[Dose and adequacy of hemodialysis measured by the urea reduction ratio (URR and Kt/V)]. / Doza i adekvatnost hemodijalize mjerena stopom redukcije uree (URR i Kt/V).

BACKGROUND: There are little reports about prescribed and delivered dose of haemodialysis (HD) in B&H. If we want to reduce acute and chronic HD complications and to improve whole result of patients treatment, it is necessary to routinely monitoring and measurement of delivered dose of HD. Prescribed and delivered dose of HD have to be equal or near equal. METHODS: Blood samples were taken after the long interval in a thrice-weekly regimen before and 10 min after ultrafiltration, using Slow Flow/Stop Pumping. We measured delivered and prescribed dose of HD by URR and Kt/V, and efficacy of HD by QE. The results were processing by computerized urea kinetic modelling program. RESULTS: The mean URR was 64.69%. Mean prescribed Kt/V was 1.25 +/- 0.16 and delivered 1.23 +/- 0.14, and QE 0.99 +/- 15. Delivered Kt/V and QE were positively associated (p < 0.001). QE was significantly associated with post HD urea, and sex, but not with treatment time. CONCLUSIONS: We suggest that Kt/V can serve as an important parameter in the dose of HD, and QE as a measure of dialysis "efficacy" in a single treatment of an individual patient.

[Efficiency of high-flow dialyzers in removal of beta-2-microglobulin]. / Efikasnost visokoprotocnih dijalizatora u odstranjivanju beta-2-mikroglobulina.

BACKGROUND: [corrected] Beta-2-microglobulin (beta 2M) is protein with a molecular weight of 11.800 Daltons. A 30-fold or greater increase is found in patients(pts) over 10 years (ys) on haemodialysis (HD). The main aim of study is to evaluate high-flux (HF) dialyzer efficacy on beta 2M removal. METHODS: A sample of 15 pts was selected, 9 males and 6 females, aged 45.7 ys (31.60), mean duration on HD 156,3 months. All pts were dialyzed by standard bicarbonate HD. We used 2 type of HF membrane: cellulose diacetate (CDA) and polysulphone (PS). A blood sample for beta 2M was drown before HD, 20 minute after start of HD (for clearance beta 2M) and after HD. RESULTS: Average plasma beta 2M concentration was 53.15 mg/L (27-fold increase than normal values). Post/pre beta 2M ratio was 0.73 with clearance of 23.1 +/- 8.9 ml/min (QB = 250 ml/min, QD = 600 ml/min) for CDA dialyzers, and post/pre beta 2M ratio 0.51 with clearance of 31.9 +/- 4.5 ml/min(QB = 250 ml/min, QD = 600 ml/min) for PS dialyzer, respectively. The CDA membrane was able to remove 103 +/- 29 mg of beta 2M during a 4-hours HD session, and PS membrane 139 +/- 5,1 mg, respectively. CONCLUSION: The only HF membranes are efficient on beta 2M removal.

[Echocardiographic changes in patients with chronic renal insufficiency on hemodialysis]. / Ehokardiografske promjene kod pacijenata sa hronicnom bubreznom insuficijencijom na hemodijalizi.

Cardiovascular diseases cause death in 40% patients on the chronic haemodialysis program. Our aim was to assess the heart changes in these patients by echocardiography. We have tested 40 patients, but 34 of them accomplished criteria for this study. There were 19 (55.88%) females and 15 (44.12%) males. The average age was 44 years and average duration of haemodialysis treatment was 4.72 years. The research was made with ultrasound device TOSHIBA SSH 65 A SONOLAYER and transducers 3.5 and 2.75 MHz. Twenty patients (58.82%) have had pathological echocardiogram. Ten patients (29.42%) have had conditionally normal echocardiogram while four patients (11.76%) have had completely normal echocardiogram. In patients with pathological echocardiogram, some of the left ventricle hypertrophy forms dominated. Echocardiography is a useful method in morphologic and functional cardiac assessment at the last stage renal disease patients on the chronic haemodialysis program. Using the aforementioned method we are able to select the patients who need intensive cardiac care.