Unusual malpositioning of hemodialysis catheter into the hepatic veins.

Malpositioning of long-term hemodialysis catheter is a known complication that may lead to a gradual decline in blood flow. We report two rare catheter malpositions in the hepatic veins in two patients with end-stage renal disease in whom a dialysis catheter was inserted through the left external jugular vein and the right external jugular vein. Because of gradual reduction of catheters' blood flow, an angiography was performed, which confirmed catheters' tip positioning into the hepatic veins.

Metformin induced severe hypophosphatemia in a patient on hemodialysis.

A 67-year-old diabetic and hypertensive woman presented to us with very low serum phosphate levels (PO₄⁻ =1.1 mg/dL) about 40 days after initiation of hemodialysis (HD). The phosphate binders were discontinued, because they were thought to be the cause of hypophosphatemia.

Insertion of long-term tunneled cuffed hemodialysis catheters via the external jugular vein by using a simple, safe and reliable surgical technique.

Objective: Description of our technique for the insertion of long-term tunneled cuffed hemodialysis (HD) catheters via the external jugular vein.

Methods: From December 1999 to August 2006, 357 long-term tunneled cuffed HD catheters were inserted in 308 patients, who were referred to us from various hospitals and clinics in Greece. About half of them (168, or 47%) were inserted via the external jugular vein.

Dose-related effects of prolonged NaHCO3 ingestion during high-intensity exercise.

Purpose: Sodium bicarbonate (NaHCO3) ingestion may prevent exercise-induced perturbations in acid-base balance, thus resulting in performance enhancement. This study aimed to determine whether different levels of NaHCO3 intake influences acid-base balance and performance during high-intensity exercise after 5 d of supplementation.

Methods: Twenty-four men (22 +/- 1.

The red blood cell deformability in patients suffering from end stage renal failure on hemodialysis or continuous ambulatory peritoneal dialysis.

Anemia is the main problem for patients suffering from end stage renal disease (ESRD). This study aimed to determine whether the index of rigidity (IR), that shows red blood cells (RBCs) deformability and the possible IR disturbances can provide an explanation about the cause of anemia, in patients undergoing maintenance hemodialysis (HD) or on peritoneal dialysis. The IR was determined in 39 hemodialyzed patients, who were already in dialysis for a period of time ranging from 16 to 120 months (mean+/-SD=41.

The effect of intense passive apnea in the acid-base balance and electrolytes.

The aim of this study was to investigate the disturbances of the acid-base balance and electrolyte disorders in healthy individuals in the greatest passive apnea (prior to apnea and prior to first inhalation). The changes of the acid-base balance, the serum potassium and calcium levels as well as the disturbances of the cardiac rhythm were studied in a group of 15 healthy males aged 18 to 41 years old. Seven individuals part of the original group participated in a second trial.

The influence of l-carnitine supplementation on hematocrit and hemoglobin levels in patients with end stage renal failure on CAPD.

The influence of L-carnitine supplementation on hematocrit (Hct) and hemoglobin (Hb) levels, in patients suffering from end stage renal disease (ESRD) on maintenance hemodialysis, are well known from several studies. The data concerning the serum levels of carnitine, in patients with ESRD on continuous ambulatory peritoneal dialysis (CAPD) are contradictory, but most of them support that they are rather normal. In this study the effect of L-carnitine supplementation on Hct, and Hb levels were investigated in patients suffering from ESRD on CAPD.

Anticipation of end stage renal disease in patients with autosomal dominant polycystic kidney disease in successive generations.

Autosomal dominant polycystic kidney disease is a disorder, which is inherited in 50% of offspring, irrelevant the sex and it has a variable clinical expressivity. Initially it was noticed that the clinical expression was interfamilial, but some studies found out that it was different. The aim of this study was to evaluate the age of onset of end-stage renal disease (ESRD) in affected parents in comparison with their offspring in successive generations.

The incorrect placement of hemodialysis catheters in veins. The necessity for urgent x-ray evaluation for its position.

We describe a 56-year-old woman with end stage renal failure, who has an unusual complication in relation to catheter placement. She started hemodialysis in 1992 and until October of 1996 had many arteriovenous fistulas in her upper arms and we placed a lot of grafts. Because she had no vascular access for hemodialysis, we decided to place a polyurethane catheter in the left internal jugular vein.