Effects of acetate and bicarbonate dialysates on tolerance to dialysis have been examined in 30 patients with chronic renal failure (CRF). Symptomatic homeostatic impairment (nausea, vomiting, headache) and cardiovascular instability (tachycardia, arrhythmia, dyspnea) were less common (p less than 0.05) in bicarbonate dialysis. The cardiovascular symptoms correlated with antihypertensive effects of acetate (p = +0.48). Tolerance to ultrafiltration was better with bicarbonate dialysis. Gas chromatographic measurement of blood acetate concentrations in 7 patients on bicarbonate dialysis showed them to be 1.4 +/- 0.31 mmol/l at the beginning of dialysis treatment and 1.7 +/- 0.24 mmol/l at its end (normal, 1.7 +/- 0.14 mmol/l). Of 26 patients on acetate dialysis, 9 patients showed initial and late acetate concentrations of 1.7 +/- 0.26 and 2.5 +/- 0.23 mmol/l, respectively, while in 17 patients an initial concentration of 4.8 +/- 0.32 mmol/l rose to 9.0 +/- 1.1 mmol/l at the end of the treatment (p less than less than 0.01). Dialysis-induced complications had a higher incidence in the latter group (p less than 0.02). Acetate dialysis was poorly tolerated by 65% of the patients. The intolerance was aggravated by myocardial lesions and slow acetate turnover indicated by blood acetate concentrations above 7-8 mmol/l.

Acetates↗

PubMedDate not supplied

[Enterosorption in experimental acute kidney failure].

The paper provides the results of 32 experiments on 22 mongrel male dogs with a view to measuring creatinine levels in the lumen of various intestinal segments before and after bilateral nephrectomy and evaluating the effects the enterosorbent brand SKN administered into isolated portions of the intestinal tube on alteration of intraluminal concentrations of creatinine, serum creatinine, and "middle-sized" molecules. Four parts of the intestine were identified: (1) proximal; (2) middle and (3) distal portions of the small intestine, and (4) the large intestine up to the anal sphincter. Two days following bilateral nephrectomy, creatinine levels were increased in the proximal, middle, distal portions of the small bowel and in the large bowel by 18, 11, 5, and 1.4 times, respectively, as compared to the baseline creatinine concentration in the intestinal parts mentioned. The administration of the enterosorbent into the different intestinal parts revealed that with its 6-hour exposure, the most potent effect (lower concentrations of creatinine and "middle-sized" molecules in serum) was observed in the proximal portions of the small bowel. This phenomenon is likely to be attributable to greater vascularization and the maximal creatinine and "middle-sized" molecule concentration in these intestinal portions. With this, it was shown that the higher baseline concentrations of serum creatinine and "middle-sized" molecules were, the more actively they absorbed on the charcoal enterosorbent brand SKN in the intestine.

Acute Kidney Injury↗

PubMedDate not supplied

[Effect of hemodialysis on erythrocyte acetylcholinesterase and adenosine triphosphatase activity in chronic renal insufficiency].

Erythrocytes of patients with chronic kidney insufficiency exhibited high hexokinase activity as well as low activity of acetylcholinesterase and K+, Na+-dependent ATPase. The Km value of acetylcholinesterase for acetyl thiocholine was not altered in the reaction and the enzyme proved to be more resistant to heat denaturation. Therapy with permanent hemodialysis [8-10 hrs per day within some months] normalized K+, Na+-dependent ATPase activity and activated acetylcholinesterase. These effects may be considered as evidence for detoxication and normalization of metabolism. At the same time, high hexokinase activity and increased resistance of acetylcholinesterase to heat inactivation were maintained.

Acetylcholinesterase↗

PubMedDate not supplied