Prevention of tunneled cuffed catheter dysfunction with prophylactic use of taurolidine locking solution containing urokinase : a prospective and randomized placebo-controlled trial

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Effect of desferrioxamine on bone calcium accretion rate in fracturing renal osteodystrophy with intolerance to vitamin D

Bone biopsy of two dialyzed patients with fracturing osteomalacic osteodystrophy showed aluminium deposit on bone surfaces and on cemental lines. Bone metabolism was studied before and after parathyroidectomy and during the course of desferrioxamine (DFO) therapy. Before treatment, low bone calcium acretion rate, low bone uptake of (99m)Tc-pyrophosphate, hypercalcemia with minimal doses of 1 α-hydroxyvitamin D and high serum aluminum levels were observed. The patients were unresponsive to parathyroidectomy. After 1 month of DFO therapy (2 g i.v. per dialysis), the clinical status had improved dramatically. The bone calcium accretion rate had increased 5-fold and bone scintigraphy revealed a high uptake of (99m)Tc-pyrophosphate. Due to 'hungry bone' syndrome, hypocalcemia developed, and necessitated treatment with high doses of vitamin D metabolites and calcium. After 12 months of DFO therapy, the bone calcium accretion rate returned to normal and aluminum deposits on bone decreased. Bone disease in these patients was characterized by a marked impairment of calcium accumulation in bone, a defect that is rapidly reversed by DFO. The observation of the bone metabolic events during therapy was facilitated by prior parathyroidectomy.SCOPUS: NotDefined.jinfo:eu-repo/semantics/publishe

Is uremic morbidity more related to BUN than to middle molecule clearance?

info:eu-repo/semantics/publishe

Blood urea nitrogen and morbidity in dialysed patients

info:eu-repo/semantics/publishe

Pharmacokinetics of atorvastatin and its metabolites after single and multiple dosing in hypercholesterolaemic haemodialysis patients

Background. Patients with chronic renal failure commonly suffer from a secondary form of complex dyslipidaemia, and may benefit from lipid-lowering treatment. Atorvastatin has been shown to reduce efficiently the levels of atherogenic lipoproteins also in patients with renal failure, but pharmacokinetic data in haemodialysis patients are lacking. Methods. In this study, hypercholesterolaemic haemodialysis patients received 40 mg (n = 12) or 80 mg (n = 11) atorvastatin once daily, first as a single dose and then continuously for 2 weeks. Plasma levels of atorvastatin and its active and inactive metabolites were measured by LC/MS/MS, and pharmacokinetic parameters (Cmax, tmax, AUC, t1/2) compared between single and multiple dosing, and between the different doses. Results. The pharmacokinetic parameters of the parent drug atorvastatin acid were not significantly different after single and 2-week multiple dosing; they showed dose-proportionality between the 40 and 80 mg dose, and were comparable to findings in healthy volunteers. Dose-proportionality and absence of accumulation was also observed for the major active metabolite orthohydroxy-atorvastatin and the inactive metabolites atorvastatin lactone and ortho-hydroxy-atorvastatin lactone, but the levels of the active metabolite were relatively lower, and the inactive metabolites higher, compared with healthy volunteers. The para-hydroxymetabolites constituted only a minor pathway in atorvastatin's metabolic elimination. Haemodialysis did not cause enhanced clearance of atorvastatin or its metabolites, the drug was well tolerated and there were no serious adverse events. Conclusion. While subtle differences may exist in the metabolic processing of atorvastatin in haemodialysis patients, active drug did not accumulate nor did it show enhanced elimination, and levels were comparable to those measured in healthy volunteers. Therefore there is no need to adapt atorvastatin dosage in this particular patient population.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Effect of desferrioxamine on bone accretion rate in fracturing renal osteodystrophy with Intolerance to vitamin D

info:eu-repo/semantics/publishe

Middle molecule removal in HDF comparison of mid- versus post-dilution (MIDEMM study)

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Erythromycin prophylaxis for Legionnaire's disease in immunosuppressed patients in a contaminated hospital environment

Between January 1 and June 30, 1983, immunosuppressive drugs were administered in 20 renal transplant recipients undergoing 23 rejection episodes and in 3 patients with renal failure secondary to systemic disease. Legionella pneumophila, serogroup 1, pneumonia was diagnosed on 12/26 (47%) occasions. In an attempt to decrease this high rate, a program of erythromycin prophylaxis was instituted for every new patient who received immunosuppressive chemotherapy until eradication of the organism from the water supply could be realized. From July 1, 1983 to April 30, 1984, erythromycin prophylaxis (1.5-3 g/day by mouth) was administered during 39 episodes of high-dose immunosuppression (20 kidney graft recipients and 4 patients with systemic diseases); no cases of Legionnaire's disease were recorded. During the same period, erythromycin prophylaxis was withheld from 9 other high-dose immunosuppression episodes (7 kidney graft recipients and one patient with sarcoidosis); 5 cases of Legionnaire's disease occurred (56%) in this group. We conclude that erythromycin effectively protects immunocompromised patients in an environment contaminated with L pneumophila.SCOPUS: ar.jinfo:eu-repo/semantics/publishe