Ramipril and Risk of Hyperkalemia in Chronic Hemodialysis Patients

Angiotensin converting enzyme (ACE) inhibitors provide well known cardiorenal-protective benefits added to antihypertensive effects in chronic renal disease. These agents are underused in management of patients receiving hemodialysis (HD) because of common concern of hyperkalemia. However, few studies have investigated effect of renin angiotensin aldosterone system (RAAS) blockade on serum potassium in hemodialysis patients. We assessed the safety of ramipril in patients on maintenance HD. We enrolled 28 adult end stage renal disease (ESRD) patients treated by maintenance HD and prescribed them ramipril in doses of 1.25 to 5 mg per day. They underwent serum potassium concentration measurements before ramipril introduction and in 1 to 3 months afterwards. No significant increase in kalemia was found. Results of our study encourage the use of ACE inhibitors in chronically hemodialyzed patients, but close potassium monitoring is mandatory

Badania procesu demetylacji nikotyny w warunkach in vivo [Investigations of nicotine demethylation process in vivo]

Investigations were carried out on intact leaves of Nicotiana alata which contain practically not alkaloids. Whey these leaves are infiltrated with nicotine it undergoes some chemical changes rather quickly. After introducing the nicotine into the leaves the alkaloid composition was investigated in three day intervals after the infiltration was stopped. No oxynicotine was present in the investigated material. The formation of nornicotine was determined quantitatively in outer and internal layers of the leaf blade. On the basis of these results determination of order and rate of nicotine demethylation was attempted. The reaction was classifield as a first order monomolecular reaction. In this connection a presumed mechanism of nicotine demethylation in leaves of Nicotiana alata was discussed

Chemiczna charakterystyka substancji pektynowych w liściach tytoniu [Chemical analysis of the pectic substances in the tobacco leaves]

Chromatographic analysis of pectic substances from leaves of Nicotiana tabacum, N. rustica and N. glauca has shown that the pectic substances from these species have similar composition of monosaccharides. The only differences found are in the relative quantities of the sugars present in pectic substances

Review Article Residual Renal Function in Children Treated with Chronic Peritoneal Dialysis

Residual renal function (RRF) in patients with end-stage renal disease (ESRD) receiving renal replacement therapy is defined as the ability of native kidneys to eliminate water and uremic toxins. Preserved RRF improves survival and quality of life in adult ESRD patients treated with peritoneal dialysis. In children, RRF was shown not only to help preserve adequacy of renal replacement therapy but also to accelerate growth rate, improve nutrition and blood pressure control, reduce the risk of adverse myocardial changes, facilitate treatment of anemia and calcium-phosphorus balance abnormalities, and result in reduced serum and dialysate fluid levels of advanced glycation end-products. Factors contributing to RRF loss in children treated with peritoneal dialysis include the underlying renal disease such as hemolytic-uremic syndrome and hereditary nephropathy, small urine volume, severe proteinuria at the initiation of renal replacement therapy, and hypertension. Several approaches can be suggested to decrease the rate of RRF loss in pediatric patients treated with chronic peritoneal dialysis: potentially nephrotoxic drugs (e.g., aminoglycosides), episodes of hypotension, and uncontrolled hypertension should be avoided, urinary tract infections should be treated promptly, and loop diuretics may be used to increase salt and water excretion