[20 years' experience with "difficult" vascular access].

The increased survival of patients in dialysis and the gradual increase in the age of uremic patients commencing chronic dialysis raises serious problems for the creation and maintenance of efficient vascular access. In cases in which it is extremely difficult to create arteriovenous fistulas (AVF) using existing upper limb veins, it is possible to resort to vascular grafts, lower limb AVF, central venous catheters or refer the patients for peritoneal dialysis if this method is technically possible. In order to evaluate the incidence of these phenomena in quantitative terms, the authors have made a retrospective analysis of patients undergoing vascular access surgery since the opening of the Dialysis Centre on 1/9/1973 to 30/9/1996.

Increased serum pancreatic enzymes in uremia: relation with treatment modality and pancreatic involvement.

Increased levels of pancreatic enzymes have been reported in patients with renal insufficiency and ascribed either to impaired urinary excretion or, in a few studies, to the presence of pancreatic damage. In the present study serum total amylase, pancreatic amylase, and lipase were evaluated in 63 patients with chronic renal insufficiency (CRF), in 98 patients on hemodialysis (HD), in 28 patients on continuous ambulatory peritoneal dialysis (CAPD), in 23 patients with renal transplantation (RT), and in 34 normal volunteers (C). Serum parathyroid hormone and triglyceride levels were also measured in the majority of patients.

[14 years' experience with large-surface-area dialyzers].

Hemodialysis treatments with large surface area dialyzers were introduced in our dialysis unit since 1974. 129 uremic subjects were treated between September 1974 and August 1988. Age at start of high efficiency therapy ranged between 16 and 72 years; patients survival was: 95.

Morphometric evidence of the trophic effect of L-carnitine on human skeletal muscle.

We investigated the effect of long-term i.v. administration of L-carnitine on human muscle fibers using morphometric parameters.