Value of magnetic resonance/computed tomography peritoneography technique in the evaluation of dialysate leakage and hernia following peritoneal dialysis.

Magnetic resonance and computed tomography peritoneography are diagnostic imaging procedures that involve the intraperitoneal administration of a mixture of contrast material and dialysate for direct visualization of the peritoneal cavity and assessment of the integrity of peritoneal membrane. In a clinical series of patients with end-stage renal disease treated with continuous ambulatory peritoneal dialysis, who presented with genital or low abdominal edema, advanced peritoneographic imaging studies allowed direct visualization of the dialysate leakage and peritoneal hernias. Both magnetic resonance and computed tomography peritoneographic procedures allowed accurate diagnosis of continuous ambulatory peritoneal dialysis-related complications that may need to be addressed promptly so that the effectiveness of continuous ambulatory peritoneal dialysis is not compromised.

Laparoscopic placement of the Tenckhoff catheter for peritoneal dialysis.

Continuous ambulatory peritoneal dialysis catheters can be inserted by open laparotomy as well as by laparoscopy. A prospective randomized study was scheduled to investigate the results of the laparoscopic versus open laparotomy technique for placement of continuous ambulatory peritoneal dialysis catheters. Fifty patients were enrolled and randomly allocated into two groups of 25 patients each.

Effect of L-carnitine supplementation on lipid parameters in hemodialysis patients.

It has been reported that cumulative carnitine losses through dialysis membranes may worsen hyperlipidemia during long-term hemodialysis. However, carnitine supplementation has not shown a consistent beneficial response. We undertook the present study to determine if there is any hypolipidemic effect of L-carnitine on Greek dialysis patients in concert with the dialysate buffer composition (acetate or bicarbonate).

Absence of HCV viraemia in anti-HCV-negative haemodialysis patients.

Background: Immunologic alterations have been reported in chronic haemodialysis (HD) patients. Some HD patients may have, therefore, an inability to produce detectable amounts of serum antibodies to hepatitis C virus (anti-HCV). Previous studies have shown the presence of HCV viraemia in anti-HCV-negative HD patients (ranging from 1 to 15%).

Quantitative computed tomography for spinal bone mineral measurements in chronic renal failure.

The aim of this study was to assess non-invasively the status of spinal trabecular bone in patients with chronic renal failure and the influence of the disease stage. Single energy quantitative computed tomography (CT) was used in 89 patients with chronic renal failure to measure spinal trabecular bone equivalent density. 23 patients were independent of dialysis and 66 were receiving long-term haemodialysis.

Lipid parameters including lipoprotein (a) in patients undergoing CAPD and hemodialysis.

Objective: Dyslipidemia possibly contributes to the vascular complications commonly afflicting uremic patients. Lipoprotein (a) [Lp(a)] has been identified as an independent risk factor for atherosclerotic vascular disease. The aim of our study was to compare lipidparameters, including Lp(a), between hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients.

Bone mineral status after renal transplantation. Assessment by noninvasive techniques.

Rationale And Objectives: Bone mineral status in recipients of renal grafts is related to preexisting renal osteodystrophy and immunosuppressive treatment. The authors assessed bone mineral status after renal transplantation.

Methods: Bone mineral status of 20 male graft recipients was evaluated using the following noninvasive techniques: 1) neutron activation analysis, to measure hand bone phosphorus (HBP); 2) single photon absorptiometry, to measure forearm bone mineral content (BMC); and 3) single energy spectrum quantitative computed tomography, to measure spinal trabecular bone equivalent density (TBED).

Effects of isradipine on hypertension and renal hemodynamics.

The safety and efficacy of isradipine as well as its long-term effects on renal hemodynamics were evaluated in a study of 17 patients with mild-to-moderate essential hypertension and normal or slightly impaired renal function. After a 4-week placebo period, isradipine was administered according to a schedule of increasing dosages ranging from 1.25 to 5 mg twice daily.

Pituitary adrenal responsiveness to corticotropin-releasing hormone in chronic uremic patients.

We investigated the effect of exogenous ovine corticotropin-releasing hormone (oCRH) on plasma levels of adrenocorticotropic hormone (ACTH) and cortisol in 24 chronic renal failure patients: 8 nondialysis (NDCRF), 8 on hemodialysis (HD), and 8 on continuous ambulatory peritoneal dialysis (CAPD). In all groups the acute administration of oCRH caused a further increase (less pronounced in NDCRF patients) in the already elevated levels of cortisol. Following oCRH administration, plasma ACTH rose significantly in CAPD patients, but there was a blunted response of the hormone in the NDCRF and HD groups.

Ovine corticotropin-releasing hormone stimulation test in patients with chronic renal failure: pharmacokinetic properties, and plasma adrenocorticotropic hormone and serum cortisol responses.

The data on the status of the hypothalamic-pituitary-adrenal (HPA) axis in haemodialysis (HD) patients are conflicting. Moreover, a state reminiscent of Cushing's syndrome has been reported in this group of patients. Corticotropin-releasing hormone (CRH), that is produced by the hypothalamus and modulates the secretion of adrenocorticotropic hormone (ACTH), has been shown to be useful as a provocative test of the HPA axis.