Disodium pamidronate for treating severe hypercalcemia in a hemodialysis patient.

Background: A 48-year-old man with a recent diagnosis of multiple myeloma and rapidly progressive oliguric end-stage renal disease requiring hemodialysis, presented with a serum calcium concentration of 3.4 mmol/l (13.6 mg/dl).

Thrombotic events of arteriovenous fistulae in hemodialysis patients related to the C677T thermolabile variant of methylenetetrahydrofolate reductase.

Background: Hyperhomocysteinemia is a risk factor for thrombosis, a frequent complication of vascular access (VA) in hemodialysis (HD). The enzyme methylenetetrahydrofolate reductase (MTHFR) is necessary for the remethylation of homocysteine (Hcy) to methionine. It has been postulated that patients homozygous and, to a lesser extent, heterozygous for the C677T thermolabile variant of this enzyme present a reduced catalytic activity, with secondary increases in plasmatic Hcy levels (normal: 10 +/- 5 micromol/L) and an elevated risk of vascular thromboses.

Clopidogrel diminishes hemodialysis access graft thrombosis.

Background: The most common complication of hemodialysis access graft is thrombosis. Clopidogrel, an inhibitor of platelet aggregation, was assessed to prevent this serious complication.

Methods: Nineteen patients on chronic hemodialysis whose vascular accesses were grafts were divided into two groups: Group A (n=11, 58%) consisted of patients who did not receive anti-thrombotic therapy after graft placement; Group B (n=8, 42%) received clopidogrel 75 mg/day from two days after surgery onwards.

[Hyperhomocysteinemia as a vascular risk factor in chronic hemodialysis patients].

Homocysteine is an independent risk factor for cardiovascular disease in the general population. In addition, it plays a main role in the development of atherogenesis and thrombosis, particularly in end-stage renal disease patients. Therefore, hemodialysis patients are under the burden of homocysteine toxic effects, present in nearly 90% of dialysis patients.