Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
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Nephrol. Dial. Transplant. · Jan 1996
Vena cava diameter measurement for estimation of dry weight in haemodialysis patients.
A correct estimation of volume status and so-called dry weight in dialysis patients remains a difficult clinical problem. Clinical status and chest X-ray are not sensitive enough, while invasively measured central venous pressures are not routinely available. Recently, the sonographic determination of the diameter and collapse of the inferior vena cava (IVC) has been proposed as a noninvasive method for estimating intravascular volume. ⋯ Intravascular volume changes are reflected by IVC measurements, as shown by the correlation to other indices of intravascular volume, such as CVP and alpha-hANP. IVC sonography is noninvasive and easily available; serial measurements allow an estimation of changes of intravascular volume in patients without cardiac filling impairment. However, unlike with body impedance, interstitial volume is not reflected by IVC diameters.
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Nephrol. Dial. Transplant. · Jan 1996
Randomized Controlled Trial Comparative Study Clinical TrialThe effect of sodium and ultrafiltration modelling on plasma volume changes and haemodynamic stability in intensive care patients receiving haemodialysis for acute renal failure: a prospective, stratified, randomized, cross-over study.
Haemodynamic stability in intensive care unit (ICU) patient with acute renal failure (ARF) during intermittent dialytic support has been the focus for several variations to dialysis delivery. Indeed this has been noted by many as a possible cause for prolonged renal dysfunction created by repeated hypotensive renal insult, as well as a reason for the lower delivered dialysis dose afforded. End-stage renal failure patients supported by intermittent dialysis have benefitted from variable sodium dialysate and variable ultrafiltration rate protocols. The current study has focused upon the response to these dialysis variations in the ICU ARF patient. ⋯ Haemodynamic stability was greater during Protocol B than during Protocol A in all patients. Significantly less intervention was noted during Protocol B, despite the same dialysis delivery during both Protocols. Relative Blood volume changes were less during Protocol B, despite a greater total ultrafiltration. Variable sodium dialysate coupled with a variable ultrafiltration rate seems to be the preferred dialysis prescription for ICU ARF patients undergoing intermittent haemodialysis.
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Nephrol. Dial. Transplant. · Jan 1996
ReviewAutosomal dominant polycystic kidney disease--the patient on renal replacement therapy.
In Europe approximately 6% of all patients on chronic renal replacement therapy suffer from polycystic kidney disease. Survival of patients with polycystic kidney disease on renal replacement therapy is better than for other primary renal diseases, despite a similar cardiovascular risk profile. ⋯ There is no increased risk of renal cell carcinoma in patients with autosomal dominant polycystic kidney disease. Polycystic patients on dialysis should be followed for cardiac valve abnormalities and cerebral aneurysms.
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Nephrol. Dial. Transplant. · Oct 1995
Randomized Controlled Trial Comparative Study Clinical TrialGranulocyte sequestration in dialysers: a comparative elution study of three different membranes.
The present study was designed to investigate the expression of activation markers on polymorphonuclear cells (PMN) in peripheral blood and dialyser eluates, comparing three different membranes. ⋯ Dialyser eluates of all three dialysers consisted mainly of PMN. Based on the relatively modest cell numbers and the expression of the activation markers described, our results suggest primarily degranulation within the dialyser. Apart from differences in cell numbers, CTA yielding the highest cell counts, no differences between CTA, CU, and PS could be demonstrated in dialyser eluates.
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Nephrol. Dial. Transplant. · Jan 1995
Case ReportsIs there a place for isolated renal transplantation in the treatment of primary hyperoxaluria type 1? Experience from Paris.
We report our local experience of two patients with type 1 primary hyperoxaluria (PH1) who received successful isolated cadaver kidney transplantation. The indication of isolated renal transplantation exists for PH1, but it must probably be restricted to the less severe forms of this disease. Recipient and donor selection is crucial.