Comparision between effects of bicarbonate and acetate dialysates on spirometry parameters in patients with chronic renal failure undergoing hemodialysis

Chronic renal failure causes impairment of all body organs including heart and lungs. Main problem in these patients are pulmonary edema due to increased permeability of capillaries, intravascular and interstitial volume overload, hypertension and heart failure. These changes cause altered physiologic and mechanical function of lungs. The objective of this study is evaluating the effect of dialysates and other intervening factors on spirometry parameters. This cross-sectional study was performed on 41 patients with chronic renal failure in September and October 2006 in Labbafi Nejad Hospital, Tehran. Patients were randomly divided to bicarbonate and acetate groups. Prior to and after hemodialysis, patients were meticulously weighed and spirometry parameters [FVC, FEV1, FEV1/FVC%. FEF 25-27] were measured. Biochemical indices were checked. Spirometry parameters were analyzed using t-test, and p-value less than 0.05 was considered statistically significant. We compared 29 patients undergoing dialysis with bicarbonate and 21 patients on dialysis with acetate. Respiratory function improvement in spirometry parameters was only significant in patients undergoing dialysis with bicarbonate dialysate, and when results were compared according to gender, they were statistically significant only in men. This improvement was meaningful in FEF [25-27%], FEV1, FVC. Post dialysis weight loss and serum chemistry had no significant correlation with improvement of spirometry parameters. Dialysis with bicarbonate dialysate causes significant improvement in spirometry parameters and respiratory function in men

[Relationship between cyclosporine blood level and CMV infection during the first 3 months after kidney transplantation]

Organ transplantation is revolutionized since production of cyclosporine. Considering the increased incidence of cytomegalovirus [CMV] infection in patients with transplantation, this study is designed to evaluate the relationship between cyclosporine blood level in patients undergone kidney's transplantation and the rate of CMV infection. This retrospective descriptive study evaluated 511 kidny's transplanted patients for cyclosporine blood level and rate of CMV infection during 100 postoperative days in Labbafinejad hospital [2001-2003]. 57 [11%] out of 511 developed CMV infection. The minimum interval between surgery and infection was 20 days, the maximum interval was 99 days with a mean of 56 days. Mean blood cyclosporine levels in infected and non-infected patients were 383.3 and 310 ng/ml respectively. This difference was statistically significant [p<0.05]. We conclude that CMV infection is closely related to cyclosporine blood level. In order to obtain more efficacy and less cytomegalovirus infections, careful cyclosporine blood level monitoring [<300 ng/ml] is recommended