Further advances of chronic renal replacement therapy in eastern Germany, 1994 versus 1989.

Unlike the other former Soviet-block countries, Eastern Germany/the "GDR", had the opportunity to the re-unification with a highly developed western country, the Federal Republic of (West) Germany in 1990. In order to record the following rapid improvements in renal replacement therapy, we performed our own survey in Eastern Germany--excluding Eastern Berlin--by questionnaire, comparing the years 1989/December, and 1994/December. 112 of the 113 dialysis facilities for adult regular dialysis patients replied to our questionnaire (99%). From 1989 to 1994, the number of dialysis centers increased from 53 to 113 (-->213%), reaching 7.9 centres p.m.p. Of these facilities, 29% were hospital centers, 48% were private dialysis units, and 23% were run by nonprofit dialysis organizations. The number of dialysis stations increased from 602 to 1,719 (-->286%), i.e. 120 stations p.m.p. The number of patients in regular dialysis treatment rose from 2,127 to 5,335 (-->251%), that means a prevalence of 373 patients p.m.p. In 1989, 67 new patients (p.m.p.) had been accepted for maintenance treatment (incidence), in contrast to 130 new patients p.m.p. in 1994 (-->194%), now under the conditions of unlimited accessibility to dialysis treatment. Questions referring to this point--the incidence of new patients--were only asked in Thüringen (2.5 mio. inhabitants). Alternative treatment modalities became feasible under the new conditions in Eastern Germany. In contrast to 99% hemodialysis patients in December 1989, at the end of 1994 92.8% of the patients were treated by hemodialysis, 2.0% by hemofiltration, and 5.2% by peritoneal dialysis, predominantly CAPD.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of acclimation temperature on intraerythrocytic acid-base balance and nucleoside triphosphates in the carp, Cyprinus carpio.

In carp acclimated to 20 degrees C or 10 degrees C intraerythrocytic pH (pHi) and plasma pH (pHe) were determined in vitro after equilibration with CO2 in either O2 or N2. ATP and GTP were determined with an enzymatic assay described in detail. The relationship between pHi, pHe and oxygen saturation was not affected by the acclimation temperature and was (pHi-6.10) = (0.853-0.159 X S) X (pHe-6.21) There was a slight but significant decrease in ATP at 20 degrees C. Apparent buffer values were affected by oxygenation and temperature. It is concluded from the recalculated CO2 Bohr factor and from the temperature effect on the buffer value that carp hemoglobin forms carbamate which decreases at a higher temperature. These changes in ATP and carbamate can partly account for the increase in whole blood oxygen affinity in carp acclimated at a high temperature.