ABSTRACT
Biofiltration (BF) was performed on 60 patients from 12 dialytic centers in Puglia. The protocol was 9-10.5 hours a week with 1.2 m2 PAN dialyzers. A dialysate with 140 Na+, 2-2.5 K+, 3.5-4 Ca++, 38 mEq/l acetate was used in 49 patients; the acetate was replaced by bicarbonate (35-40 mEq/l) in 11 patients. The same patients were treated for 1 year with standard acetate dialysis (49 patients) and standard bicarbonate dialysis (11 patients). The two protocols were compared on the basis of the clinical state, BUN and serum creatinine, acid-base balance, PTH, anemia, and nerve conduction velocity (NCV). Favourable effects were achieved in 55 patients. Four patients left the program because of progressive hyperhydration. BUN and serum creatinine levels showed a moderate, but insignificant increase. PTH, anemia and NCV did not worsen. BF gave better correction of metabolic acidosis in the patients undergoing acetate dialysis.
Subject(s)
Blood , Ultrafiltration/methods , Acetates/administration & dosage , Acidosis/prevention & control , Adult , Aged , Bicarbonates/administration & dosage , Female , Humans , Hypotension/prevention & control , Italy , Kinetics , Male , Middle Aged , Renal Dialysis , Ultrafiltration/instrumentation , Urea/bloodABSTRACT
Clotting time under basal conditions and 30', 60' and 120' after 100 I.U. heparin/kg i.v. was determined in four groups:1) 15 healthy subjects aged less than 50 yr; 2) 27 "healthy" subjects over 65 yr; 3) 20 subjects with either myeloma (7 cases), benign monoclonal gammopathy (7) or rheumatoid arthritis (6); 4) 4 subjects with amyloidosis (2 primary, 1 secondary to rheumatoid arthritis, and 1 secondary to myeloma). Rectal biopsy and a histological search for amyloid substance were carried out in all subjects from the 3rd and 4th groups. Heparin tolerance was too widely scattered to enable statistically significantly means to be deduced. Comparison between the arithmetical means of the four groups, however, showed a greater resistance in aged opposed to young subjects, and in patients with amyloidosis as opposed to those in the other three groups. This was constant and marked after 60' and 120', suggesting that this test may offer indirect evidence in support of a diagnosis of amyloidosis.
