Low-dose atorvastatin in severe chronic kidney disease patients: a randomized, controlled endpoint study.

Objective: There have been no endpoint studies with statins for patients with severe renal failure. The purpose of this prospective, open, randomized, controlled study was to investigate whether atorvastatin (10 mg/day) would alter cardiovascular endpoints and the overall mortality rate of patients with chronic kidney disease stage 4 or 5 (creatinine clearance < 30 ml/min).

Material And Methods: The study subjects comprised 143 patients who were randomized either to placebo (controls; n=73; mean age 69.

Minimized weight gain between hemodialysis contributes to a reduced risk of death.

Unlabelled: The risk of death is higher in dialysis patients compared to age matched healthy subjects, the main reason being cardiovascular. This prospective study investigated if the extent of ultrafiltration was of importance for the outcome.

Material And Methods: 88 hemodialysis patients were included and followed prospectively.

Safety and efficacy of atorvastatin in patients with severe renal dysfunction.

Objective: To investigate the efficacy and safety of a daily dose of 10 mg of atorvastatin in patients with chronic kidney disease (CKD) stages 4 and 5 and a glomerular filtration rate of <30 ml/min.

Material And Methods: This was an open, prospective, randomized study. A total of 143 patients were included: 73 were controls and 70 were prescribed 10 mg/day of atorvastatin.

Access in therapeutic apheresis.

Various modes may be used to perform apheresis, such as plasma exchange, plasmapheresis, immunoadsorption, and blood perfusion. The vascular access used for acute procedures may be sufficiently supplied by two peripheral veins or catheters placed in the femoral vein or the right internal jugular vein. For chronic treatment it might be necessary to place an arteriovenous fistula or graft.

No increased risk for peritonitis by insulin injected into peritoneal dialysis solution bag through Coloplast.

Objective: This study assessed the incidence of peritonitis that occurred when insulin was injected intraperitoneally with an insulin pen (Novo Pen) through an elastic plastic plate (Coloplast) attached to the dialysis solution bag.

Design: A retrospective, exploratory descriptive study was used. SETTING AND SAMPLES: Seventeen patients (7 women and 10 men) with insulin-dependent diabetes mellitus (IDDM) and end-stage renal disease (ESRD), who were treated with continuous ambulatory peritoneal disease (CAPD), were studied.

One-dose cefuroxime i.v. and i.p. reduces microbial growth in PD patients after catheter insertion.

Background: When a peritoneal dialysis catheter is inserted intra-abdominally in a patient starting peritoneal dialysis (PD) there is always a risk for postoperative wound infection and peritonitis. At our centre, PD is started immediately after the dialysis catheter is inserted. This may increase the postoperative risk for peritonitis and wound infection.

[A killer bacteria caused fasciitis with sepsis. Prompt handling saved the patient's life].

The article consists in a case report of a patient with rapidly progressive pain in the axillary region and deterioration in his clinical condition during the course of a skin infection, found to have pectoral muscle fascitis, and in whom progressive septic shock was accompanied by multiorgan failure. Blood culture yielded streptococci group A type 1 M1. In addition to conventional intensive care, he was treated with antibiotics, inotropic drugs, plasma exchange, and infusion of antithrombin and immunoglobulin.

PD treatment for severe congestive heart failure.

Our objective was to evaluate if peritoneal dialysis (PD) could improve survival of patients with progressive severe congestive heart failure resistant to drug therapy. The patients were selected by the cardiologist in cooperation with a nephrologist, including patients not responding to conventional medication with an expected fatal outcome within the next months. The study included 16 consecutive patients with a chronic progressive severe refractory heart failure (sHF) of NYHA class III (n = 6) or IV (n = 10) who did not respond to diuretics and angiotension converting enzyme (ACE) inhibitors.

Blood glucose and cholesterol control improved by continuous ambulatory peritoneal dialysis in patients with end-stage renal disease and diabetes mellitus.

This longitudinal study was performed to evaluate the change of total cholesterol, triglycerides, and glucose control in patients with insulin-dependent diabetes mellitus (IDDM) and end-stage renal disease (ESRD) during predialysis (PreD), on continuous ambulatory peritoneal dialysis (CAPD) and after kidney graft. A total of 20 consecutive patients (7 women, 13 men, mean age 42 years) with IDDM and ESRD were studied retrospectively in 1991 during PreD and during CAPD. Twelve were also investigated after obtaining a kidney graft.

CAPD bag changing with integrated disconnect system gives lower incidence of peritonitis than with UV-box system.

Unlabelled: The use of a UV-box disconnect system reduces the incidence of peritonitis as compared with manual exchanges. An integrated disconnect system (IDS) also gives good results. See Figure 1.

Reduced risk for peritonitis in CAPD with the use of a UV connector box.

A common route for peritoneal infection is the bag transfer connecting site. To investigate possible reduction of such transfer infections with the use of a bag transfer set (UV-XD, Travenol, Baxter, Minneapolis), this study sampled patients using a transfer set with or without UV light sterilization. Calculations excluded peritonitis due to penetrating tunnel infection or defective peritoneal dialysis bag (4 episodes in 2 patients).

Absence of leakage by insertion of peritoneal dialysis catheter through the rectus muscle.

To reduce leakage of peritoneal dialysis fluid, insertion of a 2-cuff Tenckhoff catheter (TeC) was performed under local anaesthesia by a lateral approach on 30 occasions in 26 patients. Incision was 3 cm laterally of the linea alba. The inner cuff of the TeC was fixed by a purse-string suture of the peritoneal membrane on the abdominal side of the cuff and another purse-string suture, of the inner fascial blade, around the distal end of the cuff.