ABSTRACT
INTRODUCTION: Hemodialysis therapy and the aging process have been reported to interfere with the trace element (TE) status in the body. This multicenter collaborative study on blood levels of TE in geriatric hemodialysis (HD) patients was carried out with an aim to clarify the impact of the aging process and HD therapy on the TE status in such patients. METHODS: One hundred and fifty-one HD patients (65 male, 86 female), all aged over 60 (68.2+/-3.86 y), and 112 elderly controls (58 male, 54 female) with a mean age of 67.5+/-3.03 were enrolled. All patients underwent standard HD for at least 6 months. The artificial kidneys used were hollow-fiber dialyzers of cellulose membranes. Water used for HD was prepared by reverse osmosis. Blood was collected in the morning prior to dialysis and after fasting. Atomic absorption spectrophotometry was applied to measure blood levels of Pb, Cd and Hg as well as plasma levels of Cu, Zn and Al. Data are presented as mean +/- SEM. Student's t-test and linear regression were applied for statistics. RESULTS: Our geriatric chronic HD patients showed a marked elevation of blood Al and decreased plasma Zn concentrations. The blood levels of Cu, Cd, Pb and Hg were within normal limits. The blood concentrations of Al, Cu and Pb were significantly higher in HD patients than in the normal elderly controls, whereas Cd and Hg were similar in both groups, and Zn were lower in HD patients. Plasma Zn value decreased as dialysis duration increased, however there was a reversely linear correlation between plasma Zn and age. CONCLUSIONS: This data reported can be regarded as a starting point and may serve as an insight to further studies on TE imbalances in geriatric and chronic HD populations.
Subject(s)
Aging/blood , Aluminum/blood , Renal Dialysis , Trace Elements/blood , Zinc/blood , Aged , Aged, 80 and over , Body Burden , Cadmium/blood , Copper/blood , Female , Humans , Lead/blood , Male , Membranes, Artificial , Middle Aged , Prospective Studies , Spectrophotometry, AtomicABSTRACT
Two patients who developed fungal peritonitis after receiving continuous ambulatory peritoneal dialysis (CAPD) for various periods were successfully treated with intracatheter retention of amphotericin B and oral flucytosine for 5 weeks. The catheter was not removed and efficient peritoneal permeability was maintained. We suggest that intracatheter retention of antifungal agents to sterilize the catheter along with simultaneous oral antifungal agents be used to eradicate peritoneal infection. The catheter may not need to be removed, and CAPD can be accomplished. The period of hospitalization may, thereby, be shortened, and the efficiency of CAPD can be maintained.
Subject(s)
Amphotericin B/administration & dosage , Catheters, Indwelling , Mycoses/drug therapy , Peritoneal Dialysis, Continuous Ambulatory/adverse effects , Peritonitis/drug therapy , Administration, Oral , Amphotericin B/therapeutic use , Drug Therapy, Combination , Female , Flucytosine/administration & dosage , Flucytosine/therapeutic use , Humans , Male , Middle Aged , Mycoses/etiology , Peritonitis/etiologyABSTRACT
Two patients who developed fungal peritonitis after receiving continuous ambulatory peritoneal dialysis (CAPD) for various periods were successfully treated with intracatheter retention of amphotericin B 1-2 mg and oral flucytosine or fluconazole 50 mg b.i.d. for 5 weeks. The catheter was not removed and efficient peritoneal permeability was maintained. We suggest that intracatheter retention of antifungal agents to sterilize the catheter with simultaneous oral antifungal agents be used to eradicate peritoneal infection. The catheter may not have to be removed, and CAPD can be accomplished. Period of hospitalization may be shortened, and the efficiency of CAPD can be maintained.
