[Why does a patient on hemodialysis have radiopaque material in his abdomen?]. / Perchè questo paziente emodializzato ha materiale radiopaco in addome?

Lanthanum is a third-generation, non-calcium and non-aluminium-based phosphate binder indicated for the treatment of hyperphosphatemia in stage 5 chronic kidney disease. The drug is well tolerated, with gastrointestinal complications as its main side effect. Recently, some case reports have described the typical X-ray features of this compound. We report another case of the radiopaque appearance of lanthanum carbonate, which underlines that clinicians need to be aware that its ingestion may cause opacifications in the colon.

Therapeutic effects of simvastatin on hyperlipidemia in CAPD patients.

A causal link between hypercholesterolemia due to elevated plasma concentrations of LDL and VLDL remnants of CAPD patients has been established. The effects of 24 weeks of treatment with Simvastatin, a new HMG coenzyme A-reductase inhibitor (at 20 and 40 mg/day) on serum lipid, lipoprotein, and apolipoprotein A-I and B concentrations, as well as safety parameters and subjective side effects, were evaluated in eight patients (mean duration CAPD 24.80 +/- 7.50 months, age 54.50 +/- 13.70 years). Maximal effects on plasma lipoprotein and apolipoprotein concentrations were achieved after 4 weeks, and remained stable thereafter during the study. Mean fasting plasma cholesterol concentrations decreased from 280.5 +/- 60.2 mg% to 190.2 +/- 40.4 mg/dl (p less than 0.005) (-47%); mean plasma LDL-cholesterol concentrations also decreased from 257.6 +/- 13.4 mg% to 190.5 +/- 15.4 mg/dl (p less than 0.001) (-35%). Apolipoprotein A and B concentrations decreased significantly from 1.78 +/- 0.19 to 1.40 +/- 0.22 g/L (p less than .005) and 1.81 +/- 0.26 to 1.38 +/- 0.20 g/L (p less than .005). These data substantiate the view that Simvastatin is well tolerated and that no serious clinical or adverse laboratory effects have been observed. It appears to be a promising drug for the effective control of hyperlipemia in a large proportion of hypercholesterolemic patients, reducing their cardiovascular morbidity while on CAPD.