ABSTRACT
Mineral metabolism was studied in 27 hemodialyzed patients with terminal chronic renal failure (CRF). Because of progressing hyperparathyroidism the initial treatment included calcium drugs, active forms of vitamin D (videchol, oxidevit), almagel, bicarbonate hemodialysis and hemosorption. The condition improved in 8 and stabilized in 12 patients. Conservative treatment was ineffective in 7 patients who consequently underwent total (4 cases) or subtotal (3 cases), parathyroidectomy. The response was achieved in 3, stabilization in 3, the disease advanced in 1 patients.
Subject(s)
Calcium/metabolism , Kidney Failure, Chronic/therapy , Phosphates/metabolism , Adult , Aluminum Hydroxide/therapeutic use , Antacids/therapeutic use , Benzocaine/therapeutic use , Calcium/therapeutic use , Drug Combinations , Female , Hemoperfusion , Humans , Kidney Failure, Chronic/metabolism , Magnesium Hydroxide/therapeutic use , Male , Middle Aged , Renal Dialysis , Vitamin D/therapeutic useABSTRACT
The authors discuss their experience in forming arteriovenous fistulas for conducting chronic hemodialysis in 361 patients with accentuation placed on the features of performing repeated and multiple operations. The formation of arteriovenous fistulas in the lower third of the upper arm or the cubital fossa with retrograde blood flow into the venous system is the operal vessels, and a history of multiple operations on the forearm vessels. Hemodialysis in such cases should be started no sooner than two weeks after the operation.
Subject(s)
Arteriovenous Shunt, Surgical , Renal Dialysis , Adult , Humans , Male , Retrospective Studies , Time FactorsABSTRACT
As many as 45 patients with terminal chronic renal failure (CRF) admitted to the hospital were examined for hemocoagulation and blood plasma content of medium-sized molecules (MSM). Animal (rabbit) experiments were made in vitro and in vivo to study the effect produced on hemocoagulation of MSM isolated from CFR patients' blood by acidic deproteinization, ultrafiltration and gel chromatography. Integrally, the MSM fraction was shown to exert marked anticoagulant and antiaggregation effects, to increase vascular permeability, promoting the development of hemorrhagic diathesis in CRF patients. Hemodialysis (HD) is an effective method for treating hemorrhagic diathesis of the given genesis. At the same time under the conditions of the presence of the cellular template (red blood cell hemolysis, platelet destruction as a result of HD) MSM may give rise to the development of thrombotic complications after HD completion and heparin neutralization. Therefore accumulation of MSM may play an important part in the onset of hemocoagulation disorders in patients with CRF.
Subject(s)
Blood Coagulation Disorders/etiology , Kidney Failure, Chronic/blood , Animals , Hemorrhagic Disorders/etiology , Hemorrhagic Disorders/therapy , Humans , Kidney Failure, Chronic/complications , Male , Rabbits , Renal Dialysis , Thrombosis/etiology , Toxins, Biological/bloodABSTRACT
An analysis of the results of chronic hemodialysis on central systems and individual apparatuses in 20 patients with the terminal stage of renal insufficiency was performed. It was established that the use of chemically pure water, disposable systems and dialyzers for hemodialysis ensured a decrease in the number of complications and improved the patients' rehabilitation. Bicarbonate hemodialysis proved to be a highly effective method for the treatment of patients with sodium acetate intolerance, decompensated metabolic acidosis and low arterial pressure. A single-needle approach to the patient's vascular system provided for a less marked decrease in uremic toxins, however statistically significant differences were undetectable as compared to the common methods.
