ABSTRACT
We measured the serum concentrations of a variety of lipid constituents--total cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein cholesterol, apolipoproteins A1 and B, and lipoprotein(a)--in well-matched uremic patients undergoing chronic hemodialysis with either cuprophane (n = 13) or polysulfone (n = 13) membranes. We found that the patients on polysulfone membrane dialysis had significantly higher mean HDL cholesterol and apolipoprotein A1 concentrations than the patients on cuprophane membrane dialysis. There were no significant differences in the other variables studied. Moreover, polysulfone membrane dialysis was associated with a lower prevalence of potentially atherogenic lipid abnormalities such as low HDL cholesterol levels and high total cholesterol/HDL cholesterol rations. We concluded that the use of more physiological dialysis procedure may improve, in the long term, lipid and lipoprotein profiles in hemodialysis patients, though the exact mechanism(s) remains unknown.
Subject(s)
Cellulose/analogs & derivatives , Lipids/blood , Lipoproteins/blood , Membranes, Artificial , Polymers , Renal Dialysis/instrumentation , Sulfones , Aged , Female , Humans , Male , Middle Aged , Time FactorsABSTRACT
The immunogenicity of a recombinant hepatitis B vaccine was evaluated in 35 hemodialysis patients who received a standard dose (20 micrograms) of the vaccine at 0, 1, 2 and 6 months. After the full vaccination course (month 7), 60% (21/35) of the patients had seroconverted (anti-HBs titer greater than or equal to 10 mIU/ml). The duration of protection lasted up to 18 months after the start of vaccination in 85.7% (18/21) of the responders. At that time, an additional dose was given to all the patients: 1-2 months later, the overall immunization rate had increased to 65.7% (23/35); lastly, in month 24 (i.e., 6 months after the booster dose), 62.5% (15/24) of the patients available for evaluation were still maintaining protective levels of anti-HBs antibodies. Comparable results had previously been obtained in 21 well-matched patients on our dialysis program who were vaccinated with a plasma-derived vaccine according to the recommended schedule.
Subject(s)
Renal Dialysis/adverse effects , Viral Hepatitis Vaccines/immunology , Adolescent , Adult , Aged , Female , Hepatitis B Antibodies/blood , Hepatitis B Vaccines , Humans , Immunization Schedule , Male , Middle Aged , Time Factors , Vaccines, Synthetic/administration & dosage , Vaccines, Synthetic/immunology , Viral Hepatitis Vaccines/administration & dosageABSTRACT
Accordingly with the new tendency of employing Rast Units (RU) instead of Rast Classes (RC) in the specific-IgE testing field, is necessary that internal Quality Control (QC) and external Quality Assessment (QA) programmes take account of these RU. So far only few experiences of controlling and assessing the quality concerned with RU, have been carried out. In Italy, a National QA-scheme organised by the National Health Institute (ISS) and the National Research Council (CNR), which involves about 90 laboratories, is starting just now, and a commercial QA programme (Galileo), started in 1989, by now is the only one which helped valuate each laboratory's performance for specific-IgE assays. The results collected in a 12 months period were elaborated in different ways as they were expressed in RC or in RU and the trial confirms that the specific-IgE testing field is still far from reaching the reliability already established for other assays. So we hope the National and the Galileo schemes will help stimulate major improvements in internal precision and in between-laboratories agreement.
Subject(s)
Hypersensitivity/diagnosis , Immunoenzyme Techniques/standards , Immunoglobulin E/analysis , Quality Assurance, Health Care/organization & administration , Radioallergosorbent Test/standards , Radioimmunoassay/standards , Allergens/immunology , Europe , Humans , Predictive Value of Tests , Quality Control , Radioallergosorbent Test/methods , Radioimmunoassay/methods , Reagent Kits, Diagnostic/standards , Sensitivity and SpecificityABSTRACT
Thirty-six of 56 (64%) patients on chronic hemodialysis for 1 to 194 months were found to have ACKD (at least 3 cysts per kidney) by means of ultrasonographic evaluation. The number, size and extent of cysts were positively and significantly correlated with the months on hemodialysis. There was also a significant positive correlation between grade of ACKD and Hb. Moreover there was a significant positive association of abdominal pain; none had suffered from hemorrhage or neoplasm.
Subject(s)
Kidney Diseases, Cystic/etiology , Renal Dialysis/adverse effects , Abdominal Pain/etiology , Adult , Aged , Anemia/etiology , Female , Hemoglobins/analysis , Humans , Incidence , Kidney Diseases, Cystic/diagnostic imaging , Kidney Diseases, Cystic/epidemiology , Kidney Diseases, Cystic/pathology , Male , Middle Aged , Risk Factors , Time Factors , UltrasonographyABSTRACT
Serum C-reactive protein (CRP) levels were measured by nephelometry in 30 healthy subjects (controls) and in 99 patients with uncomplicated terminal uremia on conservative therapy (group 1, n = 30) or chronic hemodialysis (group 2, n = 69). Whereas there was no difference between controls and group 1, both the mean concentration of CRP and the incidence of elevated levels were significantly higher in group 2 in comparison with both controls and group 1. Moreover, the degree of increase in these patients was directly correlated with the duration of hemodialysis. The abnormality, therefore, is somehow related to chronic hemodialysis per se. From a practical standpoint, we concluded that this test cannot be recommended as an acute-phase reactant in this clinical setting.
