[Comparison of clinical parameters of chronically hemodialyzed patients not requiring treatment with erythropoietin and patients treated with erythropoietin]. / Porównanie danych klinicznych chorych przewlekle hemodializowanych nie wymagajacych i wymagajacych leczenia erytropoetyna.

50 patients with terminal renal failure treated with chronic haemodialysis were examined. 24 of them (48%) did not require treatment with erythropoietin (rHuEPO) because of permanent haemoglobin concentration was 9.5 g/dl (5.91 mmol/l) and hematocrite more than 30%. Clinical data of two groups of patients were compared: 1) patients not requiring treatment with rHu EPO, 2) patients requiring treatment with rHu EPO. Attention was paid to the sex, age, the kind of disease which caused renal failure, the duration of dialysotherapy, liver function, HBs antigenemia, presence anti-HCV antibodies, ultrasonographic estimation of patients own kidneys; liver. Patients who did not require treatment with rHu EPO were older, longer treated with chronic haemodialysis and more frequently cysts in their own kidneys were seen. Any significant differences were not observed in both groups of patients as regards their antigenemia HBs or presence of anti HCV-antibodies. The important cardiovascular disease was observed more frequently in patients requiring treatment with rHu EPO.

[Carpal tunnel syndrome in hemodialysed patients]. / Zespól kanalu nadgarstka u chorych hemodializowanych.

A case of carpal tunnel syndrome in female patient treated with hemodialyses for 10 years is presented. Surgical management was applied with positive result. Histological examination of tissue collected during surgery has shown the deposits of amyloid-like substance in carpal tunnel. The authors discuss current concepts of carpal tunnel syndrome pathogenesis in hemodialysed patients.

Leukopenia with different regenerated haemodialysis membranes.

The white blood cell count (WBC) decreases during haemodialysis and it was investigated as a function of different dialysis membranes. Each of them was used four times, applying different sterilization methods. Twelve chronic haemodialysis patients were studied and dialysed with cuprophan and polyacrylonitrile (PAN) membranes. Cuprophan was studied by a dry sterilization method and after perchloric acid and formalin treatment. PAN was studied with dry sterilization and after perchloric acid. As it has been shown, cuprophan membranes cause significantly more marked neutropenia than PAN. No significant difference was seen in pO2, pH, pCO2 and bicarbonate between dialysers used four times. The results indicate differences in biocompatibility between cuprophan and PAN membranes, independent of the sterilization method employed.

Sympathetic activity, plasma renin activity (PRA) and kininogen levels in patients haemodialysed with acetate and bicarbonate.

Sympathetic, renin and kinin responses to an acetic and bicarbonate fluid in haemodialysed patients were investigated. Increases in dopamine-beta-hydroxylase (DBH) activity, PRA and kininogen levels were found during single dialysis but there was no difference in acetate and bicarbonate haemodialysis. The present results suggest that changes in sympathetic renin and kinin activity were similar in patients treated with either acetate or bicarbonate fluid.

Kinetics of continuous ambulatory peritoneal dialysis (CAPD) with four exchanges per day.

Fourteen patients who had no signs of peritonitis were studied during CAPD. Different exchange time schedules were used alternating exchanges with 1.5% and 2.6% glucose solutions. Usually longer exchanges followed shorter ones and vice versa. Total exchange time varied from 2--10 hours. Maximal ultrafiltration volumes were observed after 3 hours with 1.5% and 5 hours wit 2.6% glucose solutions. For small molecular weight solutes (urea, creatinine, sodium, potassium, and phosphate) dialyzate to plasma concentration ratios tended to be lower with 2.6% glucose solutions during the shorter exchanges. Equilibrium between plasma and dialyzate was attained for all these solutes by 10 hours total exchange time. The concentration ratios for inulin were similar with both types of solution, and did not achieve equilibrium by 10 hours. Protein concentrations and losses were higher with 2.6% glucose solution. Total protein and immunoglobulin losses per 24 hours were markedly lower than those reported for intermittent peritoneal dialysis. White blood cell counts increased slightly up to 5 hours and then remained constant up to 10 hours. Mononuclear cell counts were consistently higher than those of granulocytes. The efficiency of dialysis was not markedly influenced by uneven distribution of total exchange time. If 1.5% and 2.6% glucose solutions were used for particular time schedules, slightly higher dialysis efficiency could be obtained by using hyperosmolar solutions for the longer exchanges. Ultrafiltration volumes, protein and immunoglobulin losses, cell counts in dialyzate, and clearance of inulin varied among individual patients. Protein losses correlated positively with serum protein concentration and the body surface area of the patient. Clearances of insulin also correlated with body surface area but ultrafiltration volumes did not.