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Biomedical subjects

C Charytan

Publications and source records attributed to C Charytan.

At least 19 recordsLinked to original sources
PubMed1991

Impact of epoetin beta on dialyzer clearance and heparin requirements.

The present studies were undertaken to determine whether treatment with recombinant human erythropoietin (epoetin beta [Marogen Sterile Powder, Chugai-Upjohn, Rosemont, IL] ) necessitates an alteration in dialysis prescription or in heparin requirements. All patients had end-stage renal disease (ESRD), were on chronic hemodialysis (either high-flux or conventional) for more than 3 months, and had participated in large-scale, multicenter epoetin beta clinical trials. Nine patients were entered into the clearance study. Blood chemistry values, dialyzer clearances, and hematocrit values were determined before beginning epoetin beta administration and after approximately 40 weeks of treatment. The mean hematocrit value at the beginning of the study was 0.229 (22.9%); by week 40, it averaged 0.313 (31.3%). The mean percent change in urea clearance was -1.9%, and a mean percent change of +12.7% in blood urea nitrogen (BUN) was noted. The mean percent change in creatinine clearance was -15.3, while the mean percent change in serum creatinine was +0.2%. The mean percent change in phosphate clearance was -10.1%, and the mean percent change in serum phosphate was +44.1%. Heparin profiling was performed for nine patients (four participated in the clearance study). Seven patients showed increased requirements for heparin, with a mean percent change of +24.3%. These results underscore the necessity for careful attention to the changing status of the dialysis patient on epoetin beta. While epoetin beta treatment does not, in general, adversely affect either clearance or blood chemistry values, these values may fluctuate in individual patients in response to the increasing hematocrit values and to dietary changes that result from an increased sense of well-being.(ABSTRACT TRUNCATED AT 250 WORDS)

Anemia↗
PubMed1987

Subclavian vein stenosis as a complication of subclavian catheterization for hemodialysis.

Thirteen patients had placement of a subclavian vein catheter for temporary vascular access for hemodialysis. Peripheral venography was performed within two to six weeks of catheter placement. Forty-six percent (six of 13 patients) developed subclavian vein narrowing, which resolved in two patients. The duration of catheter placement had no impact on the incidence of this complication. Subclavian vein catheterization can frequently lead to subclavian vein stenosis, which often will resolve spontaneously. Consideration should be given to placement of subclavian lines on the contralateral side of a planned permanent vascular access.

Catheterization↗
PubMed1986

Comparison of eosinophilia in patients undergoing peritoneal dialysis and hemodialysis.

Eosinophilia (E) has been noted in hemodialysis (HD) patients, but its etiology is not clear. In an effort to clarify this phenomenon, we prospectively studied patients initiating dialysis in our outpatient HD and peritoneal dialysis programs. Rate of E was greatest for a small group of four continuous cycling peritoneal dialysis patients (75%), less for 63 HD patients (41%), and least for 66 continuous ambulatory peritoneal dialysis (CAPD) patients (21%, P less than .05, HD v CAPD). Increasing E rates among the groups paralleled increased frequency of tubing changes. There were no differences in etiology of renal disease, medications, types of dialyzers, types of access, or transfusion frequency that could account for the E. IgE levels did not correlate with E. The data suggest that the dialysis procedure or the tubing changes may be causing the E, but the possibility that uremia, itself, is important in the pathogenesis of dialysis E is also discussed.

Adult↗
PubMed1986

A comparative study of continuous ambulatory peritoneal dialysis and center hemodialysis. Efficacy, complications, and outcome in the treatment of end-stage renal disease.

We retrospectively compared 92 patients treated with center hemodialysis (CHD) and 72 patients receiving continuous ambulatory peritoneal dialysis (CAPD) over a 26-month period. The groups were comparable with respect to underlying disease and demographic characteristics. Biochemical control was also similar, with higher bicarbonate levels and hematocrits in patients receiving CAPD, despite fewer transfusions and minimal administration of anabolic steroid and iron therapy. Hospitalization rates were also similar (1.58 +/- 2.89 vs 1.43 +/- 3.35 days per patient month for patients receiving center hemodialysis vs CAPD, respectively). Access complications were the most frequent cause of hospitalization in both groups, but cardiovascular causes were more frequent among patients receiving CHD. Diabetic patients had significantly higher hospitalization rates, which were similar in both groups. Twenty-nine percent of the peritonitis episodes necessitated hospitalization. Mortality and dropout rates were virtually identical in the two groups, with a 70% retention rate during the 26-month study. Continuous ambulatory peritoneal dialysis is comparable with CHD with regard to biochemical results, complications, hospitalization rates, and outcome. It is widely applicable, as 44% of our new patients with end-stage renal disease are being sent home receiving this treatment.

Adolescent↗
PubMed1983

Serum thyroid hormone levels in patients on continuous ambulatory peritoneal dialysis and regular hemodialysis.

In vitro thyroid function tests were performed on clinically euthyroid patients undergoing regular hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD). The mean serum total thyroxine (TT4) and total triiodothyronine (TT3) values measured before HD were significantly subnormal. Similarly, CAPD subjects had reduced TT3 concentrations with low normal TT4 levels. Free thyroxine measurements, estimated by two different methods were aberrant in CAPD patients. Low normal reverse triiodothyronine (rT3) values were found in HD, in contrast to high normal rT3 levels in CAPD. Thyroid stimulating hormone determinations were normal, corresponding with the euthyroid status in both patient groups.

Adult↗
PubMed1983

Percutaneous transluminal dilatation for vascular access.

The application of percutaneous transluminal angioplasty to vascular access stenosis is described. These access problems were discovered by the technique of retrograde venous fistulography. 13 dilatations were attempted in 12 patients. Functional success was achieved in seven attempts. This resulted in a significant prolongation of access survival in these patients. Angioplasty is recommended as a nonsurgical approach to vascular access stenosis.

Angioplasty, Balloon↗
PubMed1983

Nondilated obstructive nephropathy.

Three patients had renal failure due to obstructive nephropathy associated with processes that prevented dilatation of the collecting systems. Thus, various radiologic procedures, including renal sonography, angiography, and isotope renography, all failed to identify an obstructing process. Because of the high index of clinical suspicion, surgical exploration and nephrostomy were performed on each patient. This confirmed the presence of obstructive nephropathy and led to marked improvement of renal function in each case. When renal failure develops in a setting with a high probability of ureteral obstruction, this diagnosis should be vigorously pursued despite normal radiologic results.

Acute Kidney Injury↗
PubMed1982

Continuous ambulatory peritoneal dialysis: establishment and growth of a program in a large metropolitan area.

We describe our experience at the Booth Memorial Medical Center with the development and growth of a Continuous Ambulatory Peritoneal Dialysis program. This initial experience includes the training and close follow-up of 41 patients with End Stage Renal Disease over a period of 15 months. The status of our program with respect to medical complications encountered and their management is described. Our results, in terms of biochemical control, success with training, and patient satisfaction with CAPD are outlined.

Adolescent↗
PubMed1982

Eosinophilic peritonitis.

The development of cloudy peritoneal dialysis effluent is of great concern to the patient undergoing therapy with Continuous Ambulatory Peritoneal Dialysis. As described in this study, not all cloudy fluid represents bacterial infection. We describe the occurrence of cloudy fluid in eight patients in whom culture of the dialysate did not yield any growth, and whose cell count was characterized by the presence of significant numbers of the eosinophiles. As outlined, the entity of eosinophilic peritonitis has a characteristic presentation which allows for its distinction from the more common bacterial peritonitis.

Eosinophilia↗
PubMed1982

Technique for implantation of the Toronto-Western catheter at the Booth Memorial Medical Center.

The proper placement of the chronic peritoneal dialysis catheter is pivital to the early, as well as continued success of dialysis therapy with Continued Ambulatory Peritoneal Dialysis. We describe our current technique for the implantation of the Toronto-Western catheter. The success of any particular technique is dependent upon the incidence of complications. The latter is described elsewhere in this symposium.

Anesthesia, Local↗
PubMed1979

A new aspiration-needle syringe for percutaneous renal biopsy.

We report a renal biopsy technique utilizing the disposable Jamshidi Aspiration Needle-Syringe. The equipment and procedure described greatly simplify and speed up the procedure while ensuring adequate sampling of tissue and decreasing the likelihood of complications.

Biopsy↗
PubMed1978

Amyloidosis secondary to drug abuse and chronic skin suppuration.

Amyloidosis has not been included in the wide spectrum of medical complications associated with drug abuse. Chronic visceral infection is a recognized cause of amyloidosis, but chronic suppuration of the skin is not a well-appreciated cause of this condition. Furthermore, to our knowledge, chronic skin suppuration secondary to parenteral drug abuse has not been reported as a cause for systemic amyloidosis. We report a case in which subcutaneous injections of narcotic tablets led to chronic skin suppuration and systemic amyloidosis.

Abscess↗