Unexpected Effect of Hemodialysis on Plasma Phosphate Changes Occurring during Incubation of Whole Blood

To the Editor: We have recently confirmed the observation of Carothers et al.1 that the inorganic phosphate concentration of plasma declines with time if the plasma remains in contact with red cells. We measured phosphate concentrations in 10 adult controls (the specimen contained 25 units of heparin per milliliter of blood) in plasma separated by centrifugation for 10 minutes at 1500 rpm, immediately after blood sampling, and at the end of a three-hour incubation (at 37°C). We measured plasma inorganic phosphate without delay after separation by the method of Garcic and Kratochviva.2 The mean plasma value was 1.04±0.15 mmol. No extract is available for articles shorter than 400 words. © 1977, Massachusetts Medical Society. All rights reserved

Studies on Cyanide and Thiocyanate in Uraemia

Cyanide and thiocyanate was measured in blood and in peritoneal lavage solution in patients with advanced or terminal renal failure. The behavior of these substances was comparable to that of normal people. Our finding does not support the hypothesis of an indirect toxicity of urea via its previous conversion to cyanate. Cyanate ion has not been implicated in the toxic status of chronic uraemia. </jats:p

COMBINED RECOMBINANT HUMAN ERYTHROPOIETIN-BLOOD LETTING STRATEGY FOR TREATING ANEMIA AND IRON OVERLOAD IN HEMODIALYSIS-PATIENTS

We studied the feasibility of treating refractory anemia and post-transfusional serious hemochromatosis in a patient undergoing hemodialysis (3 x 4 h weekly) for fourteen years, with recombinant human erythropoietin (r-HuEPO) associated with blood-letting. Blood transfusion previously received by the patient at a rate of two units of packed red cells every month for nine years was stopped and r-HuEPO (80 U/kg b.w.) was administered i.v. at the end of each hemodialysis. When Hct increased over 30%, approximately 40 ml of blood was removed per hemodialysis session in an attempt to accelerate iron loss. Excellent control of anemia and hemochromatosis was achieved after seven months of treatment. The patient’s general condition and skin pigmentation were significantly improved

Ferroxidase I and II in CAPD patients

In 32 patients undergoing continuous ambulatory peritoneal dialysis (CAPD) and in 56 healthy subjects, ferroxidase I (ceruloplasmin) and ferroxidase II activity were estimated in serum; in 12 of the 32, it was also measured in peritoneal fluid. Serum ferroxidase I was normal, while ferroxidase II was significantly increased. Peritoneal fluid contains appreciable amounts of ferroxidase I, but no ferroxidase II. The serum ferroxidase profile of patients on CAPD differs from that of hemodialysis (HD) patients; in latter, both ferroxidases are significantly increased. This difference could be accounted by the loss of ferroxidase I in the peritoneal fluid

Combined Recombinant Human Erythropoietin-Blood Letting Strategy for Treating Anemia and Iron Overload in Hemodialysis Patients

We studied the feasibility of treating refractory anemia and post-transfusional serious hemochromatosis in a patient undergoing hemodialysis (3x4 h weekly) for fourteen years, with recombinant human erythropoietin (r-HuEPO) associated with blood-letting. Blood transfusion previously received by the patient at a rate of two units of packed red cells every month for nine years was stopped and r-HuEPO (80 U/kg b.w.) was administered i.v. at the end of each hemodialysis. When Hct increased over 30%, approximately 40 ml of blood was removed per hemodialysis session in an attempt to accelerate iron loss. Excellent control of anemia and hemochromatosis was achieved after seven months of treatment. The patient's general condition and skin pigmentation were significantly improved. </jats:p