between the two types of bone produce interesting data. There are difference dependent on sex. The method which is more sensitive than others enables: 1) Normal and nephropathic subjects, to be distinguished from one another. The latter generally show a lower mineral content and bone index (clinical picture of osteomalacia, osteoporosis, hyperparathyroidism) seldom a higher or a normal one. 2) The same bone sites to be examined over a given period. 3) Treatment of patients to be monitored.
Assuntos
Distúrbio Mineral e Ósseo na Doença Renal Crônica/diagnóstico , Densitometria/métodos , Radioisótopos do Iodo , Osso e Ossos/química , Feminino , Humanos , Falência Renal Crônica/metabolismo , Masculino , Minerais/análise , Fatores SexuaisRESUMO
The function of the kidney in adult subjects with Cooley's disease has been hitherto inadequately investigated. In 10 patients suffering from thalassemia major, glomerular filtration rate, renal plasma flow, renal blood flow have been studied, together with urine concentration capacity. The authors emphasize certain pathological changes, such as the increase in renal plasma flow and the failure of the urine concentration ability. On the basis of renal biopsies, two pathogenetic theories are discussed: the functional impairment of the coutercurrent system and fibrosis of the medullary tissue.
Assuntos
Rim/fisiopatologia , Talassemia/fisiopatologia , Adolescente , Adulto , Feminino , Taxa de Filtração Glomerular , Hemoglobinas/análise , Humanos , Rim/irrigação sanguínea , Rim/patologia , Capacidade de Concentração Renal , Masculino , Concentração Osmolar , Poliúria/diagnóstico , Proteinúria/diagnóstico , Fluxo Sanguíneo Regional , Talassemia/sangue , Talassemia/patologia , Talassemia/urinaRESUMO
27 patients with creatinine clearances ranging from 20 to 2 ml/min were treated daily with 6.9 mg/kg of muzolimine, for 10 to 25 days. The hyperhydration state with oedema decreased gradually in all patients without hypotensive phenomena. Muzolimine benefited hypertension in patients with expansion of the extracellular space and it also strengthened the effect of clonidine or minoxidil. Important diuretic and natriuretic effects were obtained. Metabolic acidosis improved. No subjective adverse reactions to the drug or side effects were noted. High-dose muzolimine appears to be efficacious and safe for short-term treatment in patients with severe chronic renal failure.
Assuntos
Falência Renal Crônica/tratamento farmacológico , Muzolimina/uso terapêutico , Pirazóis/uso terapêutico , Desequilíbrio Ácido-Base/tratamento farmacológico , Acidose/tratamento farmacológico , Adulto , Idoso , Clonidina/uso terapêutico , Diurese/efeitos dos fármacos , Edema/tratamento farmacológico , Feminino , Taxa de Filtração Glomerular , Humanos , Hipertensão/tratamento farmacológico , Falência Renal Crônica/fisiopatologia , Masculino , Pessoa de Meia-Idade , Muzolimina/efeitos adversos , Natriurese/efeitos dos fármacosRESUMO
An intravenous infusion of 3,430mg of PO4- has been given to 11 patients on acetate and to 11 patients on bicarbonate haemodialysis. The 'phosphate spaces' and dialytic removal were determined. The bicarbonate dialysis causes lower values of phosphate pool, total phosphate space, cellular space and phosphate cellular clearance. There is also a greater phosphate removal during bicarbonate dialysis. The better correction of metabolic acidosis and the absence of acetate metabolism are two factors which may be responsible for these phenomena.
Assuntos
Fosfatos/metabolismo , Diálise Renal , Equilíbrio Ácido-Base , Bicarbonatos , Humanos , CinéticaRESUMO
A multicentric study was carried out to investigate the safety and effectiveness of long-term treatment of chronic uremic patients by a regular combination of hemodialysis and charcoal hemoperfusion. 39 RDT patients from five dialysis centers were treated for up to 12 months. The combined treatment proved to be safe, well tolerated and effective in improving certain dialysis-resistant uremic signs, mainly severe peripheral neuropathy, asthenia, anorexia, nausea, lack of well-being and relapsing pericarditis. There was also a marked decrease, after several weeks of combined treatment, in plasma values of urea, uric acid and creatinine.