Blood purification
-
Comparative Study
Trace elements in hemodialysis and continuous ambulatory peritoneal dialysis patients.
Alterations in blood and tissue concentrations of trace elements in patients with chronic renal failure have been extensively investigated. Selenium, zinc and copper are elements which play an important role in biological systems as components of proteins, enzymes and antioxidants. The concentrations of selenium, zinc and copper were determined in the plasma, erythrocytes and whole blood of patients on regular hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) treatment using the method of inductively coupled plasma mass spectrometry (ICP-MS). ⋯ These results suggest differences between plasma, erythrocytes and whole blood concentrations of the studied trace elements. The levels of trace elements are altered by HD and CAPD. A modern precise method with high accuracy, ICP-MS, which was used in our study, eliminated analytical errors and possible interferences.
-
Comparative Study
Cytokine filtration and adsorption during pre- and postdilution hemofiltration in four different membranes.
In the present in vitro study we investigated filtration and adsorption of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and interleukin-8 (IL-8) during predilution and postdilution hemofiltration with polysulfone, polyacrylonitrile, polyamide and cellulose triacetate membranes. The median sieving coefficient (SC) for all membranes was 0.0 for TNF-alpha, below 0.15 for IL-6 and below 0.15 for IL-8 during postdilution hemofiltration. Differences in SC between filtration modes were less than 0.05. ⋯ Adsorption of TNF-alpha, IL-6 and IL-8 was also seen with the other membranes. None of the membranes filtered TNF-alpha. Sieving of IL-6 and IL-8 was low for all membranes with only marginal differences between membranes or between filtration modes.
-
The present study assessed whether plasma levels of thrombomodulin and von Willebrand factor (vWF) are altered in patients with septic shock and whether treatment with polymyxin B-immobilized fiber (PMX-F) affects these levels. ⋯ These data suggest that plasma thrombomodulin and vWF may be related to septic shock and that PMX-F is effective in reducing these factors in patients with septic shock.
-
Review
Treatment of hypertension in renal failure patients: when do we overtreat? When do we undertreat?
Despite the commonplace nature of hypertension in chronic dialysis patients, many issues remain unresolved. According to current JNC/V (see text) recommendation, a systolic blood pressure of < 120 mm Hg is optimal, 120-129 mm Hg is normal, and one of 130-139 mm Hg is high-normal. The majority of dialysis patients receiving treatment in the United States is probably not maintained in the optimal blood pressure range. ⋯ In contrast to nonrenal failure patients, normotensive ESRD patients may show an increase of left ventricular mass over time. Although left ventricular hypertrophy can be reversed with good blood pressure control, patients are often undertreated based on analysis of dialysis clinic blood pressures. Even if clinic systolic blood pressure levels are optimal, chronic dialysis patients may still have unacceptably high ambulatory blood pressure levels due to a rise in nocturnal blood pressure with sleep.