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Biomedical subjects

B G Delano

Publications and source records attributed to B G Delano.

42 records · Page 3Linked to original sources
PubMedDate not supplied

Dialyzer urea and creatinine clearances are not significantly altered in erythropoietin treated maintenance hemodialysis patients.

Recombinant human erythropoietin (r-HuEPO) was given to 51 maintenance hemodialysis patients in an attempt to correct the anemia of uremia. A subset of eight randomly chosen stable patients (four men and four women, mean age 42.3 years) had in vivo urea and creatinine dialyzer clearances measured before and after their hematocrits were increased by r-HuEPO treatment. The same dialyzer was used in both the pre-r-HuEPO and post-r-HuEPO studies. Dialyzer creatinine (Ccr) and urea (Ucr) clearances were measured at a blood flow of 300 ml/min 1 hour after the initiation of dialysis. The mean hematocrit of the group of 51 patients increased from 19% (range, 14-28%) to 33% (range, 21-27%). The mean hematocrit of the eight patients in whom the clearance studies were done was 19% before r-HuEPO and 35% after. Mean creatinine and urea clearances for the eight subjects at the lower hematocrit were 143 and 190 ml/min, respectively. After the increase in hematocrit, the mean creatinine and urea clearances were slightly lower at 132 and 166 ml/min, respectively. No patient had a rise in predialysis serum potassium, creatinine, or blood urea nitrogen. The authors concluded that the magnitude of changes in creatinine and urea clearances secondary to a r-HuEPO stimulated rise in hematocrit will be small and will not necessitate increases in dialysis time.

Adult↗
PubMedDate not supplied

Perspectives on the improvement of quality of life with epoetin alfa therapy.

Epoetin alfa (recombinant human erythropoietin) effectively diminishes the anemia associated with end-stage renal disease (ESRD). Although many clinical manifestations of ESRD have been attributed to uremic toxins, the ability of epoetin alfa therapy to improve several of these conditions, such as diminished energy levels, appetite, cold tolerance, sexual function, and cognitive abilities, suggests that anemia may be an important factor in uremia-associated symptoms. Correction of this anemia results in improvements in the patient's quality of life. These improvements can be measured by objective criteria such as exercise tolerance tests, or by subjective standards such as patient response to questionnaires. In studies to date, both subjective and objective data show that epoetin alfa therapy significantly improves the quality of life of patients with ESRD.

Activities of Daily Living↗
PubMedDate not supplied

Renal disease in the elderly.

The types of renal disease that are particularly common in the elderly include acute renal failure, prerenal azotemia, multiple myeloma kidney, and obstruction. Hemodialysis and peritoneal dialysis, now proven effective in controlling renal disease in older patients, require special considerations when applied to the elderly patient.

Acute Kidney Injury↗
PubMedDate not supplied

Deficiency of serum ionized magnesium in patients receiving hemodialysis or peritoneal dialysis.

Serum total magnesium (TMg) measurements in dialysis patients are variable, with some groups reporting hypermagnesemia and some hypomagnesemia. It had not been possible to measure the biologically active fraction, ionized magnesium (IMg2+). The authors utilized an ion-selective electrode to measure IMg in 26 hemodialysis patients and 10 peritoneal dialysis (CAPD) patients and compared the results with those from 66 age matched control subjects. Dialysate magnesium was 0.375 mM/L for the hemodialysis and 0.25 mM/L for the CAPD patients. When compared with control subjects, both hemodialysis and CAPD patients had significantly lower IMg2+ (0.55 +/- 0.02 and 0.50 +/- 0.02 vs. 0.60 +/- 0.004 mM/L; p < 0.05) and greater or normal TMg values (0.99 +/- 0.04, different at the p < 0.001 level, and 0.85 +/- 0.04 vs. 0.84 +/- 0.008). Ionized calcium (ICa2+) values were similar for all three groups (1.15 +/- 0.02 and 1.21 +/- 0.04 vs. 1.17 +/- 0.01), resulting in increased mean ICa2+/IMg2+ ratios (2.14 +/- 0.07 and 2.42 +/- 0.06 vs. 1.95 +/- 0.02 for the control subjects; p < 0.05). The percent of total magnesium that was ionized (%IMg2+) was low in both the hemodialysis and CAPD patients (55.6 +/- 0.93 and 59.2 +/- 1.05) compared with that of control subjects (72 +/- 0.61; p < 0.05). IMg2+ values correlated with TMg values in both hemodialysis (r = 0.93; p < 0.0001) and CAPD (r = 0.92; p < 0.0001) patients did not correlate with age, time on dialysis, weight, fasting cholesterol or triglyceride, albumin, blood urea nitrogen (BUN), creatinine, hematocrit, phosphate, or PTH values.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Gender and racial disparity in peritoneal dialysis patients undergoing kidney transplantation.

Patients on dialysis who are women or minorities are less likely to receive a kidney transplant than are white men. Because the authors' renal program serves an inner city area and the majority of their patients are black, the authors retrospectively analyzed patients who were receiving peritoneal dialysis to see if that bias held true. Eighty-nine consecutive patients were studied. Sixty-one percent of the patients were women and 39% were men. The mean age was 47.4 years (range: 15-82 years). Sixty-seven percent of the patients were black, 17% were white, nine were Hispanic, and five were of Asian descent. Despite the preponderance of black and women patients, the majority of the 11 patients who received a kidney transplant were white (64%). Nine percent of the women were transplanted compared with 17% of the men. There was no significant difference in age between those patients who received a kidney transplant and those who did not. No assessment of comorbidity was done. The authors conclude that even in a program in which the majority of patients are black and women, white men are more likely to receive a renal transplant.

Adolescent↗