Removal of vancomycin administered during dialysis by a high-flux dialyzer.

Introduction: Hemodialysis patients frequently receive vancomycin for treatment of gram-positive bacterial infections. This drug is most conveniently administered in outpatient dialysis units during the hemodialysis treatment. However, there is a paucity of data on the removal of vancomycin by high-flux polyamide dialyzers.

Reducing symptoms during hemodialysis by continuously monitoring the hematocrit.

Previous studies have demonstrated that patients on hemodialysis develop intradialytic symptoms when the blood volume decreases to a critical level. Using a continuous monitor (CRIT-LINE; In-Line Diagnostics, Riverdale, UT) to determine the instantaneous hematocrit and blood volume, we observed that certain intradialytic symptoms occurred at a patient-specific hematocrit. In the present study, we exploited this hematocrit threshold concept to decrease the occurrence of lightheadedness, cramping, and nausea, regardless of blood pressure changes.

Prescribing hemodialysis using a weekly urea mass balance model.

Prescribing hemodialysis by monitoring only predialysis BUN concentrations is not sufficient to guarantee adequate therapy. Results from the National Cooperative Dialysis Study have suggested that hemodialysis therapy is adequate if the protein catabolic rate is maintained greater than 1 g/day/kg body weight and simultaneously if sufficient hemodialysis is prescribed to maintain either a time-averaged BUN concentration (TACurea) less than 50 mg/dl or a value of Kt/V greater than unity. In the present study mathematical relationships were derived from a weekly urea mass balance model that permit an evaluation of TACurea and of protein catabolism via the urea generation rate (G) without the need for conventional urea kinetic modeling.

Microinjection study of renal calcium absorption in the phosphate-depleted rat.

Tracer microinjection studies were performed in chronically phosphate-depleted (CPD) and phosphate-supplemented (PS) rats in order to determine the site of the defect in calcium absorption which developed in CPD. Calcium recovery in the final urine was significantly higher in CPD than in PS rats after microinjections into the early and the late proximal tubules. However, there was no significant difference in the urinary recovery between the two groups after injection into the early and late distal convoluted tubules.