Immune response to hepatitis B vaccine in staff and patients in renal dialysis units.

Anti-HBs response was detected in 96 per cent of staff members in three haemodialysis units after three 20 microgram doses of hepatitis B vaccine and in 82 per cent of adult patients treated with three 40 microgram doses. The percentage of responders and levels of antibody remained unchanged at 12 months from the beginning of the trial. Three out of six children injected with three 20 microgram doses in a paediatric haemodialysis unit remained free from markers of HBV infection and had high levels of anti-HBs after the second dose of vaccine. The other three children who developed serological markers of HBV infection seroconverted to anti-HBc within six months from the first dose and, in one of them, antigenaemia at three and four months was detected.

Carnitine balance in hemodialyzed patients.

1-Carnitine was assayed before and after dialysis in plasma, dialyzate and muscle of four patients undergoing hemodialysis. The findings suggest that plasma carnitine losses occurring during hemodialysis may be at the expense of the carnitine present in extracellular fluid. Carnitine concentrations in muscle of hemodialyzed patients and controls did not differ significantly. Chronic carnitine administration did prevent plasma carnitine from falling below base levels, but did not affect muscle concentration.

Plasmapheresis in the treatment of acute renal failure in multiple myeloma.

Three patients with multiple myeloma and severe acute renal failure were treated by repeated plasmapheresis. Recovery of renal function was observed in all. The pathogenetic role of light chains and the possible mechanisms responsible for renal damage are discussed. It is suggested that the removal of light chains by plasmapheresis may be of therapeutic value in this condition.