P Porena | PubMed Health

PubMed1992

[Is it possible to improve the nutritional status of dialysis patients?].

It is well known that hemodialyzed patients show a protein-calorie malnutrition (PCM) due to several factors: dialytic and/or biologic age, diet, hormonal status, amino acid loss. The nutritional status of 44 HD patients was quarterly evaluated from september '87 to may '90 (32 months) and ten of them (5 M, 5 F) were treated by means of L-carnitine (6 g/ev/week) from september '88 to may '90. In the 5 treated males a net gain (+ 80 g/month) of the muscle mass was observed while the 5 treated females showed a low increase of fats. This trend was different (even though not significantly different) from that observed in the untreated group, in which a muscle mass loss and a fat increase was the rule.

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PubMed1989

Different buffers for hemodiafiltration: a controlled study.

Hemodiafiltration (HDF) is usually performed using a dialytic solution (D) containing acetate (A) or bicarbonate (B) and a replacement fluid (RF) containing lactate (L). To clarify the role of buffers in HDF, 11 patients underwent different study periods, each three months long: bicarbonate hemodialysis (BHD = Baseline period); HDF with (A) in D and (L) in RF (first period of HDF); HDF with (A) in D and (B) in RF (second HDF); HDF with (B) in D and (L) in RF (third HDF); HDF with (B) in D and (B) in RF (fourth HDF = BHDF). HDF achieved: 1) an increase in dialytic efficiency (kt/V, 1.28), reducing the time-session (197 min); 2) an improvement in acid-base status (pre-dialytic values in BHDF: pH 7.36; pCO2 39.8 mmHg; HCO3- 21.8 mM/L); 3) better "dry weight" gain (reached in 92.8% of HDF and in 81% of BHD sessions); 4) a significant decrease, in dialytic side-effects (mainly during the third and fourth periods). On the whole, BHDF (HDF done using only bicarbonate buffer) represents an easy and safe technique, leading to better cardiovascular stability than BHD and HDF without bicarbonate buffer.

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