[Distribution and features of infection with hepatitis viruses B and C during hemodialysis treatment]. / Rasprostranennost' i osobennosti infitsirovaniia virusami gepatitov B i C v usloviiakh lecheniia gemodializom.

The prevalence of hepatitides B and C was evaluated in 140 patients treated by hemodialysis. Almost half of patients (48%) had acute hepatitis B which completely resolved. Acute hepatitis B was detected in 6% in the course of observation. In 6% chronic hepatitis B was diagnosed, and in 24% chronic hepatitis C. A combination of hepatitides B and C was diagnosed in 2% patients. Only 12% patients were not infected with hepatitis. Genotype 1b predominated in patients with HCV infection (73%); genotypes 1a, 21, and 3a were equally incident (9%). Replication of HBV and HCV in patients with uremia under conditions of hemodialysis was detected in 83 and 86% patients, respectively. Relationship between HBV and HCV infection and the duration of hemodialysis treatment was analyzed. The percentage of non-infected patients persistently decreased, and the time course of HBV and HCV infection was different. Infection with HBV after the beginning of hemodialysis occurred sooner (16.0 +/- 4.0 months) than with HCV (30.2 +/- 4.6 months, p < 0.04). The levels of SGPT and SGOT in patients with various manifestations of HBV and HCV infection treated by hemodialysis were followed up.

[Ways of intensification of hemodialysis therapy]. / Puti intensifikatsii gemodializnogo lecheniia.

Three methods of intensive hemodialysis were compared: routine hemodialysis (HD) (12 h/m2/week), HD on a highly permeable membrane with ultrafiltration (ordinary in volume and increased up to 10.5 l), and hemodiafiltration with the replacement of 16.4 l. Clearance, pre- and postdialysis concentration in the plasma of urea, creatinine, phosphate and average molecular mass substances were analyzed during investigation; dynamometry was used at the beginning and end of investigation to assess right forearm muscle strength. Better results were obtained with hemodiafiltration. The successive use of three methods of hemodialysis resulted in the patients' improved somatic state and a significant increase in muscle strength. In the authors' opinion, the use of hemodiafiltration would facilitate rehabilitation and reduce a period of preparation of uremic patients for kidney transplantation.