Nephron. Physiology
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Nephron. Physiology · Jan 2006
Comparative StudyAssessment of health-related quality of life in chronic dialysis patients with the COOP/WONCA charts.
The aim of the present work was to determine the health-related quality of life (HRQOL) of our patients on hemodialysis using the COOP/WONCA charts. A further aim was to explore its psychometric characteristics. ⋯ This study shows that the process of psychological adaptation to problems deriving from dialysis is satisfactory. Moreover, the COOP/WONCA charts are a useful instrument for the determination of the HRQOL in hemodialysis patients without losing psychometric quality.
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Nephron. Physiology · Jan 2006
Troponin I testing in dialysis patients presenting to the emergency room: does troponin I predict the 30-day outcome?
Troponins are often measured in acutely ill chronic dialysis patients admitted to the emergency room, irrespective of their clinical presentation. The significance of an elevated troponin level in this setting is unclear. ⋯ In acutely ill chronic dialysis patients presenting to a hospital emergency room, an elevated cTnI level indicates an increased 30-day cardiac risk, regardless of their clinical presentation.
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Nephron. Physiology · Jan 2006
Brain natriuretic peptide and N-terminal proBNP in chronic haemodialysis patients.
Brain natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are released into circulation as a result of congestive heart failure (HF). As HF and water overload are frequent complications in haemodialysis (HD) patients, we decided to study the levels of BNP and NT-proBNP and their changes during HD. ⋯ Both BNP and NT-proBNP levels were significantly increased in HD patients prior to dialysis. The change in concentrations of both peptides during HD is influenced by membrane type. HD probably triggers increased production of both peptides and this increase is emphasized by impaired LVEF. This fact can be clinically observed only on NT-proBNP levels, because BNP levels are biased by significant removal of this protein during HD.
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Nephron. Physiology · Jan 2005
Clinical TrialRegional citrate anticoagulation in continuous hemodialysis--acid-base and electrolyte balance at an increased dose of dialysis.
Citrate anticoagulation is an excellent alternative to heparin anticoagulation for patients at high risk of bleeding requiring continuous renal replacement therapy. However, citrate anticoagulation has some potential adverse effects such as metabolic alkalosis and acidosis, hypernatremia, hypo- and hypercalcemia. Thus, most citrate anticoagulation protocols use specially designed dialysis fluids to compensate for most of these disarrangements. This study aimed at establishing a citrate anticoagulation protocol designed for a dialysate flow rate of about 2 l/h. ⋯ The analyzed citrate anticoagulation protocol was well tolerated and filter lifetime was appropriate. Regional anticoagulation with trisodium citrate in combination with a customized calcium-free dialysate is a safe and effective alternative to a heparin-based anticoagulation regimen.
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Nephron. Physiology · Jan 2005
Comparative StudyComparison between 1alpha(OH)D3 and 1,25(OH)2D3 on the suppression of plasma PTH levels in uremic patients, evaluated by the 'whole' and 'intact' PTH assays.
The aim was to evaluate the acute effects of intravenous 1alpha(OH)D3 and 1,25(OH)2D3 on (1) plasma parathyroid hormone (PTH) and Ca2+ levels in chronic uremic patients and (2) circulating large C-terminal PTH fragments as measured by the 'whole PTH' assay compared to two different 'intact PTH' assays. ⋯ A single intravenous dose of both 10 microg 1,25(OH)2D3 and 1alpha(OH)D3 significantly suppressed plasma PTH. The acute suppressive effect of 1,25(OH)2D3 was 3 times greater than that of 1alpha(OH)D3. The increase in plasma Ca2+ after intravenous administration of 10 microg of 1,25(OH)2D3 was, however, significantly greater than that of 10 microg of 1alpha(OH)D3 (p < 0.005). The PTH response to acute administration of 10 microg of the two vitamin D analogs was in principle the same, when measured by the three different assays and resulted in a parallel shift of the PTH response curves. Thus, circulating levels of large C-terminal PTH fragments were not influenced by differences in plasma Ca2+ or by the vitamin D analog given.