[C-reactive protein and homocysteinemia in patients undergoing on-line hemodiafiltration]. / Proteina C-reattiva e omocisteinemia in emodiafiltrazione on-line.

PURPOSE: In renal disease therapy (RDT) patients, high plasma homocysteine (tHcy) is common and high C-reactive protein(CRP) levels can be observed, attributed to the inflammatory process caused by the dialysis itself. Hyperhomocysteinemia and bioincompatibility are considered independent vascular risk factors. This study evaluated the behavior of these parameters in patients undergoing on-line hemodiafiltration (OL-HDF). METHODS: In 56 patients, HDF was performed using high permeability polyamide membranes, exchanging in the post-dilution mode 16-18 L/session of a reinfusate obtained by the on-line system (triple filtration AK200, Gambro). CRP was measured by an immunological method at the start and the end of the session in patients without comorbidities (group 1, n=30)and with inflammatory diseases (group 2, n=26). In 23 of the 56 patients, tHCY was measured (by high performance liquid chromatography (HPLC)) before and after the mid-week session on different schedule of folinic acid, vitamin B12 and vitamin B6. RESULTS: Pre-dialytic CRP was in the normal range in group 1 patients, whereas it was higher in group 2 patients; dialysis did not induce a significant change in either group. The intradialytic percentage tHcy decrease was approximately 50% regardless of the pre-dialytic value, which was significantly different according to the vitamin supplements administered. CONCLUSIONS: HDF, as performed in this study, demonstrated biocompatibility and efficient Hcy removal; therefore, it can prevent cardiovascular disease (CVD) in patients on regular extracorporeal dialysis.

Calcitriol pulse therapy for severe hyperparathyroidism or calcium salts as phosphate binders in renal dialysis patients?

The concurrent use of calcitriol (CAL) pulse therapy to reduce parathyroid hormone (PTH) secretion and of calcium (Ca) salts as the most appropriate phosphate binders was evaluated for over 1 year in a group of 14 patients with good divalent ion control on CaCO3 therapy but with increasing levels of serum intact PTH. CAL pulse therapy was effective and safe in only 2 patients; in the remaining subjects it resulted in hypercalcemia and/or hyperphosphatemia, not reversed by adjusting the dialysate Ca concentration and or CaCO3 dose, and had to be stopped. Therefore, CAL pulse therapy does not seem to be compatible with Ca salts which, in our opinion, deserve priority in the therapy of renal dialysis patients.

[Variations in prolactinemia in 26 uremic subjects treated by periodic hemodialysis]. / Variazione della prolattinemia in 26 soggetti uremici in trattamento emodialitico periodico.

Prolactin level, creatinine, urea nitrogen and plasmatic natrium were evaluated in 26 uremic patients undergoing regular haemodialytic treatment. Prolactin level was found to be over normal range in 60% of the female patients and in 12.5% of the male patients. There was no correlation between prolactin, creatinine, urea nitrogen and natrium levels. No significant variations of the prolactin level were evident after a single haemodialytic treatment.

[Serologic methods in the diagnosis of toxoplasmosis]. / Considerazioni su alcuni metodi sierologici per la diagnosi della toxoplasmosi.

The data revealed on the same subject by the indirect agglutination test and the immunoenzyme test for IgG and IgM anti-toxoplasma antibodies were compared. The analysis shows that neither the indirect agglutination test nor the antibody count is sufficient for the diagnosis of the disease and that both are more appropriately employed in statistical epidemiological surveys.