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Biomedical subjects

S Antoniou

Publications and source records attributed to S Antoniou.

22 records · Page 2Linked to original sources
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F-waves in evaluating uremic polyneuropathy: a long-term study after the application of continuous ambulatory peritoneal dialysis.

Electrophysiological parameters were studied in 8 patients with end-stage chronic renal failure (CRF). The patients had complete evaluations of the state of CRF, clinical neurological examinations and EMG studies, performed before starting continuous ambulatory peritoneal dialysis (CAPD) as well as 10 days, 2 months and 6 months after initiation of CAPD treatment. All the conventional electrophysiological parameters studied (motor and sensory conduction velocities, terminal latencies, muscle and nerve action potentials) had a tendency to shift towards normal values, the effect being more pronounced in the upper limbs. F-wave maximum and minimum latencies improved quickly in the upper limbs, but very slowly, if at all, in the lower limbs. F-wave frequency became normal in 82% of the median and ulnar nerves, in 75% of the tibial nerves and remained unchanged in the peroneal nerves. F-wave identically, as represented by the "test of multiplicity", showed a general improvement in all nerves, including the peroneal. Studies of F-wave parameters, in addition to improving the diagnostic results, provide a more sensitive method, whereby the effects of CAPD can be examined quantitatively.

Adult↗
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Continuous peritoneal dialysis in heavyweight individuals: urea and creatinine clearances.

OBJECTIVE: To study whether or not continuous peritoneal dialysis (CPD) can provide acceptable levels of normalized urea and creatinine clearance in heavyweight individuals. DESIGN: Retrospective analysis of urea and creatinine clearance studies. SETTING: CPD patients followed in four dialysis units in Albuquerque, two dialysis units in Thessaloniki, and two dialysis units in Athens. PARTICIPANTS: One hundred and ninety-nine patients on CPD with 266 clearance determinations between 1991 and 1995. INTERVENTIONS: The heavyweight group consisted of 22 patients (24 clearance studies) weighing 100 kg or more (109 +/- 8.7 kg) at the time of the clearance study. All subjects were obese. The reference group consisted of 177 CPD subjects (242 clearance studies) of normal weight (68.7 +/- 12.2 kg). Urea fractional clearance (KT/V) and normalized creatinine clearance (Ccr) were compared between the heavyweight and the reference groups. MAIN OUTCOME MEASURES: The lowest acceptable weekly levels were set at 1.70 for KT/V and 54.4 L/1.73 m2 for Ccr. RESULTS: Weekly KT/V was 1.75 +/- 0.41 in the heavyweight group and 1.94 +/- 0.52 in the reference group (p = 0.047). Corresponding weekly Ccr levels were 64.0 +/- 24.3 and 77.6 +/- 40.3 L/1.73 m2, respectively (p = 0.021). In the heavyweight group, 13 studies (54.2%) had acceptable KT/V values compared to 160 studies (66.1%) in the reference group (NS). Corresponding values for acceptable Ccr were 17 (70.8%) and 165 (68.2%), respectively (NS). Drain volume was 12.96 +/- 4.40 L/24 hours in the heavyweight group and 9.63 +/- 2.58 L/24 hours in the reference group (p = 0.001). High daily exchange volume was delivered by a combination of daily continuous ambulatory peritoneal dialysis (CAPD) and nocturnal automated peritoneal dialysis (APD) in 13/16 heavyweight studies. This combination was tolerated better than any other method of delivering a large daily exchange volume. CONCLUSION: Although normalized urea and creatinine clearances are lower in obese, heavyweight individuals than in lean CPD subjects with lower weight, approximately equal percentages of these two groups achieve acceptable clearance levels. However, heavyweight individuals require larger-than-usual daily exchange volumes. The preferred way to deliver these large dialysate volumes is a combination of daily CAPD and nocturnal APD.

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Fractional urea clearance estimates using two anthropometric formulas in continuous peritoneal dialysis: sex, height, and body composition differences.

OBJECTIVE: To compare estimates of urea volume (V) and KT/V obtained by the Watson and Hume anthropometric formulas, and to identify the similarities and differences between these estimates. DESIGN: Theoretical analysis applying wide variations in the determinants of anthropometric V (age, height, weight) in hypothetical women and men. Analysis of urea kinetic studies performed in patients on continuous peritoneal dialysis (CPD). SETTING: Four dialysis units in Albuquerque, two in Athens, and two in Thessaloniki. PARTICIPANTS: Three hundred and two CPD patients who had 440 urea kinetic studies. INTERVENTION: Standard urea clearance was performed by 24-hour collections of urine and drained dialysate followed by blood sampling. V was estimated by both the Watson and Hume formulas. MAIN OUTCOME MEASURES: Estimates of V and KT/V were compared separately in women and men by Student's t-test, linear regression, and limits of agreement (mean difference +/- 2 SD). The agreement of the KT/V estimates was also tested by the kappa ratio using a value of 1.70 weekly as the lowest acceptable K/TV. RESULTS: The theoretical analysis indicated important disagreement only in extreme variations from the ordinary in height and, to a lesser extent, weight. Differences due to height variation were pronounced only in hypothetical women. CPD patient findings were as follows: in women, Watson V and weekly KT/V were 30.4 +/- 4.4 L and 2.10 +/- 0.61, respectively. Corresponding Hume estimates were 30.3 +/- 5.4 Land 2.1 2 +/- 0.66, respectively. Corresponding estimates for men were 40.5 +/- 5.7 L and 1 .92 +/- 0.57 (Watson) plus 41.4 +/- 5.6 L and 1.88 +/- 0.57 (Hume), respectively. By linear regression, KT/V(Hume) = -0.083 + 1.052 (KT/V(Watson)), r = 0.961 (women); and KT/V(Hume) = -0.026 +/- 0.992 (KT/V(Watson)), r = 0.985 (men). Limits of agreement were -1.41 L and 2.10 L for V, and -0.15 and 0.14 weekly for KT/V. In 94.3% of the cases, KT/V(Watson) and KT/V(Hume) agreed (both > 1 .70 or both < 1 .70 weekly). Kappa ratio was 0.875 (excellent agreement). The concordant and discordant groups differed in height and degree of obesity, in agreement with the theoretical analysis. CONCLUSION: The Watson and Hume formulas provide similar estimates of V and KT/V in CPD patients. Differences may be noted only if women's height or, to a lesser extent, both sexes' weight is at a great variance with the ordinary values.

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