ABSTRACT
A retrospective study was conducted in June 1997 concerning all Lebanese children with end stage renal failure. This study was able to recognize 20 children and infants (age less than 15) dialysed regularly in 8 hemodialysis centers. The other 23 centers are not following children. Thirteen children are dialysed on bicarbonate and seven on acetate. Children receive erythropoietin occasionally; 30% of them are polytransfused, 60% of them suffer from anemia. Four children have never received immunization against hepatitis B and three are seropositive for hepatitis C. None of these children has regular school attendance and psychological support for the child and his family do not exist. We conclude that the situation of children on hemodialysis in Lebanon is alarming. Solutions are possible and available; they need to be undertaken urgently.
Subject(s)
Kidney Failure, Chronic/therapy , Renal Dialysis , Adolescent , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Infant , Kidney Failure, Chronic/epidemiology , Lebanon/epidemiology , Male , Needs Assessment , Patient Care Team , Retrospective StudiesSubject(s)
Blood , Ultrafiltration , Adult , Female , Home Care Services , Humans , Hyperparathyroidism/therapy , Hypertension/therapy , Male , Middle Aged , Phosphates/blood , Renal Dialysis , Uremia/therapyABSTRACT
To assess whether betablockers (BB) would better control blood pressure than central antihypertensive drugs (CAD) clonidine or alpha methyldopa in hypertensive patients during exercise, comparable triangular ergometric bicycle exercises were performed by the same patients while their hypertension had been controlled at rest either with CAD or BB. Blood pressure, heart rate and blood lactate before and during exercise were compared in II patients treated with metoprolol and CAD, and in 12 other patients treated with atenolol and CAD. Systolic and diastolic blood pressure on exercise were significantly lower with BB than with CAD. Heart rate and rate-pressure product were always lower with BB than with CAD. Blood lactate increase was greater with BB than with CAD. The work capacity was greater with atenolol than with CAD, but comparable between metoprolol and CAD.
Subject(s)
Adrenergic beta-Antagonists/therapeutic use , Atenolol/therapeutic use , Hypertension/drug therapy , Lactates/blood , Metoprolol/therapeutic use , Physical Exertion/drug effects , Propanolamines/therapeutic use , Adult , Female , Humans , MaleABSTRACT
Tienilic acid (250 mg/day) was compared with chlorothiazide (500 mg/day) in 25 hypertensive patients in a randomized cross-over study (2 periods of 2 months). Mean supine arterial pressure was lower with tienilic acid than with chlorothiazide (106 +/- 3 vs 111 +/- 3 mm Hg, p less than 0.05) whereas no difference could be noted in body weight, natriuresis and plasma renin activity. Glucose tolerance tests were altered in the same fashion. Serum cholesterol (234 with tienilic acid and 239 mg/dl with chlorothiazide) and serum triglyceride levels (178 with tienilic acid and 179 mg/dl with chlorothiazide) were not different. Serum urate concentrations were lower with tienilic acid (4.8 mg/dl) than with chlorothiazide (7.8 mg/dl) whereas fractional excretion of urate was much higher with tienilic acid (17 +/- 2%) than with chlorothiazide (7 +/- 2%). Thus, the only metabolic advantage of tienilic acid over chlorothiazide is its hypouricemic effect which warrants long term studies to evaluate its vascular prognostic significance.
Subject(s)
Blood Glucose/metabolism , Blood Pressure/drug effects , Chlorothiazide/adverse effects , Glycolates/adverse effects , Lipid Metabolism , Ticrynafen/adverse effects , Adult , Aged , Chlorothiazide/therapeutic use , Female , Humans , Hypertension/drug therapy , Kidney Function Tests , Male , Middle Aged , Ticrynafen/therapeutic use , Uric Acid/urine , Water-Electrolyte Balance/drug effectsABSTRACT
The suppressive effect on PTH secretion of propranolol, a beta 1 and beta 2 blocker, and that of atenolol a specific beta 1 betablocker was compared in 24 uraemic patients not yet on dialysis in a cross over study. Although plasma PTH concentrations were comparable, plasma bicarbonate was higher with propranolol suggesting that the initial suppression of PTH secretion by propranolol was greater as a higher bicarbonate should lead to lower ionised calcium. The suppressive effect of cimetidine on PTH secretion was assessed in 12 patients on chronic haemodialysis. In the seven compliant patients there was no change in N and C terminal plasma PTH values but plasma calcitonin concentrations significantly decreased with cimetidine and returned to initial values after cimetidine was discontinued.
