Effect of chronic peritoneal fluid eosinophilia on peritoneal membrane function.

This study was undertaken to evaluate the effects of long-term persistent peritoneal fluid eosinophilia on the peritoneal membrane as reflected by a change in dialysis function. This was a prospective study undertaken at a community-based peritoneal dialysis unit, where thirty-one patients were enrolled over a 9-month period. Chronic, long-term peritoneal fluid eosinophilia was noted in 12/31 (38.7%) patients. Significant differences were not noted between values of creatinine clearance, D/P urea and Kt/V, compared to their baseline values. This study shows that long-term peritoneal fluid eosinophilia does not significantly affect peritoneal membrane function in patients on maintenance peritoneal dialysis.

Use of a phosphorus-enriched dialysate in a hypercatabolic renal failure patient receiving intensive hemodialysis therapy.

An elderly man with end-stage renal disease required intensive hemodialysis therapy because of sepsis-induced hypercatabolism. We were able to prevent the occurrence of hypophosphatemia by using a phosphorus-enriched dialysate during hemodialysis treatments.

Effect of dialysate temperature on central hemodynamics and urea kinetics.

Use of cool dialysate is associated with increased intradialytic blood pressure, but the hemodynamic mechanism is unknown. Whether changes in dialysate temperature affect muscle blood flow, which may the alter the degree of urea compartmentalization, also is unknown. We measured hemodynamics and blood and dialysate-side urea kinetic indices in nine hemodialysis patients during two cool (35.0 degrees C) versus two warm (37.5 degrees C) dialysate treatments. The % change in mean arterial pressure was different when using the cool (+6.5 +/- 9.7 mm Hg) versus the warm (-13.4 +/- 3.6) dialysate (P < 0.01), despite comparable amounts of fluid removal. Percent changes in cardiac output were similar with the two dialysates, and thus the blood pressure effect was due primarily to changes in total peripheral resistance (% delta TPR, cool +26 +/- 13.6, warm +8.6 +/- 14.5; P < 0.02). During cool dialysate use tympanic membrane temperature changed by -0.51 +/- 0.23 degree C, whereas body temperature increased by 0.52 +/- 0.14 degree C during use of warm dialysate. Measured urea recovery normalized to the predialysis urea nitrogen concentration was similar with the two treatments: cool 31.3 +/- 0.039 liter-1; warm 29.7 +/- 0.021; P = NS. In a second study, post-dialysis urea rebound values from 15 seconds to 30 minutes, expressed as the percent of the post-dialysis SUN, were similar after the two treatments: cool 11.79 +/- 1.4; warm 12.21 +/- 2.27, P = NS.(ABSTRACT TRUNCATED AT 250 WORDS)

Use of a phosphorus-enriched dialysis solution to hemodialyze a patient with lithium intoxication.

A normophosphatemic patient suffering from lithium intoxication was hemodialyzed with a phosphorus-enriched, bicarbonate-based dialysis solution. A post-dialysis fall in plasma phosphorus level was prevented.

Gastrospirillum hominis in acute gastric erosion.

Gastrospirillum hominis is a spirochete that has been described in association with chronic gastritis and duodenal ulcers. We report the case of a patient having acute gastric erosion in whom biopsy showed abundant organisms. The erosion resolved while the patient was receiving sucralfate and omeprazole therapy. We discuss the histopathology and mode of transmission of G hominis, along with the role of antibiotic therapy.

Septic shock in an elderly patient: unusual presentation of echovirus infection.

We have described a case of fulminant echovirus infection that progressed rapidly to purpura and septic shock. To our knowledge, this is a previously unreported presentation of acute echovirus infection in an immunocompetent adult.