1 alpha(OH) vitamin D3 increases plasma aluminum in hemodialized patients taking AI(OH)3.

1 alpha(OH) vitamin D3 at the dose of 6 micrograms per week was given for 4 weeks to 16 stable patients on chronic hemodialysis with a low dialysate aluminum while taking a constant dose of Al(OH)3. A significant increase of their plasma aluminum was observed from 1.2 +/- .25 mumol/l before 1 alpha(OH)D3 to 1.7 +/- .35 during the second fortnight of 1 alpha(OH)D3 administration and this increase surprisingly was maintained at 1.71 +/- .3 up to 6 weeks after 1 alpha(OH)D3 discontinuation. Increases in plasma calcium and decreases in plasma PTH were observed during 1 alpha(OH)D3 administration and these changes were correlated to the changes in plasma aluminum. It is concluded that the increase in plasma aluminum observed with 1 alpha(OH)D3 and after its discontinuation is either due to body aluminum burden redistribution or to increased aluminum intestinal absorption whatever the mechanism is, this effect should lead to close monitoring of plasma aluminum in uremic patients taking 1 alpha OH vitamin D3.

Low molecular weight heparin in haemodialysis and haemofiltration--comparison with unfractioned heparin.

The low molecular weight heparin CY 222 (CHOAY) has been compared to unfractioned heparin (UFH) in patients on chronic haemodialysis and haemofiltration at various doses as regards it biological activity (measured by Activated Partial Thromboplastin Time and by anti-Xa activity) and its clinical effect on clot formation in the blood lines and bleeding at the puncture sites or recent wounds. Compared to UFH, CY 222 has a greater anti-Xa activity for a shorter APTT. This biological difference is of clinical advantage since clotting in lines is comparable or less than with UFH whereas compression time at puncture sites is shorter and recently bleeding wounds in 28 patients did not bleed again. The long half life of CY 222 allows its use as a single priming dose of 300 anti-Xa U/kg in haemodialysis and 450 anti-Xa U/kg in haemofiltration.

1 alpha OH vitamin D3 increases plasma aluminium in haemodialysed patients taking Al (OH)3.

1 alpha OH vitamin D3 at the dose of 6 micrograms per week was given for four weeks to 16 stable patients on chronic haemodialysis with a low dialysate aluminium while taking a constant dose of Al(OH)3. A significant increase of their plasma aluminium was observed while on 1 alpha(OH)D3 therapy and during the six weeks following. This increase correlated with the cumulative dose of Al(OH)3 and duration on dialysis but not with the recent dose of Al(OH)3. The increase in plasma aluminium observed with 1 alpha(OH)D3 and after its discontinuation is more likely to be due to aluminium redistribution than to increased intestinal aluminium absorption. This effect indicates the need for close monitoring of plasma aluminium in uraemic patients treated with 1 alpha(OH)D3.