Hemodialysis in the Compact Nations of the US Affiliated Pacific: History and Health Care Implications.

The epidemic of non-communicable disease in the Compact nations of the US Affiliated Pacific Islands and the associated renal complications drive the demand for hemodialysis. Limited healthcare budgets and a lack of trained human health resources in these areas make hemodialysis a challenging undertaking that may require significant sacrifices in competing health care priorities. Two nephrologists who developed hemodialysis in the US Affiliated Pacific Islands provide its history.

Multiple-dose study of imipenem/cilastatin in patients with end-stage renal disease undergoing long-term hemodialysis.

Multiple doses of imipenem/cilastatin were administered to patients with end-stage renal disease undergoing long-term hemodialysis. Schedules of 250 mg every six hours, 500 mg every six hours, and 500 mg every 12 hours were studied. Five hundred mg every 12 hours was the most efficient schedule that maintained effective trough antibiotic activity.

Ceftriaxone pharmacokinetics in patients with various degrees of renal impairment.

The effects of renal impairment on the pharmacokinetics of ceftriaxone in humans were examined after intravenous infusion of a 1-g dose over 15 min to 30 renally impaired patients. The study included 12 dialysis patients and 18 patients with severe, moderate, or mild renal impairment. Plasma and, where appropriate, urine and dialysate samples were collected at predetermined times and analyzed for ceftriaxone by high-pressure liquid chromatography.

Coping with transplant failure: grief vs. denial.

A major drawback to kidney transplantation as a treatment for end stage renal disease is the common occurrence of rejection and failure of the transplanted kidney. We evaluated twenty-five dialysis patients, all of whom had suffered transplant failure during a ten year period. Of these, twenty-four had good psychological readjustment to chronic dialysis.