Oxalate Dynamics and Removal Rates during Haemodialysis and Peritoneal Dialysis in Patients with Primary Hyperoxaluria and Severe Renal Failure

1984 ◽  
Vol 66 (5) ◽  
pp. 591-597 ◽  
Author(s):  
R. W. E. Watts ◽  
N. Veall ◽  
P. Purkiss
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
Extracellular Fluid ◽  
Primary Hyperoxaluria ◽  
Distribution Volume ◽  
Pool Size ◽  
Severe Renal Failure ◽  
Oxalate Excretion ◽  
Metabolic Pool

1. We have measured the plasma oxalate concentration (POx), urinary oxalate excretion (UOx), oxalate equilibrium distribution volume (ODV), oxalate metabolic pool size [(ODV) × (POx)], total plasma oxalate clearance (PCOx), renal (or dialyser) oxalate clearance (RCOx), non-renal oxalate clearance (NRCOx) and the tissue oxalate accretion rate (TOA)= [(NRCOx) × (POx)] in three patients with severe renal failure due to primary hyperoxaluria who were being treated by peritoneal dialysis or haemodialysis, or by renal transplantation. The clearance (either GFR or dialyser) of [99mTc]diethylenetriaminepenta-acetate (DTPA) and the extracellular fluid volume (ECF) measured as [99mTc]DTPA distribution volume were also determined. 2. Negligible amounts of 14C were found in faeces or as 14CO2 in expired air and hence (NRCOx) = (PCOx-RCOx). 3. Haemodialysis removed oxalate more efficiently than peritoneal dialysis in the patient where a direct comparison was possible. Neither treatment could keep up with the TOA when performed for clinically acceptable times. 4. The plasma oxalate concentrations calculated from 14C clearance through the dialyser and the chemically determined concentration of the oxalate in the dialysate were in the range 111–146 μmol/l. This is higher than in normals and in hyperoxaluric patients who are not in renal failure. Hence, although the ODV and ECF are similar to those of hyperoxaluric patients without renal failure and normal control subjects, the oxalate metabolic pool (ODV × POx) is grossly enlarged. 5. In the patient treated by renal transplantation, the oxalate pool size diminished concurrently with the resumption of oxalate excretion but expanded again as renal function decreased due to oxalosis. 6. The quantitative data show that dialysis procedures can only be a temporary holding operation and the prognosis with transplantation remains bad unless excessive oxalate production can be controlled.

A Study on the Distribution of Body Fluids after Rapid Saline Expansion in Normal Subjects and in Patients with Renal Insufficiency: Preferential Intravascular Deposition in Renal Failure

1983 ◽  
Vol 64 (2) ◽  
pp. 153-160 ◽  
Author(s):  
Hendrik A. Koomans ◽  
Anton B. Geers ◽  
Peter Boer ◽  
Jan C. Roos ◽  
Evert J. Dorhout Mees
Keyword(s):  
Renal Failure ◽  
Blood Volume ◽  
Plasma Volume ◽  
Extracellular Fluid ◽  
Normal Subjects ◽  
Distribution Volume ◽  
Fluid Distribution ◽  
Severe Renal Failure ◽  
Control Value ◽  
Stage Renal Disease

1. The effect of rapid intravenous infusion of 25 ml of isotonic sodium chloride solution (saline)/kg body weight on extracellular fluid volume (ECFV, 82Br distribution volume), plasma volume (131I-labelled albumin distribution volume) and blood volume (from plasma volume and packed cell volume) was studied in nine normal subjects and a group of 11 patients with end-stage renal disease (ESRD). 2. Immediately after the infusion, the increases in ECFV were equal in the two groups but the increases in plasma and blood volumes were significantly larger in the patients with ESRD. .3. Ninety minutes after the end of the infusion, the blood volume/ECFV ratio was significantly decreased from the control value in the normal subjects, but slightly increased in the patients with ESRD. 4. It is concluded that in severe renal failure the control of fluid distribution is changed in a way which leads to a preferential distribution of rapidly infused saline into the intravascular compartment.

The effect of Pyridoxine on Oxalate Dynamics in three Cases of Primary Hyperoxaluria (with Glycollic Aciduria)

1985 ◽  
Vol 69 (1) ◽  
pp. 87-90 ◽  
Author(s):  
R. W. E. Watts ◽  
N. Veall ◽  
P. Purkiss ◽  
M. A. Mansell ◽  
E. F. Haywood
Keyword(s):  
Accumulation Rate ◽  
Extracellular Fluid ◽  
Primary Hyperoxaluria ◽  
Pool Size ◽  
Type I ◽  
Total Clearance ◽  
Biochemical Basis ◽  
Oxalate Concentration ◽  
Measured Glomerular Filtration Rate ◽  
Metabolic Pool

1. We have measured glomerular filtration rate (GFR), extracellular fluid volume (ECF), oxalate distribution volume (OxDV), plasma oxalate concentration (POx.), plasma total clearance of oxalate (PCOx.), oxalate metabolic pool size [(OxDV) × (POx.)], renal clearance of oxalate (RCOx.), oxalate excretion, tissue clearance of oxalate (TCOx.) and tissue oxalate accumulation rate [(TOx.A) = (TCOx.) × (POx.)] in three patients with type I primary hyperoxaluria (hyperoxaluria with hypergrycollic aciduria) when they were taking pyridoxine and after discontinuation of the vitamin. 2. Seven days after stopping pyridoxine the plasma oxalate concentration, oxalate metabolic pool size and the urinary excretion of oxalate had all increased between seven- and eight-fold in two of the patients. The third patient showed no changes on stopping pyridoxine. 3. These results support the view that pyridoxine acts by reducing oxalate biosynthesis in some patients with type I primary hyperoxaluria. 4. The possible biochemical basis for this effect is discussed.

Overview of blood purification in uremia

1980 ◽  
Vol 3 (4) ◽  
pp. 203-208
Author(s):  
B.T. Burton
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
Rejection Rate ◽  
Blood Purification ◽  
Maintenance Hemodialysis ◽  
Dialysis Patients ◽  
Transplant Patients ◽  
Maintenance Dialysis ◽  
Transplanted Kidneys

Today, management of irreversible renal failure is based primarily on maintenance hemodialysis and renal transplantation with a growing minority of patients treated by peritoneal dialysis. With regard to renal transplantation — the early promise of renal transplantation in the mid 1960's has given way to the realities of the late 1970's. There have been no major changes in the rejection rate of transplanted kidneys in recent years though today's mortality of transplant patients is considerably reduced over what it used to be. Moreover, universally the lack of availability of a sufficient number of organs for transplantation poses a formidable problem. It is all too apparent that current methods of blood purification in uremia are far from optimal. Even though the mortality in maintenance dialysis is relatively low, hemodialysis is characterized by a variety of complications and most maintenance dialysis patients are not optimally rehabilitated.

Continuous Ambulatory Peritoneal Dialysis in South Africa -A Four-Year Experience

1984 ◽  
Vol 4 (2) ◽  
pp. 78-81 ◽  
Author(s):  
I. Parsoo ◽  
Y.K. Seedat ◽  
S. Naicker ◽  
J.C. Kallmeyer
Keyword(s):  
South Africa ◽  
Developing Countries ◽  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
Chronic Renal Failure ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Minority Groups ◽  
Alternative Therapy ◽  
Major Complication

This study describes our experience with continuous ambulatory peritoneal dialysis (CAPD) over a four year period, during which 88 patients were offered CAPD. It compares and contrasts the response to CAPD among four racial groups in Natal viz asiatics, blacks, coloureds and whites. Peritonitis -the major complication, occurred with an overall incidence of one episode every 4.41 patient months. CAPD remains a useful alternative therapy in developing countries where a high percentage of patients with chronic renal failure would be denied a chronic renal failure program because of lack of expertise in hemodialysis and/or renal transplantation, or limited financial resources. Continuous ambulatory peritoneal dialysis (CAPD) was first described by Moncrief and Popovich (1) and, since its modification by Oreopoulos and his group (2), this technique has gained world wide usage. South Africa, like many developing countries has a high incidence of end-stage renal disease (ESRD) but because of lack of resources and economical problems, few patients with ESRD can be treated by dialysis or renal transplantation. CAPD affords a relatively simple and inexpensive form of therapy for these patients. At the present time about 200 patients are on CAPD in South Africa. Natal, the smallest of four provinces in South Africa, has a population of about five million, the majority being blacks. The minority groups include whites, asiatics and coloureds. There is only one chronic dialysis centre in Natal; situated in Durban, it serves the entire province including parts of the Transkei. This paper describes a four-year experience with CAPD in this mixed population and discusses problems unique to this situation.

Dialysis in Adults in Year 2000 in the Republic of Macedonia

2002 ◽  
Vol 25 (5) ◽  
pp. 386-390 ◽  
Author(s):  
M.H. Polenakovic ◽  
A. Sikole ◽  
R. Grozdanovski ◽  
V. Amitov ◽  
Lj. Stojkovski ◽  
...  
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
Alternative Methods ◽  
Unknown Etiology ◽  
Recombinant Erythropoietin ◽  
Republic Of Macedonia ◽  
Terminal Renal Failure ◽  
The Republic ◽  
Year 2000

1,019 adult patients with terminal renal failure were treated with dialysis (D) in the first part of the year 2000 in the Republic of Macedonia. 1,010 patients (99%) were treated with chronic intermittent (maintenance) hemodialysis (HD) while nine patients (1%) were on continuous ambulatory peritoneal dialysis (CAPD). For the children, a special peritoneal dialysis program was developed; 509 patients per million of the population (PMP) were on dialysis. The Republic of Macedonia is, therefore, among those central and eastern European countries with a higher PMP number in the treatment of end-stage renal disease, following Croatia, the Czech Republic and Slovenia. The patients were treated at 18 Centers in a network of HD Centers at a distance of 30–50 km. from their place of residence in order to facilitate their access to treatment and to work. All patients who have had symptoms indicating need for treatment with D were accepted for treatment. The government payed all the expenses of the treatment and the salaries of the staff. 56% were male and 44% were female patients. The youngest patient was aged 9 and the oldest was 82 years old. There has been an increase in the age of the patients on D as well as an increase in their number. In 1993 we had 727 patients being treated with D, and now we have 1,019 with a constant increase in the number of patients with ESRD and a need for D and renal transplantation. Mortality per year at the different Centers ranged from 8–19% in 1999 and the average is 12%. Glomerulonephritis (GN) – both primary and secondary – is the main cause of renal failure (RF) in some Centers up to 45%. Tubulo-interstitial disease follows GN. ADPKD patients constitute 9.4% with a difference among the Centers of 3–29%, and diabetic nephropathy is found in 10%, 5–15% in different Centers. 11–61% of patients have an unknown etiology. 352 patients are on treatment with human recombinant erythropoietin (rhuEPO) – in some Centers up to 60%. The mode of application was subcutaneous and the initial dose is 20 U/kg body weight and the mean maintenance dose of EPO per patient weekly is 4,000 U. The Cimino-Brescia arteriovenous fistula is being applied as a standard vascular access. The survival rate of our patients treated with maintenance HD at 5 years was 58%. CAPD and particularly renal transplantation are to be further developed as alternative methods in treating terminal renal failure.

Metanephric Adenoma with Embryonal Hyperplasia of Bowman's Capsular Epithelium: Previously Unreported Association

2000 ◽  
Vol 3 (5) ◽  
pp. 472-478 ◽  
Author(s):  
Keshani de Silva ◽  
Vivienne Tobias ◽  
Gad Kainer ◽  
Bruce Beckwith
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
Chronic Renal Failure ◽  
Focal Segmental Glomerulosclerosis ◽  
Left Kidney ◽  
Bilateral Nephrectomy ◽  
Metanephric Adenoma ◽  
Histological Features ◽  
Segmental Glomerulosclerosis

We report a case of a 9-year-old boy with focal, segmental glomerulosclerosis who, following peritoneal dialysis, underwent renal transplantation and bilateral nephrectomy. The kidneys showed histological features of embryonal hyperplasia of Bowman's capsular epithelium, an uncommon lesion that is seen most often in patients with chronic renal failure who are being maintained on dialysis. In addition, a 1-cm tumor in the left kidney showed features of metanephric adenoma. Although both lesions are uncommon, they share many similarities on a morphological, immunohistochemical, and ultrastructural basis. This association has not been previously reported and may shed some light on the histogenesis of these recently described lesions.

Primary Hyperoxaluria

2016 ◽  
Author(s):  
Jaap W. Groothoff
Keyword(s):  
Renal Failure ◽  
Autosomal Recessive ◽  
Therapeutic Option ◽  
Primary Hyperoxaluria ◽  
Stone Disease ◽  
Severe Renal Failure ◽  
Course Of Disease ◽  
Life Threatening ◽  
The Central Nervous System ◽  
Recurrent Stone

Primary hyperoxalurias (PH) are rare autosomal recessive metabolic disorders characterized by an increased endogenous oxalate production which leads to the development of urolithiasis, nephrocalcinosis, and ultimately to renal failure.PH patients with severe renal failure develop life-threatening systemic oxalosis, which affects many organs such as bone, skin, retina, myocardium, vessel walls, and the central nervous system. So far, combined or sequential liver-kidney transplantation is the only therapeutic option for patients with advanced disease. Contrary to the former impression of a relatively mild course of disease in patients diagnosed as adults, recent data have shown that patients diagnosed in adulthood mostly present with established ESRD and systemic oxalosis. The fact that some of these patients respond to pyridoxine therapy underlines the importance of early diagnosis and measures to prevent renal failure and systemic oxalosis. All children with stone disease or nephrocalcinosis and all adults with recurrent stone disease should therefore be screened for PH.

scholarly journals P1843NEPHROLOGICAL THEMATOLOGY IN PUBLICATIONS DIACHRONICALLY APPEARING IN THE PUBMED BIBLIOGRAPHICAL DATABASE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ioannis Stefanidis ◽  
Athanasios Diamandopoulos
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
Renal Biopsy ◽  
Historical Analysis ◽  
Medical Specialty ◽  
Pubmed Database ◽  
Number Of Publications ◽  
First Time

Abstract Background and Aims Nephrology is a medical specialty, which in the last 50 years experienced very important scientific developments, which formally revolutionized clinical practice, namely renal biopsy, renal replacement therapy and transplantation. In addition understanding pathogenesis and clinic of renal disease also improves steadily, resulting in renewal of definitions, classifications and therapeutics in nephrology. In this context publications with nephrological content are also expanding. The aim of this bibliography-study was to analyze the publications, related to nephrology specific keywords, as they appear in the PubMed database. Method Certain nephrology related keywords were applied: “nephrology”, “acute renal failure”, “renal biopsy”, “hemodialysis”, “peritoneal dialysis” and “renal transplantation” were applied as terms in PubMed. Instead of renal kidney was used as an alternative term. Results Nephrology as a term appears 141573 times in the database and beginning from 1946 its appearance is expanding in the last three decades. The term “acute renal failure” is found for the time in 1932 in one publication and in a total number 92278 of publications. Renal biopsy appears from 1943 in a total number of 15506 publications. Hemodialysis appears in 182730 citations for the first time in 1915 in human application. Peritoneal dialysis appears in 32266 citations for the first time in 1901 and 1946 in human application. One publication on renal transplantation appears in 1946 and the total number of publications related to renal transplantation is 106075. Conclusion According to the above findings there is a clear expansion of nephrological publications in the last decades. In addition, hemodialysis remains still the most frequent term used in nephrology related publications. Historical analysis the PubMed database is very useful as a tool to understand the research and publication trends in nephrology, as we approach to the new era of precision medicine.

Pharmacokinetics of Iopentol in Patients with Chronic Renal Failure

1992 ◽  
Vol 33 (5) ◽  
pp. 482-484 ◽  
Author(s):  
M. G. Svaland ◽  
F. Kolmannskog ◽  
P. E. Lillevold ◽  
K. P. Nordal ◽  
L. Ressem ◽  
...  
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Half Life ◽  
Extracellular Fluid ◽  
Reference Value ◽  
Apparent Volume ◽  
Volume Of Distribution ◽  
Severe Renal Failure ◽  
Elimination Half ◽  
The Difference

Iopentol 350 mg I/ml was injected in doses of 265 to 533 mg I/kg b.w. (mean 417 mg I/kg b.w.) in 10 patients with advanced nondiabetic chronic renal failure (S-creatinine 672 ± 259 μmol/l (mean ± SD)). Urine (10 patients) and feces (7 patients) were collected at 24 h intervals for 5 days after the injection. The elimination of iopentol was delayed. Five days after injection a mean of 54% (range 35–79%) of the dose was recovered in urine, and 11% (0–20%) in feces. Mean elimination half-life was 28.4 h, about 14 times the half-life found in healthy volunteers. The apparent volume of distribution was 0.27 1/kg b.w., indicating distribution only to extracellular fluid. Using renal iopentol clearance as reference value, GFR was overestimated by 40 to 60% with iopentol total clearance, showing extrarenal elimination of iopentol. The difference was most pronounced in patients with low GFR. In conclusion, this study shows an extrarenal elimination of iopentol and demonstrates a substantial increase in the fecal elimination in patients with severe renal failure.

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