Objective To determine whether continuous modes of renal replacement therapy result in improved cardiovascular stability compared with standard daily intermittent treatment critically ill patients. Design Prospective, randomized controlled trial. Setting Intensive care unit a quaternary referral center for liver failure/transplantation. Patients Thirty-two consecutive, ill, mechanically ventilated patients combined acute hepatic and failure. Interventions were to either machine...

INTRODUCTION: In CAPD patients serum albumin is frequently used as an index of nutritional status, although it recognized that hypoalbuminaemia may be caused by many factors. We have further examined the relationship between and nutrition. METHODS: Nutritional status was assessed biochemistry, anthropometry, mid-arm muscle circumference, strength (hand grip back), lean body mass (from creatinine kinetics bioimpedance) in a group 76 stable patients. Correlations biochemical parameters were...

Although prostacyclin has been reported to be an effective extracorporeal anticoagulant for intermittent haemofíltration and dialysis treatments, it suggested that is inferior heparin in preventing clotting spontaneously driven continuous and/or circuits. We studied the effectiveness of both as anticoagulants a variety circuits 17 patients with combined acute hepatic renal failure who were at risk haemorrhage. there no differences pump-assisted circuits, was found superior during...

Blood urea concentration is artificially low immediately following high-efficiency dialysis of duration T and will rise ('rebound') due to the continued diffusion from intracellular extracellular space. This leads an overestimate efficiency given by KT/V (where V total distribution volume K clearance dialyser) if true equilibrium blood not used in calculation single-pool kinetic model (UKM). The measurement entails additional sample 60 min after dialysis, but estimate may be calculated using...

The 2-pool urea kinetic model has been developed analytically and applied to the description of observed increase in blood levels following dialysis (urea rebound), assuming that dialyser clearance K less than 0.4X where X is mass transfer coefficient between intracellular extracellular pools (volumes V1, V2 respectively). Urea generation was also neglected. Measurements were made a group six children suffering from chronic renal failure. From X, efficiency dialysis, equilibrium...

In view of the recent interest in weekly erythropoietic regimens and lack studies directly comparing available agents, clinical effectiveness darbepoetin-alpha (DA) epoetin-beta (EB), when administered via subcutaneous route on a basis, after conversion from thrice-weekly EB, was studied. this 9-mo, single-center, randomized study an unselected hemodialysis population, anemia managed with computerized decision-support system. Per-protocol analysis 81 patients each arm who completed showed...

We have investigated the effect of an exogenous lactate load given during machine haemofiltration treatment in 22 patients with acute renal failure and 12 chronic failure, without any overt evidence liver disease. Hyperlactataemia occurred all patients, but expected changes acid base status, increase bicarbonate a reduction arterial hydrogen ions were observed less than 40% treatments group. Ultrafiltrate losses could not alone explain acid-base status. There was positive correlation between...

We measured the effect of posture on intracranial pressure (ICP) and cerebral perfusion (CPP) in eight patients admitted with grade 4 hepatic coma due to fulminant failure complicated by renal failure. Upward head elevation ≤20° did not consistently reduce ICP; instead, ICP increased three who later died edema. CPP was reduced significantly >20°, falling < 50 mm Hg those subsequently Our study does support current practice nursing coma, are at risk dying from edema, head-upright postures >20°.

Seven consecutive patients with grade IV hepatic encephalopathy, due to fulminant failure complicated by oliguric renal were allocated at random treatment daily machine haemofiltration (MHF) or continuous arteriovenous (CAVHF). Intracranial pressure (ICP) was continuously monitored using a subdural catheter. Four received 17 treatments MHF, and ICP increased from 8.4 ± 1.5 mm Hg (mean + SEM) prior 12.6 1.8 on completion (p < 0.05). Active intervention required twenty occasions treat...

Abstract Theoretical considerations suggest that patients undergoing continuous ambulatory peritoneal dialysis (CAPD) may fare less well after renal transplantation than their haemodialysed (HD) counterparts. Review of 121 consecutive cadaveric allografts performed in this centre indicate to be the case with graft survival rates at 1 year 63·5 per cent HD group compared 35·5 CAPD-treated patients. This difference appeared independent duration and, although a significant blood transfusion...

AIM: To investigate the relationship between serum albumin and extracellular fluid volume, as measured by multifrequency bioelectrical impedance, in stable patients treated CAPD. METHOD: Fifty-nine CAPD were assessed. Serum (bromocresol green) CRP, age, dialysate to plasma (D/P) creatinine ratio, normalized protein catabolic rate (nPCR), daily urine peritoneal losses, volume (Vecf) each patient. Vecf was calculated a percentage of actual body weight (Vecf% ABW), lean mass derived from...

The use of 24-h urine protein collections for the assessment proteinuria in renal transplant patients has been compared with creatinine index (PCI) obtained from spot samples. Paired data 148 showed a correlation 0.77 (P less than 0.001) between excretion and PCI. A PCI 750 identified greater 1.0 g/24 h sensitivity 89% specificity 93%. predictive value positive test was 81% that negative 96%. Similar performance observed detection differing severities ranging 0.5 to 2.0 h. testing popular...

Une observation d'encephalopathie hepatique et d'insuffisance renale apres intoxication volontaire (100 comprimes de paracetamol). Traitement par hemofiltration selon 2 methodes differentes. Pendant l'hemofiltration machine Gambro FH77, la pression intracrânienne est augmentee pendant premiere heure, puis diminuee. Lors arterioveineuse continue inchangee. Apres 5 j ces traitements alternes diurese se retablit malade rapidement sans sequelles

The achievement of desirable hemoglobin levels in renal anemia that is treated with epoetins often incomplete and subject to much variation outcome values applied dosage. further development clinical decision support for requires the characterization patient responses an analysis dynamics dosage response variables. In this methodologic article, extended data a randomized, controlled trial comparing two were examined by techniques functional establish how precisely patterns treatment might be...

The natural killer (NK) cell activity of human peripheral blood lymphocytes falls following major surgical procedures including renal transplantation but in non-immunosuppressed individuals returns to normal levels within the first 72 hr after operation. In allograft recipients, if this early postoperative fall is excluded from analysis, NK function appears follow changes function, suggesting that vivo, as has been reported vitro, generated during activation alloreactive process. an...

Background. The availability of haemodialysis machines equipped with on-line clearance monitoring (OCM) allows frequent assessment dialysis efficiency and adequacy without the need for blood samples. Accurate estimation urea distribution volume ' V is required Kt/V calculated from OCM to be consistent conventional sample-based methods. Methods. Ten stable HD patients were monitored monthly 6 months. Time-averaged ( KOCM ) pre- post-dialysis samples collected at each session. second...

We investigated the effect of an exogenous lactate load given during intermittent machine haemofiltration to three groups patients with renal failure: those dialysis-dependent end-stage failure (6 patients) and either acute (8 and/or hepatorenal patients). As expected, group exhibited greatest degree hyperlactataemia, this was associated development a metabolic acidosis. There were correlations between maximum blood measured treatment increase in arterial hydrogen ion concentration (r=;0.76,...

A preparation of low molecular weight heparin (Fragmin) was administered to patients with multiorgan failure receiving continuous venovenous hemodialysis. Three received a high-dose regimen (35 IU/kg bolus followed by 13 infusion), and 7 low-dose (8 5 IU/kg, respectively) for 36 h. High-dose Fragmin associated minimal clotting in the extracorporeal circuit. Plasma fibrinopeptide levels declined, mean anti-Xa activity range 0.47-0.79 IU/ml. The urea equilibration coefficient (UEC) (100% at...

Abstract: We developed a continuous, volumetrically controlled veno‐venous renal replacement system that can be operated in filtration or dialysis modes. compared the clearances of substances with range molecular weights (MW) each mode. Ten patients acute failure underwent serial postdilutional hemofiltration and hemodialysis, for 30 min each, sequence randomized order. All were receiving vancomycin concurrent sepsis. The incorporated Filtral 10 AN69 artificial kidney; blood flow rate was...