Search results for " dialysis."

Acute dialysis: PMN-elastase as a new parameter for controlling individual anticoagulation with low molecular weight heparin (Fragmin).

1991

Despite the improvements in the development of dialyzer membranes with greater hemocompatibility, an activation of the coagulation system occurs when blood comes into contact with exogenous surfaces. The large number of heparin dosage regimens demonstrate the difficulty to adapt general therapeutic guidelines. Low molecular weight heparin (Fragmin®) was administered as a single bolus dose for anticoagulation during 58 acute dialyses. Anti-Xa-activity, the plasma levels of the lysosomal elastase of the polymorphnuclear granulocytes (“PMN-elastase”) and of the thrombin-antithrombin III-complex (TAT) were measured at hourly intervals. Therapeutic anti-Xa-levels did not show evidence of suffici…

Continuous ambulatory peritoneal dialysis and clinical outcomes in patients with refractory congestive heart failure.

2012

A B S T R A C T Introduction and objectives: Peritoneal dialysis has been proposed as a therapeutic alternative for patients with refractory congestive heart failure. The objective of this study was to assess its effect on long-term clinical outcomes in patients with advanced heart failure and renal dysfunction. Methods: A total of 62 patients with advanced heart failure (class III/IV), renal dysfunction (glomerular filtration<60 mL/min/1.73 m 2 ), persistent fluid congestion despite loop diuretic treatment and at least 2 previous hospitalizations for heart failure were invited to participate in a continuous ambulatory peritoneal dialysis program. Of these, 34 patients were excluded and adj…

The control of anti-coagulation in acute dialyses with sensitive laboratory parameters.

1992

In seven patients who had to be dialysed between four and 13 times due to acute renal failure, low molecular weight heparin (LMWH) Fragmin was used for anticoagulation. According to dose-finding studies, 80-90 U kg-1 body weight of LMWH as a single bolus were administered initially, producing dose-related levels of 0.3-1.5 anti-factor Xa U ml-1 in plasma. Apart from the anti-Xa activity in the plasma, the thrombin anti-thrombin III complex (TAT complex) and a fibrin degradation product (D-dimer) were measured as parameters of a coagulation activation. A sufficient anti-coagulation during dialysis was supposed to exist at a normal range (5.0 micrograms l-1 or below) of TAT complex. Pathologi…

Calcium-enriched bread for treatment of uremic hyperphosphatemia

2004

Abstract Objective To assess phosphate-binding efficacy of a new food product, bread with unusually high calcium content (Ca-bread). Design and setting A randomized parallel group trial in the university hospital outpatient dialysis unit. Patients Fifty-three randomly selected uremic patients who met the following inclusion criteria: (1) required maintenance hemodialysis treatment, (2) were not to receive vitamin D throughout the study, (3) were nondiabetic, and (4) were diagnosed with hyperphosphatemia. Intervention Fifty-three patients were randomized into 2 groups: control group (n = 26), which received calcium acetate as a phosphate binder throughout the study, and Ca-bread group (n = 2…

Continuous ambulatory peritoneal dialysis as a therapeutic alternative in patients with advanced congestive heart failure.

2012

Aims Continuous ambulatory peritoneal dialysis (CAPD) has been proposed as an additional therapeutic resource for patients with advanced congestive heart failure (CHF). The objective of this study was to determine the therapeutic role of CAPD, in terms of surrogate endpoints, in the management of patients with advanced CHF and renal dysfunction. A total of 57 candidates with New York Heart Association (NYHA) class III/IV CHF, renal dysfunction (glomerular filtration rate , 60 mL/min/1.73 m 2 ), persistent fluid congestion despite loop diuretic treatment, and at least two previous hospitalizations for acute heart failure (AHF) were invited to be included in the CAPD programme; however, 25 pa…

CAPD + hemoperfusion once a week in the management of children with end-stage renal disease

1983

With hemoperfusion there is a sharp decline in the solute concentration of the blood compartment, but immediately after HP the concentration of these substances rises to the original level (post-Hp rebound). It may be inferred that the result would be better and the rebound phenomenon less marked if hemoperfusion could be combined with a continuous dialysis system such as CAPD. The study was performed in 3 children of our CAPD programm. All patients were dialysed with 5 daily exchange each of one liter. The patients underwent at 2-hours hemoperfusion with a charcoal column (Gambro Adsorba 150 c) once a week. The data obtained with this form of treatment are indicative for a: significant in…

Changes in serum fetuin-A and inflammatory markers levels in end-stage renal disease (ESRD): effect of a single session haemodialysis.

2007

Background: The aim of the present study was to evaluate the effect of a single haemodialysis (HD) session on serum fetuin-A levels, considered a negative acute phase response marker; moreover, we evaluated the behaviour of fibrinogen and high sensitivity C-reactive protein (hsCRP) as acute phase response and chronic/subclinical inflammation markers, respectively, after a single HD session. Methods: Serum fetuin-A, albumin, hsCRP and fibrinogen were measured in 72 patients before and after a single HD session. Results: After a single HD session, we observed a significant increase in fibrinogen levels, while fetuin-A levels decreased (p<0.05). Also, hsCRP levels were significantly increased.…

Is It Possible to Create a “Mechanical” Arteriovenous Fistula in Hemodialysis Patients?

2010

Manual suturing still remains the best technique for the creation of vascular anastomoses on uremic patients with excellent results, despite being time consuming, difficult to perform with small vessels, and associated with a significant learning curve. We created a full mechanical arteriovenous fistula on a 65-year-old uremic patient with a new device already used in cardiac bypass surgery. The fistula was created automatically and rapidly, without the need for temporary occlusion of the artery, reducing the risk of blood clotting. We believe that mechanical devices may be useful to produce precise and fast anastomoses requiring minimal training for the surgeon.

Incidence of chronic pain in patients with end-stage renal disease on dialysis

2005

Vancomycin pharmacokinetics during continuous ambulatory peritoneal dialysis in patients with peritonitis.

2011

The aim of this study was to define a two-compartments pharmacokinetic model and to estimate the pharmacokinetic parameters of IP administered vancomycin in patients with continuous ambulatory peritoneal dialysis (CAPD) associated peritonitis. Ten patients with peritoneal dialysis treatment and peritonitis were prospectively enrolled in the study. The empiric treatment is: vancomycin 2 g every 5-7 days and ceftazidime 1500 mg per exchange, once daily. Pharmacokinetic modeling and parameter calculations were carried out using the nonlinear regression. The mean peritoneal concentration 10 min after the first peritoneal exchange of vancomycin free dialysis liquid was 9.5±7.3 μg/ml, showing tha…