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Biomedical subjects

C Ciancioni

Publications and source records attributed to C Ciancioni.

At least 19 recordsLinked to original sources
PubMed1989

In vivo induction of interleukin-1 during hemodialysis.

In vivo induction of interleukin-1 (IL-1) production during hemodialysis was investigated by measuring IL-1 activity in monocyte lysates from 59 patients undergoing long-term maintenance hemodialysis with complement activating and non-complement activating devices. In patients dialyzed with new hollow-fiber cuprophane dialyzers, predialytic (T0) monocyte-associated IL-1 activity was 12.5 +/- 3.0 U/ml (mean +/- SEM), a value that was higher than that found in normal individuals (2.85 +/- 0.85 U/ml; P less than 0.0025) and in non-dialyzed patients with chronic renal failure (0.95 +/- 0.85 U/ml, P less than 0.0001). Cell-associated IL-1 activity was consistently increased after five hours of dialysis with cuprophane membranes (42.4 +/- 5.5 U/ml, P less than 0.0005). Systemic complement activation was demonstrated by the finding of increased plasma levels of C3adesArg antigen during dialysis. In patients dialyzed with high permeability polyacrylonitrile and polysulfone membranes, no intradialytic change in cell-associated IL-1 and no complement activation occurred. However, the mean predialytic values of monocyte-associated IL-1 in these patients (that is, 32.9 +/- 5.6 U/ml and 38 +/- 5.65 U/ml for the polyacrylonitrile and the polysulfone groups, respectively) were higher than the predialytic levels of cell-associated IL-1 in the patients from the cuprophane group (P less than 0.0025). Monocytes obtained at the beginning and five hours of dialysis from patients dialyzed with polyacrylonitrile devices, and monocytes obtained at five hours but not at the beginning of dialysis from patients dialyzed with cuprophane membranes, spontaneously released extracellular IL-1 after 24 hours of culture in serum free conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

[Treatment of chronic kidney failure by the keto-analogs of essential amino acids: 4 years' experience].

From June 1981 to June 1985, 22 patients with advanced chronic renal failure were treated with a preparation of ketoanalogues of essential amino acids (Ketosteril, 1 tablet/5 kg/day) combined with a protein supply of 0.4 g/kg/day. At the beginning of treatment, their mean plasma creatinine was 762 +/- 135 mumol/l and their creatinine clearance, 8.4 +/- 3.1 ml/min/1.73 m2. By the end of November, 1985, among the 20 assessable patients, 4 had been on ketoanalogues for 8 to 52 months, 9 had to be dialyzed after 4 to 20 months, 5 had died and 2 had abandoned treatment. A mean 28% decrease in plasma urea level and daily urinary urea output was observed after 1 month on ketoanalogues, and a sustained reduction in plasma creatinine was observed in 12 patients. Mean renal survival was 15.6 +/- 12 months (median: 12 months), and was longer in patients whose plasma creatinine was lower than 700 mumol/l at the beginning of treatment. The ketoanalogues were well tolerated, and no denutrition occurred. Our experience confirms the usefulness of this therapeutic approach in uremic patients and suggests that the best results would be obtained if ketoanalogues were introduced before end-stage renal failure.

Adult↗
PubMed1987

Pharmacokinetics of desferrioxamine and of its iron and aluminium chelates in patients on haemodialysis.

We have used a new analytical micromethod to study the pharmacokinetics of desferrioxamine and its aluminium chelates in patients with chronic renal failure on haemodialysis. Desferrioxamine (Desferal, CIBA, Basle) was given by 1-h infusion just after the haemodialysis at 20, 40, 80 mg/kg body wt. and during the first and the last hour of the haemodialysis at 40 mg/kg. The concentrations of desferrioxamine during infusions showed a linear increase with increasing doses. The maximum concentrations and the AUC obtained when desferrioxamine was infused during the haemodialysis were not statistically different but slightly lower than those obtained in post dialysis administration. This result indicates that the loss of desferrioxamine by transfer in the dialysate is quite moderate within 1 h. During the interdialysis period, there was a decrease of plasma desferrioxamine concentrations with a mean half-life of 18.7 +/- 5.2 h and an increase in plasma concentrations of aluminium desferrioxamine chelate. In vitro studies show that a lengthy contact between desferrioxamine and plasma is necessary for complete chelation of A1 already present in plasma. During the following dialysis session, there was an important decrease of desferrioxamine and of its iron and aluminium chelates in blood plasma representing their transfer to the dialysis fluid.

Adult↗
PubMed1986

[Use of hormonal parameters of phospho-calcium metabolism as a means of discriminating bone and joint disorders in patients with renal insufficiency].

Serum carboxyterminal parathyroid hormone (PTH) concentration (homologous measurement of the 53-84 fragment and heterologous bovine measurement) has been measured and correlated with both clinical and radiological findings of secondary hyperparathyroidism (HPT), studied quantitatively according to a score published in literature, in 95 patients with chronic renal failure on maintenance hemodialysis. Mean serum PTH concentration (53.84) is statistically higher in patients with severe clinical and radiological evaluation of HPT than in patients with moderate or slight manifestations of HPT (M +/- DS: 515.8 +/- 243.7 pg/ml VS 271.3 +/- 166.1 pg/ml p less than 0.001). However, even with high serum concentration, serum PTH level does not allow to predict HPT severity, suggesting a retention of PTH fragments in serum without biologic activity probably.

Adolescent↗
PubMed1986

[Effect of keto analogs of essential amino acids on the progress of advanced chronic renal insufficiency: controlled prospective study].

We prospectively compared the efficacy and tolerance of a very low protein intake (0.4 g/kg/day) supplemented with keto analogues of essential amino acids and of the standard low protein diet (0.6 g/kg/day) in 19 patients with advanced chronic renal failure (mean plasma creatinine level: 726 +/- 113 mumol/l), who were randomly assigned to either treatment. Long term acceptability was similarly good in both groups and no biochemical or morphometric sign of denutrition was observed in neither group, whereas the mean renal survival duration until dialysis was longer, and the mean slope of 1/Cr was lower in patients treated with keto analogues. We suggest that ketoacid treatment is more effective than protein restriction alone in slowing the progression of advanced chronic renal failure.

Adult↗
PubMed1985

Concomitant removal of aluminium and iron by haemodialysis and haemofiltration after desferrioxamine intravenous infusion.

In six anuric haemodialysed patients, aluminium and iron mass transfer were determined 48 hours after 40 and 80mg/kg body weight desferrioxamine intravenous infusion. All patients were aluminium overloaded (mean +/- SEM: 2.91 +/- 1.05 mumol/g wet tissue bone) and two had high plasma ferritin. Haemodialysis and haemofiltration were performed using a highly permeable membrane. The adequate dose of desferrioxamine for aluminium removal is 40mg/kg, since aluminium mass transfer induced by haemodialysis and haemofiltration (47.4 and 40 mumol/session) are not significantly different from that obtained with 80mg/kg. Iron removal is dose related in high plasma ferritin concentration patients: 50 and 100 mumol/session with haemodialysis and 29 and 175 mumol/session with haemofiltration after 40 and 80mg/kg body weight respectively.

Adult↗
PubMed1981

[Does echocardiography Tm permit to determine the true contractile state of the left ventricle of hemodialysis patients? (author's transl)].

M. mode echocardiography was performed on 16 chronic hemodialysis patients (12 men, 4 women, average use of 21, hematocrit around 24 +/- 5%) with a normal blood pressure and no clinical or roentgenographic signs of heart failure, 18 to 22 hours after the end of a dialysis. Renal diseases due to hypertension, diabetes or amyloidosis were excluded from the study. 8 normal subjects of similar age, heart rate and blood pressure were used as a test group. On these 24 persons, and diastolic time diameter index (DTDI) and end systolic time diameter index (STDI), ejection time (ET), mean velocity of circumferential fiber shortening (VCF) and ejection fraction were calculated. DTDI of hemodialysis patients (31 mm/m(2) +/- 2) is greater than DTDI of the control subjects, and STDI and ET are the same. This explains the increase of VCF (1,69 +/- 0,10 c/s) and EF (0,78 +/- 0,05). After a three minute compression of the fistulas the differences disappear. These results suggest that the previous exam conditions permit a better determination of the true contractile state of the left ventricule of hemodialyzed patients if one disregards the load changes due to the fistula, anemia and the intermittent volume expansion.

Adolescent↗
PubMed1980

Carnitine improves lipid anomalies in haemodialysis patients.

51 chronic haemodialysis patients with hypertriglyceridaemia were given a daily oral dose of 2.4 g D,L-carnitine for 30 days to investigate a possible hypolipaemic effect. After 30 days' D,L-carnitine treatment the mean (+/- SEM) serum triglyceride concentration had decreased significantly from 3.50 +/- 0.39 to 2.87 +/- 0.27 mmol/l. Serum total cholesterol did not change. However, HDL cholesterol increased significantly from 0.89 +/- 0.05 to 1.35 +/- 0.07 mmol/l. This decrease in serum triglycerides and return of HDL cholesterol to normal levels in haemodialysis patients may be the result of correction of carnitine deficiency. Such treatment could reduce the risk factors for atherosclerosis and coronary-artery disease in uraemic patients.

Adult↗
PubMed1980

[Has haemofiltration a specific therapeutic effect? A co-operative study involving 20 patients (author's transl)].

In order to evaluate the effects of haemofiltration (HF) on blood pressure control, hyperparathyroidism and hypertriglyceridaemia, the relevant clinical and biological parameters were compared under haemodialysis (HD) and under haemofiltration using a substitution fluid (SF) acetate. Blood pressure control was achieved with HF in only one of 14 hypertensive patients. In 17 patients, with the same doses of Al (OH)3, plasma phosphate levels were similar under HD (63 mg/l) and HF (67 mg/l). In 3 patients, measurements of plasma parathyroid hormone (PTH) levels in the presence of increasing concentrations of SF calcium showed that a concentration of 90 mg/l was required to obtain a positive calcium balance and a decrease in PTH levels. After 6 months, PTH levels under HD and under HF were comparable. In 20 patients, there were no significant differences between HD and HF in mean plasma concentration values of total lipids, cholesterol and triglycerides. Finally, HF was better tolerated than HD in 58% of the cases and less well tolerated in 8%.

Blood↗
PubMed1977

Prevention of hepatitis B in hemodialysis patients using hepatitis B immunoglobulin. A controlled study.

In a controlled study, the protection effect of hepatitis B immune globulin (HBIG) was evaluated in patients hemodialyzed for less than one month in two collaborating units. Fifteen randomly selected patients received HBIG at five to eight week intervals throughout the study, and 13 other control patients received no immunoglobulin. During a follow-up period of 14 to 30 months, none of the HBIG-treated and 12 of the control patients developed evidence of exposure to virus B hepatitis, including 10 with HBs Ag antigenemia (p is less than 0.001): five of these remained persistently antigen positive. Evidence of non-B hepatitis was found in 8 HBIG-treated and in 3 non-treated patients. Only two HBIG-treated patients developed active antibodies against hepatitis B surface antigen. Thus, HBIG seems effective in preventing hepatitis B in hemodialysis patients, provided the interval between two injections is not greater than two months. However, prolonged administration of HBIG may impair passive-active immunization to hepatitis B virus.

Adult↗