Reagent strip blood glucose testing methods have not been extensively validated in dialysis patients, a serious omission as thousands of diabetic patients are now entering dialysis. Severe anemia and uremia are potentially confounding variables that might impair those testing methods. Various methods were tested pre- and postdialysis, and compared with standard laboratory results. In general, strip methods (SM) underestimated laboratory results by approximately 15%. Extremes of blood urea nitrogen, hematocrit, or blood glucose levels did not affect this reliability. Such methods appear to be suitable for use in chronic hemodialysis patients.

Blood Glucose↗

PubMedDate not supplied

The renin-angiotensin-aldosterone system in primary and secondary hypertension.

Important advances have been made in understanding the role of the renin-angiotensin-aldosterone system in the pathogenesis and diagnosis of hypertensive disorders. Measurement of plasma renin activity (PRA) and aldosterone is very important in the assessment of secondary hypertension. Hypertensions with increased PRA include renovascular hypertension, some cases of unilateral and bilateral renal parenchymal disease, malignant hypertension, hypertension associated with oral contraceptive agents, and renin-secreting tumors. Hypertension with decreased PRA is observed in four recognized types of primary aldosteronism: adenoma, bilateral hyperplasia, indeterminate aldosteronism, and glucocorticoid-responsive aldosteronism. Other conditions with hypertension and depressed PRA include ACTH and DOC secreting tumors, primary hyperpituitarism, syndromes of 17-hydroxylase and 11-beta-hydroxylase deficiency. Liddle's syndrome, licorice abuse, exogenous administration of mineralocorticoids, and preeclampsia.

Acute Kidney Injury↗

PubMedDate not supplied

Current status of renal clearances.

Determination of renal clearances continues to have value in clinical situations. Current knowledge of renal function permits expansion of the clearance concept to include non-excretory mechanisms by which kidneys clear substances from blood. Measurement of clearances is useful in quantifying renal function, progression of renal disease, response to therapy, determining the amount of dialysis required. Because accurate chemical methods are clinically cumbersome, isotopic techniques are under development and simple, accurate methods are approaching routine availability.

Aminoglycosides↗