Variations in living donor graft rates by dialysis clinic: effect on outcome and cost of chronic renal failure therapy.

Object: Examination of nephrology practice variations in living donor renal grafts to determine their influence on organ supply, quality, and cost of chronic renal failure therapy.

Materials: Saskatchewan chronic dialysis, cadaveric, and living donor renal grafts in 1983-1994 inclusive.

Results: Saskatchewan has three dialysis (I, II, III) and one transplant clinic.

Protein malnutrition and decreased protein turnover in chronic renal allograft failure.

Object: To define the longitudinal relationship of declining renal function to protein consumption and turnover in the failing renal allograft model of chronic renal failure.

Method: The study group is our first eight consecutive cadaveric renal graft recipients who after attaining a normal creatinine clearance, then developed chronic renal failure. We analysed their urea and creatinine clearances (Cur, Ccr), serum urea (SU), urinary urea and creatinine (Ur, Ucr), serum albumin (SA), urinary protein (Upr), body weight (BW), and steroid dose.

HLA-identity--long-term renal graft survival, acute vascular, chronic vascular, and acute interstitial rejection.

The object is analysis of the impact of acute and chronic rejection on long-term function in HLA-identical renal transplants performed from 1967 to 1995 by the Saskatchewan Renal Transplant Unit. Forty-eight grafts in 46 patients were studied, of which 39 were first and nine second grafts. Forty-two were for primary and six for secondary renal disease.

Improved urea clearance raises the BUN in continuous peritoneal dialysis.

Cross-sectional studies in steady state dialysed chronic end-stage renal failure patients show urea clearance (Kt/V) and total urea excretion (protein catabolic rate) correlate positively. However, urea clearance is total urea excretion divided by BUN. Thus urea clearance and BUN relate reciprocally, and so their mathematical product (total urea excretion) is independent of clearance.