[Comparison of anti-HBV vaccine efficacy given intradermally and intramuscularly in hemodialysis patients]. / Porównanie skutecznosci szczepienia anty-HBV metoda sródskórna i domiesniowa wsród chorych hemodializowanych.

Patients chronically hemodialysed are recognised as a group of especially high risk for viral hepatitis B (HBV) infection. Moreover, their hyporesponsiveness to vaccination is widely known. So establishment of highly effective vaccination protocol is indispensable. We are presenting 5 year prospective observations of results of hemodialysis patients anti-HBV vaccination. 36 patients were vaccinated intramuscularly (among them 30 were revaccinated intradermally) and 40 patients--only intradermally. We revealed that seroprotective level of anti-HBs antibodies should be at least 100 IU/ml. We disclosed, that intradermal anti-HBV vaccination--compared to intramuscular--was significantly more effective (77.5%--and including answer in the second vaccination cycle 85.0%--vs 38.9%) and, moreover, less amount of vaccine could be used (28.2 micrograms--and for patients answering barely in the second vaccination cycle 53.7 micrograms--vs 123 micrograms). However, after intradermal vaccination seroprotective antibodies level falls faster and should be checked every 3 months. Patients answering efficiently to vaccination--comparing to answering inefficiently--have significantly higher albumin level and are younger. Moreover, higher dialysis dose favors the successful long-time answer to vaccination.

Rheological properties of red blood cells (including reticulocytes) in patients with chronic renal disease.

Hemodialysis is a method of treatment of patients suffering from terminal renal disease and consists in removing uremic toxins from blood. The influence of hemodialysis on rheological properties of red blood cells was ascertained. We studied the deformability of RBC after density gradient separation of whole blood drawn from patients with renal disease before and after dialysis. The improvement in deformability of cells from the top layers was observed in postdialysis samples.