[Comparative study on sequential colon dialysis, hemodialysis and peritoneal dialysis in patients with hyperuricemia].

OBJECTIVE: To evaluate the effects of sequential colon dialysis (SCD), hemodialysis (HD) and peritoneal dialysis (PD) on the serum level of uric acid (UA) in patients with hyperuricemia. METHODS: A total of 293 patients with mild, moderate and severe degree of hyperuricemia were randomly assigned to three groups according to digital randomized method, and treated with SCD, HD and PD respectively. The serum level of UA was determined with unicase-peroxidase conjugate method, the blood levels of K+, Na+, Cl-, Ca2+ were determined by automatic biochemical analysor, and changes of body weight were measured before and after dialysis. RESULTS: In the 293 cases, the three modes of dialysis showed no difference in lowering uric acid in patients of mild degree (P > 0.05). But the HD did show a better efficacy than that of the other two in severe degree patients (P<0.01), while in patients of moderate degree, significant difference (P<0.01) showed between HD and SCD, PD and SCD, but not between HD and PD (P > 0.05). No obvious effect of the various modes of dialysis on the level of K+, Na+, Cl-, Ca2+, body weight. CONCLUSION: SCD can decrease the serum level of UA effectively and reduce the incidence of complication of hyperuricemia to some extent, as hemodialysis and peritoneal dialysis can.

[Combination therapy with losartan and fosinopril for early diabetic nephropathy].

OBJECTIVE: To observe the effects of combined use of losartan and fosinopril in the treatment of early diabetic nephropathy. METHODS: Fifty-seven patients with diabetic nephropathy were divided equally into group A with treatment with losartan (50 mg) and fosinopril (10 mg) daily, group B with daily losartan treatment (50-100 mg), and group C with fosinopril treatment at the daily dose of 10-20 mg. After the 6-month medication, the patients underwent examinations for changes in the mean arterial blood pressure (MABP), serum creatinine (SCr), blood urea nitrogen (BUN) and 24-h urine protein excretion. RESULTS: Losartan or fosinopril used alone or in combination significantly lowered MABP, 24-h urine protein excretion, SCr and BUN in the patients ( P < 0.05 or P < 0.01). In spite of the absence of significant differences between the patient groups, combination use of the two drugs produced the most obvious reduction of the parameters measured. CONCLUSION: Combined use of losartan and fosinopril may decrease MABP, 24-h urine protein excretion, SCr and BUN to a greater extent than the use of losartan or fosinopril alone.

[Effect of angiotensin-converting enzyme inhibitors on serum levels of erythropoietin in patients on peritoneal dialysis].

OBJECTIVE: To assess the effect of angiotensin-converting enzyme inhibitors (ACEI) on the serum level of erythropoietin (EPO) in patients receiving peritoneal dialysis and explore the possible mechanism. METHODS: Thirty-six patients receiving peritoneal dialysis were enrolled in this study, among whom 26 received EPO treatment and the other 10 did not. The 2 groups were randomly subdivided into experimental group and control group with equal cases in each, the former with ACEI prescription to control blood pressure while the latter with calcium channel blocker or alpha-receptor blocker. Serum levels of EPO and hemoglobin (Hb) in all the patients were determined before and 6 months after their respective therapies. RESULTS: The serum levels of EPO and Hb decreased significantly after therapy in the experimental group (P<0.05), obviously lower than those in the control group (P<0.05). CONCLUSION: ACEI may decrease the serum EPO and Hb levels in patients receiving peritoneal dialysis.