Hyperphosphatemia In Haemodialyzed Patients

Dietary regulation of serum phosphate levels is one of the most important therapies for the haemodialyzed patients. This is particularly difficult to apply since these patients must take huge amount of animal proteins that contain a large quantity of phosphate. However, a diet with a small amount of phosphate is required. This guideline is difficult to be implemented because patients get at least 50% of their phosphate from sources that are not obvious and from foods that are easily processed and preserved. In this retrospective study, serum levels of phosphate, calcium and parathyroid hormone were assessed in 123 haemodialyzed patients to determine their levels and differences, depending on age. Patients were grouped into two according to their age. Group A included those who were ? 70 years old (n = 55, 29M/26F), and Group B were those > 71 years old (n = 68, 39M/29F). Higher phosphate levels were found in Group A with a statistically significant level of p < 0.0001, while overall serum phosphate levels of 47% of patients were below 4.6 mg/dl. Elderly patients with more diabetics (Group B) had lower serum phosphate levels than the younger ones (Group A). Thus, a large percentage of our patients have satisfactory serum phosphate levels, and the younger ones have less satisfactory phosphate levels, compared with the elderly

Changes in blood during storage for transfusion

Introduction: Over the past 20 years, extensive research has been conducted on blood transfusion and the hazards arising from them, as well as on safest maximum storage duration for blood derivatives. Blood transfusion rates in patients with and-stage renal disease may have declined markedly after the discovery and use of erythropoietin in the mid-1980s, but is still remains a standard of care. Since several biochemical changes take place in stored blood, physicians should be alert when transfusing blood in end-stage renal disease patients, who are, theoretically at least, at higher risk of complications. Methods and Results: This study were designed to investigate changes in storer blood over time (every 10 days from 0 to 40 days). Changes in sodium, potassium, chloride, total calcium, lactate, pH, partial pressure of carbon dioxide, bicarbonate and hematocrit, as well as the degree of hemolysis, were recorded. The findings show a significant increase in potassium, lactate, partial pressure of carbon dioxide and hematocrit and a reduction in chloride, pH and bicarbonate. The serum levels of sodium initially increased (up to day 20) and then declined. Conclusions: In conclusion, stored blood undergoes significant changes, which can be life-threatening, especially + when the transfusions are massive or in patients with end-stage renal disease, who are more sensitive to significant K or acid overload.