To determine whether bacteriologic hazards associated with bicarbonate concentrate may be reduced or prevented, evaluation of a system consisting of a mixing tank supplied with R.O. water and two separate storage tanks was undertaken. Bicarbonate was mixed on a schedule specific to usage and dispensed to the storage tanks from which it was drawn off into 2.5 gallon jugs for each treatment. The mixing tank was disinfected with hypochlorite solution (200 ppm) before each use. Storage tanks and 2.5 gallon jugs were disinfected weekly and sampled immediately before scheduled disinfection and after the longest storage time. The mixing tank was sampled for corresponding batches. A 1 ml inoculum of concentrate was plated onto tryptic soy sheep blood agar, incubated for 48 hours at 35 degrees C and colony counts/ml recorded. A total of 225 batches on a 10% sampling schedule were monitored. All cultures have grown less than 50 cfu/ml, which is less than AAMI standards for maximum allowable level for water and dialysate. Bacteriologically safe bicarbonate concentrate can be reliably produced using R.O. water, controlled storage times, and rigid disinfection schedules.

Bacteria↗

PubMedDate not supplied

Role of the laboratory in management of acute and chronic renal failure.

The initial assessment and differential diagnosis of acute renal failure is greatly facilitated by laboratory procedures of varying sensitivity and specificity; these are reviewed in detail. Patients with chronic renal failure receiving maintenance dialysis exhibit many laboratory abnormalities which may differ significantly between patients treated with hemodialysis and those receiving peritoneal dialysis. These are also reviewed.

Acute Kidney Injury↗

PubMedDate not supplied

Disorders of protein and lipid metabolism associated with chronic renal failure and chronic dialysis.

Patients with chronic renal failure treated with maintenance dialysis demonstrate many abnormalities of protein, carbohydrate, and lipid metabolism. Losses into dialysate of amino acids and glucose during the course of hemodialysis and protein losses during peritoneal dialysis, associated with inadequate dietary intake and/or increased endogenous catabolism, may result in chronically negative nitrogen balance and a state resembling clinical malnutrition. Hypertriglyceridemia and low levels of high density lipoprotein cholesterol are also characteristic of the chronic dialysis patient. Patients receiving peritoneal and chronic ambulatory peritoneal dialysis may be at particular risk for hypertriglyceridemia because of high obligate glucose loads. Literature relating to these areas is reviewed, and specific recommendations outlined for dietary protein, amino acid, carbohydrate, and lipid content and composition in the chronic renal failure and chronic dialysis patient.

Amino Acids↗