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  • 1
    ISSN: 1432-1440
    Keywords: Hemodialysis ; changes of Ca and Mg ; concentration in red blood cells and plasma ; Elektrolytveränderungen unter Hämodialyse ; Ca- und Mg-Konzentrationen in Plasma und Erythrocyten
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei 10 Patienten aus dem chronischen Hämodialyseprogramm wurden die Calcium- und Magnesiumkonzentrationen im Plasma und in den Erythrocyten jeweils vor und nach der Dialyse gemessen und mit den an 16 nierengesunden Kontrollpersonen ermittelten Werten verglichen. Die Konzentrationen in den Erythrocyten wurden aus den im Plasma und Vollblut mit einem Atomabsorptions-Spektralphotometer gemessenen Ca- und Mg-Konzentrationen unter Berücksichtigung des Hämatokritwertes nach einer neuen Formel berechnet. Bei den Dialysepatienten waren dabei die im Mittel auf das Vierfache der Norm erhöhten Ca-Konzentrationen in den Erythrocyten besonders auffallend. Die von anderen Arbeitsgruppen bei chronisch niereninsuffizienten Patienten beschriebene Hypermagnesämie konnten wir bestätigen. Unter der Hämodialyse kam es zu einem deutlichen Abfall der Plasma-Mg-Konzentrationen, während die Ca-Konzentrationen konstant blieben. In den Erythrocyten fielen unter der Dialyse sowohl die Ca- als auch die Mg-Konzentrationen ab. Bei 2 unter gleichen Bedingungen dialysierten Patienten hingegen kam es zu einem noch ungeklärten Anstieg der intraerythrocytären Ca- und Mg-Konzentrationen. Die Analysenmethodik sowie das Verhalten der gemessenen Elektrolyte unter der Dialyse werden diskutiert.
    Notes: Summary In ten patients undergoing chronic hemodialysis, the plasma and red blood cell concentrations of calcium and magnesium were measured just before and directly after dialysis. The results were compared with the values obtained from sixteen healthy subjects. A new formula was derived—using the measured concentrations in plasma and whole blood as well as the hematocrit corrected for the trapped plasma—which permits the calculation of electrolyte concentrations in erythrocytes. Calcium and magnesium were determined by atomic absorption spectroscopy. A remarkable increase of calcium concentrations in the red blood cells of the hemodialysed patients was noted. In the mean, these concentrations reached a value four times higher than in the control group. Furthermore, a hypermagnesaemia was found in patients with chronic renal failure, which is in accordance to previous findings of other authors. During hemodialysis plasma magnesium decreased whereas plasma calcium remained constant. Both, calcium and magnesium in the red blood cells decreased during dialysis. Two patients, however, showed an unexplained increase of both calcium and magnesium content in their red blood cells. The analytical procedure and the alterations in the electrolytes measured are discussed.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 63 (1985), S. 49-55 
    ISSN: 1432-1440
    Keywords: Low-molecular-weight heparin ; Hemodialysis ; Coagulation ; Lipoproteinlipase
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Low-molecular-weight (LMW) heparin has been compared to standard unfractionated (UF) heparin in a total of 49 patients on hemodialysis and hemofiltration in order to determine the necessary therapeutic dose and its effect on the coagulation system. A LMW heparin dose corresponding to 50% of the normal UF heparin dose was found to produce similar plasma heparin levels (anti-FXa-U/ml) in particular on minimal heparinization. At higher doses, UF heparin produced a more marked increase in plasma-heparin than did LMW heparin. Highly significant differences were found between UF and LMW heparin in their effects on PTT and thrombin time. Partial thromboplastin time (PTT) increased under UF heparin by an average of 120 s whereas LMW heparin only produced an increase of 5–7 s. Thrombin time was increased by 250–280 s under UF heparin and by 5–8 s under LMW heparin. With this LMW heparin dose of 50% of the UF heparin dose, no thrombosis of the extracorporal system occurred and no macroscopic detectable thrombotic material was found in the dialyzers or filters. No significant differences were observed between the effects of UF and LMW heparin on Factor VIII activity and fibrin monomers, so that a difference in coagulation activation between the two heparins can be excluded. Furthermore, there were no changes in thromboplastin time according to Quick, fibrinogen, antithrombin III, plasminogen, and a2-antiplasmin. Thus effective Anti-FXa levels and by similar antithrombotic activity, LMW heparin will probably present less of a bleeding risk because of its reduced effect on PTT and thrombin time. LMW heparin therefore appears to be a good alternative to UF heparin for patients with renal insufficiency requiring dialysis. LMW heparin is indicated in particular in patients at bleeding risk, with diabetic retinopathy, on therapy with oral anticoagulants or platelet aggregation inhibitors, and with thrombocytopenia.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1440
    Keywords: Atrial natriuretic peptide ; Cyclic GMP ; Hemodialysis ; Hemofiltration ; Ultrafiltration ; Atriales natriuretisches Peptid ; zyklisches GMP ; Hämodialyse ; Hämofiltration ; Ultrafiltration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei 7 chronisch niereninsuffizienten Patienten, die regelmäßig hämofiltriert (HF) wurden, erfolgten während der Behandlung periodische Bestimmungen von ANP and c-GMP. Um den Einfluß des Blutreinigungsverfahrens auf die Veränderungen der Plasmakonzentrationen dieser Hormone zu untersuchen, wurde bei den Patienten eine Hämodialyse (HD) mit identischer Ultrafiltration und Behandlungsdauer durchgeführt. Bei beiden Behandlungsverfahren wurde ein gleichartiger kontinuierlicher Abfall von ANP und c-GMP beobachtet. Nach Kopf-Tieflagerung wegen Hypotonie unter HD stiegen die ANP und c-GMP Werte akut an. Bei einem anderen Patienten wurde gleichfalls ein akuter Anstieg während der HD beim Auftreten einer Tachyarrhythmia absoluta beobachtet. Diese Befunde zeigen, daß die Freisetzung von ANP bei chronischer Niereninsuffizienz nicht verändert ist. Da eine enge Beziehung zwischen Intravasalvolumen und der Höhe des Plasma ANP besteht, kann die regelmäßige Bestimmung dieses Hormons zur Beurteilung des Hydratationszustandes terminal niereninsuffizienter Patienten herangezogen werden.
    Notes: Summary ANP and c-GMP concentrations in 7 patients with chronic renal failure (CRF) undergoing regular hemofiltration (HF) were determined. After switching to hemodialysis (HD) under identical ultrafiltration and treatment time no significant difference of the ANP and c-GMP profiles was detected, suggesting that the type of treatment does not affect ANP and c-GMP plasma levels. In both procedures a continuous decrease of ANP and c-GMP was observed. Head down tilting to compensate hypotension during HD was immediately followed by an increase in ANP and c-GMP during ultrafiltration. An acute onset of tachyarrhythmia absoluta during HD was also accompanied by a rise in ANP plasma concentrations. This demonstrates that ANP secretion is not altered in patients with CRF. Since ANP plasma levels closely correlate with intravascular volume, periodic determination of this hormone in HD/HF patients may provide diagnostic information to detect volume overload.
    Type of Medium: Electronic Resource
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