Impact of convective flow on phosphorus removal in maintenance hemodialysis patients.

Objective: Hyperphosphatemia leads to increased risk of death in maintenance hemodialysis patients (MHD). This study investigated phosphorus (P) removal, P reduction rate (PRR), and P rebound, comparing on-line, high-volume hemodiafiltration in postdilution (HDF) and high-flux hemodialysis (HD) in a setting of an equal amount of produced dialysate solution in both modalities.

Methods: A total of 22 MHD patients, treated with regular 3 x 4 hours HDF weekly, were randomly dialyzed with one 4-hour session of HDF and of HD.

On-line haemodiafiltration. Remarkable removal of beta2-microglobulin. Long-term clinical observations.

Background: The accumulation of beta2-microglobulin (beta2-M) in long-term dialysis patients may lead to dialysis amyloidosis. In this respect, the removal with different modes of on-line haemodiafiltration (HDF) of beta2-M was studied. Long-term clinical observations in patients with more than 10 years of dialysis, treated mainly with biocompatible and highly permeable membranes and in the last years with on-line HDF are also reported.

Intermittent venovenous haemodiafiltration in critically ill patients with acute renal failure.

Various renal replacement therapies have been used for the treatment of acute renal failure in critically ill patients in the last decade. Due to the slower rate of solute and fluid removal, the continuous renal replacement therapies are generally better tolerated than conventional therapy. There is no consensus whether different treatment strategies effect the outcome of critically ill patients and no clear definition of adequacy of renal support in the severely ill patient.

Remarkable removal of beta-2-microglobulin by on-line hemodiafiltration.

Unlabelled: Eight chronic, anuric hemodialysis patients were randomly treated with a high-flux polysulphone dialyzer (F80), using 6 different modes: conventional bicarbonate hemodialysis (HD), hemodiafiltration (HDF) with a replacement solution at 40, 60, 80 or 100 ml/min in postdilution and 80 ml/min in predilution. The differences in beta 2-microglobulin (beta 2M) reduction ratio and clearance were evaluated statistically by analysis of variance (ANOVA). Both studies revealed no significant difference between HD and HDF40 in postdilution, but an increasing significant difference from HDF60 to HDF100 in postdilution and with HDF80 in predilution.

Guanidino compounds in serum and urine of nondialyzed patients with chronic renal insufficiency.

Levels of 15 guanidino compounds and urea were determined in serum and urine of nondialyzed patients with chronic renal insufficiency subdivided according to etiology and creatinine clearances. No significantly different guanidino compound levels in serum and urine were found for the interstitial nephritis, glomerulonephritis, nephrangiosclerosis, and diabetic nephropathy subgroups. Subdividing the patients according to creatinine clearance yields the following results: (1) Serum guanidinosuccinic acid (GSA) and methylguanidine levels of patients with end-stage renal failure (creatinine clearance < 10 mL/min) are up to 100 and 35 times higher than control levels, while guanidine, creatinine, and symmetrical dimethylarginine (SDMA) are increased about 10 times.

Pharmacokinetics of aluminoxamine and ferrioxamine and dose finding of desferrioxamine in haemodialysis patients.

We investigated the pharmacokinetics of desferrioxamine and its chelated compounds aluminoxamine and ferrioxamine in normal volunteers and haemodialysis patients with and without iron overload. Desferrioxamine was administered in a single dose of 30 mg per kg body-weight was a 30-min infusion to five healthy volunteers and to 20 haemodialysis patients (five patients without haemosiderosis and 15 patients with haemosiderosis). The interdialytic half-life of ferrioxamine was 2.

Serum guanidino compound levels and the influence of a single hemodialysis in uremic patients undergoing maintenance hemodialysis.

Guanidino compounds are increased in uremia and are highly suspected to be uremic toxins. The serum levels of 11 guanidino compounds and the influence of a single hemodialysis were evaluated in 30 steady-state uremic patients undergoing maintenance hemodialysis. Guanidino compound levels were detected using liquid cation exchange chromatography with a highly sensitive fluorescence detection method.

Guanidino compounds in uraemic dialysed patients.

The concentrations of guanidino compounds in blood are raised in uraemic patients and may have toxic effects. The concentrations of 13 guanidino compounds in serum were measured in 29 patients with chronic renal failure treated by chronic intermittent haemodialysis using liquid cation exchange chromatography with a highly sensitive fluorescence detection method. For taurocyamine we used another column system.

Autogenous saphenous vein AV fistulae for haemodialysis: eight years experience with 30 patients.

Since 1973, 41 autogenous saphenous vein (ASV) fistulae in the arm or the leg have been constructed in 30 chronic haemodialysis patients. The mean patency rate for the arm fistulae was 36.8 months and 21.

Shunt nephritis.

A case of nephritis occurring in a 40-year old patient with a ventriculojugular shung infected with staphylococcus albus is described. Circulating antistaphylococcal antibodies could be demonstrated. Renal manifestations disappeared after treatment with systemic antibiotics and surgical removal of the shunt.