The beneficial effect of low initial dose and gradual increase of erythropoietin treatment in hemodialysis patients.

It is well known that the effects of human recombinant erythropoietin (rHuEPO) are dose-dependent. However, when higher doses of rHuEPO are used, the frequency of the side effects also increases. The aim of our study was to analyze the hematologic parameters and blood pressure response in hemodialysis patients treated with low initial and gradually increased rHuEPO.

[Acute kidney failure caused by rhabdomyolysis].

Rhabdomyolysis developed in the muscles of the left lower extremity of a 43 year old man leading to myoglobinuria and acute renal failure. The diagnosis of rhabdomyolysis was strengthened by muscle and renal biopsy. The renal functions were restituted after peritoneal dialysis performed four times (12 hours each) within two weeks.

Changes of arterial prostaglandin E2 during haemodialysis.

The absence of a reduction in peripheral vascular resistance secondary to hypervolaemia leads to so-called volume hypertension. In order to study whether a deficient formation of the vasodilator autacoid prostaglandin E2 (PGE2) contributes to the preservation of inadequate vascular tone during extracellular volume expansion, arterial plasma PGE2 and the stable PGE2 metabolite 13,14-dihydro-15-keto-PGE2 (PGE2-M) were determined in 13 oligoanuric women on chronic haemodialysis. Prior to treatment eight of them had hypervolaemia and hypertension (mean arterial pressure (MAP) 128 +/- 3 mmHg (mean +/- SE] and five patients had hypervolaemia of a similar degree but were not hypertensive (MAP: 99 +/- 4 mmHg P less than 0.

[Myocardial calcification in chronic renal failure].

The authors present the case of a young man who--as a consequence of chronic renal failure and long-term dialysis--developed a calcific cardiopathy. The myocardial calcification was proved histologically by light microscopy. They established that the calcification started in damaged myofibers and was principally caused by the secondary parathyroid hyperfunction.

[Peritoneal dialysis in chronic renal insufficiency].

The author reviews a possibility of the use of peritoneal dialysis in the treatment of patients with chronic renal failure. Demonstrates that this procedure compares very favourably with chronic hemodialysis (less economic losses, simplicity, no burden of the heart). Recommends the performance of the automatized procedure 3 to 5 times a week, with each session lasting 10 to 12 h.

Dialysis treatment in multiple myeloma.

The histories of three patients suffering from acute renal failure and multiple myeloma are reviewed. In two patients oliguric acute renal failure appeared following intravenous urography. Although renal failure was treated by dialysis, all the three patients died of pulmonary infection.

Statistical analysis of monitoring examinations in chronic peritoneal dialysis program.

In dialysis centres the major part of laboratory tests is indicated by the routine monitoring strategy of the centre and not by the evidence of a new complication to be diagnosed. The aim of our study was to define an improved strategy, minimizing financial costs without loss of information. Findings of routine laboratory check-up of eleven patients undergoing chronic intermittent peritoneal dialysis were analysed.

Short-time peritoneal dialysis.

On the evidence of observations comprising approximately 200 treatments by peritoneal dialysis (PD), the advantages of the weekly 3 X 9-h schedule over the 2 X 24-h schedule are pointed out. Utilization of dialysing fluid per week was 45.11 versus 54.

Effect of haemodialysis on the antibody-dependent and spontaneous cell-mediated cytotoxicity of patients with chronic renal failure.

Antibody-dependent and spontaneous lymphocytotoxicity of blood mononuclear cells from 10 patients with chronic renal failure was studied before and after haemodialysis in xenogeneic chicken erythrocyte and allogeneic K-562 test systems. The originally impaired antibody-dependent and spontaneous lymphocytoxicity of uraemic patients significantly improved following haemodialysis. Both pre- and post-haemodialysis uraemic sera strongly inhibited the antibody-dependent and spontaneous cytotoxicity of autologous and of healthy control lymphocytes.

Decreased antibody-dependent and spontaneous cell-mediated cytotoxicity in patients with chronic renal failure.

Antibody-dependent and spontaneous lymphocytotoxicity of blood mononuclear cells from 15 patients with chronic renal failure was studied in allogeneic K-562 and xenogeneic chicken erythrocyte test systems. Both antibody-dependent and spontaneous cytotoxic activities were significantly decreased in uremic patients as compared to the corresponding mean values of healthy control persons and non-uremic patients with the same underlying diseases. The addition of autologous serum further reduced the impaired cytotoxic capacity of uremic lymphocytes.

[Changes in cellular immunity during peritoneal dialysis].

In 8 patients with chronic peritoneal dialysis before and after 24-hour peritoneal dialysis examinations on the cellular immunity were performed (lymphocyte blast transformation with PHA and Con A, ADCC). There was no difference to the normal findings in healthy control persons. Blast transformation decreased during peritoneal dialysis, no changes were visible with ADCC.

Renal function following branch-artery ligation in the canine kidney.

Viable kidney mass has been reduced in dogs by branch-artery ligation combined with uninephrectomy. 1. When viable kidney remnants amount to about 1/4 of the original kidney mass dogs survive in apparent good health with moderate azotaemia; with 1/8 to 1/10 kidney remnants azotaemia is progressive and uraemic death supervenes within some days.

Resistance to acute renal failure afforded by prior renal failure: examination of the role of renal renin content.

In this study, rats recovering from glycerol-induced acute renal failure were found to be protected from mercury-induced nephropathy, and HgCl2 poisoning protected rats from developing myohemoglobinuric renal failure. In view of the widely disparate nature of the renal failure models used, refractoriness appears to relate to an altered sensitivity of the organism itself rather than reflecting resistance to a particular nephropathic challenge. Renal renin content of the rats at the time of rechallenge was normal or high, a finding which contrasts sharply with that of chronically saline-loaded animals which also are refractory to ARF but have a maximally suppressed renal renin content.