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Biomedical subjects

V S Timokhov

Publications and source records attributed to V S Timokhov.

At least 19 recordsLinked to original sources
PubMed2001

[Several hormonal indices during hemofiltration in patients with acute kidney failure].

AIM: To study hormonal aspects of hemofiltration (HF) in acute renal failure (ARF). MATERIAL AND METHODS: Hydrocortisone (HC), thyroxine (T4), triiodothyronine (T3), TSH, thyrocalcitonine (TC), PTH, insulin (I), C-peptide (CP), STH, beta-endorphine (BE) were examined for plasma content, elimination with filtrate, sifting rate, filtration clearance in 29 patients with oliguric ARF (18 males and 11 females) aged 12-62 years. 19 patients underwent intermittent HF (rate 145.2 +/- 9.2/27-260/ml/min, volume 1.02 +/- 0.20/0.45-1.43/). 10 patients received continuous HF (rate 25.9 +/- 2.3 l/day or 0.36 +/- 0.05/0.17-0.95/). The hormones were measured with radioimmunoassay. The results were processed with variate statistics using Student's criterium. RESULTS: Oliguria was associated with high plasma levels of HC, PTH, TC, I, CP; normal levels of TSH and STH, low ones of T4, T3 and BE. Intermittent HF led to an increased plasma concentrations of HC, T4, I, CP, decreased one of PTH, while TC, TSH, STH and T3 remained unchanged. The filtration rate of the hormones was different. The elimination was greatest for HC, T4, T3, BE. Concentration of the former three in the filtrate surpassed that in blood plasma. CONCLUSION: Besides intensive elimination of the hormones with low molecular mass (HC, T4, T3), HF causes elimination of appreciable quantities of BE, PTH, I, CT and, probably, other peptide hormones. Plasma levels of hormones did not reflect their elimination with filtrate.

Acute Kidney Injury↗
PubMed2000

[Enzyme clearance in intermittent hemofiltration in patients with acute renal failure].

AIM: To characterize elimination of some enzymes in intermittent hemofiltration (HF) in patients with acute renal failure (ARF). MATERIAL AND METHODS: 22 patients with oliguric ARF have undergone 52 procedures of intermittent HF. Before the procedure and after it the activity of enzymes (AA, AP, ACE, LAP, GGT, GDG, AlAT, AsAT, CPG, LDG) was measured in the samples of plasma and filtrate. RESULTS: Besides ACE and AlAT, all the enzymes concentrations were elevated in all the patients. HF did not change significantly the enzymes activity. Most of the enzymes were eliminated from the blood. In some samples the enzymes activity was low or absent. CONCLUSION: Further studies are necessary to answer questions aroused by the findings.

Acute Kidney Injury↗
PubMed1998

[Metabolic effects of intermittent hemofiltration in patients with acute renal failure].

AIM: Investigation of postaggressive reaction of metabolism on intermitten hemofiltration (IHF) in patients with acute renal failure (ARF). The speed of generation of urea, creatinine and oligopeptides was estimated in the course of (IHF) and in interval between the procedures. Hormonal stress was evaluated by concentration of hydrocortisone in plasma and and filtrate. MATERIALS AND METHODS: The trial covered 36 patients with oliguric ARF (21 males and 15 females) for whom IHF was the main method of replacement renal therapy. The kinetic modelling accounted for distinctive distribution of markers in body fluids. Statistical processing was made according to Student-Fisher T-criterion. RESULTS: IHF runs with intensive proteinolysis with acceleration of oligopeptides generation by 810%, degradation of large quantities of creatine triphosphate and 770%-accelerated production of creatinine, with protein catabolism and 440%-accelerated production of urea. Hydrocortisone blood levels rise about two-fold despite intensive elimination of the hormone with filtrate. Between speeds of IHF, generation of creatinine and secretion a direct correlation was found. This indicates the importance of the perfusion rate for induction of the stress and catabolism. Background hydrocortisone Irvrl has significant effects only on urea accumulation rates in IHF-free intervals. However, in the course of IHF, generation of urea and oligopeptides is to a great extent independent of hydrocortisone secretion. CONCLUSION: Application of IHF in ARF patients results in rather strong stress with enhanced proteinolysis and protein catabolism. To compensate protein loss associated with only urea generation, additional administration of minimum 60 g of plasma or amino acids is required.

Acute Kidney Injury↗
PubMed1997

[Plasma myoglobin and continuous hemofiltration in patients with rhabdomyolysis and acute kidney failure].

Plasma and filtrate levels of myoglobin, specific antibodies and immune complexes were measured by radioimmunoassay or enzyme immunoassay in patients with rhabdomyolysis and acute renal failure on continuous hemofiltration (CHF). 14 of them had crush syndrome, 7 had other forms of rhabdomyolysis. 11 patients died (52%) because of the underlying disease or its complications. Rhabdomyolysis was associated with marked and long-lasting myoglobinemia. Early amputation and restoration of diuresis combined with CHF resulted in a fall in myoglobin content. CHF provided elimination of large amounts of myoglobin with filtrate. In rhabdomyolysis in all cases there appeared specific antibodies and circulating immune complexes.

Acute Kidney Injury↗
PubMed1997

[Tumor necrosis factor-alpha kinetics during renal replacement therapy in patients with sepsis and multiple organ failure].

Peptide TNF-alpha (tumor necrosis factor alpha) secreted by monocytes and resident macrophages is a key proinflammatory mediator. It can generate response systemic inflammation leading to shock and polyorganic insufficiency. Elimination of circulating TNF-alpha is pathogenetically perspective in respect to therapy of septic shock. Plasma level of TNF-alpha and its elimination with the filter/dialysate was traced in 23 patients with sepsis and polyorganic insufficiency receiving substitute renal therapy (continuous hemodiafiltration, intermittent hemodialysis) for acute renal failure. Sepsis and polyorganic insufficiency was associated with elevated plasma levels of TNF-alpha correlating in many cases with the disease severity. TNF-alpha was for the most part eliminated with the filter/dialysate. The degree of this elimination was related to the technique of blood perfusion and characteristics of the procedure.

Adolescent↗
PubMed1990

[Blood plasma amino acids and total protein, their elimination and catabolism during the hemofiltration of patients with acute kidney failure].

Intermittent hemofiltration (HF) was applied to the treatment of 8 patients (3 men and 5 women) with the grave pattern of acute renal failure (ARF) of prerenal origin. Altogether 23 sessions (from one to six in every patient) were performed with replacement of 44.3 +/- 2.8 1 liquid on the average. Two patients died. Of these, one female patient died from progressive peritonitis and sepsis and the other one from cisplatinum intoxication, bone marrow aplasia and sepsis. The content of blood plasma amino acids (AA), total protein and its fractions was measured before and after HF. Measurements were also made of excretion of those substances with filtrate. Besides, the amount of protein AA catabolized during the procedure was calculated according to the kinetics of urea. The authors hold that ARF-associated changes in the content of AA are primarily determined by adaptive shifts in metabolism. Differences in AA consumption were revealed to depend on the period and quality of adaptation. On the average HF brought about losses of 7.5 g AA and 73.1 g protein with filtrate. At the same time 37.5 g AA underwent oxidation, while urea generation rose 2-fold, amounting to 0.48 mmol/kg bw per hour. It is concluded that in ARF patients undergoing intermittent HF, it is necessary that anabolizing glucose and insulin therapy be applied together with replacement infusion of AA and (or) protein.

Acute Kidney Injury↗
PubMed1988

[Ways of intensification of hemodialysis therapy].

Three methods of intensive hemodialysis were compared: routine hemodialysis (HD) (12 h/m2/week), HD on a highly permeable membrane with ultrafiltration (ordinary in volume and increased up to 10.5 l), and hemodiafiltration with the replacement of 16.4 l. Clearance, pre- and postdialysis concentration in the plasma of urea, creatinine, phosphate and average molecular mass substances were analyzed during investigation; dynamometry was used at the beginning and end of investigation to assess right forearm muscle strength. Better results were obtained with hemodiafiltration. The successive use of three methods of hemodialysis resulted in the patients' improved somatic state and a significant increase in muscle strength. In the authors' opinion, the use of hemodiafiltration would facilitate rehabilitation and reduce a period of preparation of uremic patients for kidney transplantation.

Adult↗
PubMed1988

[Urea balance in the treatment of acute renal failure by hemofiltration].

Hemofiltration efficacy was assessed in 14 patients with acute renal insufficiency. Purification quality was controlled by the balance of urea as a marker of low molecular mass substances. Ten patients survived. Adequate purification could be attained with the help of hemofiltration disregarding the level of azotemia and catabolism. An indispensible condition for effective treatment was the substitution of an adequate volume of body fluid (approximately 1.2 volume). The effectiveness of the method could be enhanced as many patients tolerated filtration at rate of 200 ml/min and more. A substitution solution was adequately saturated with urea and purification efficacy corresponded to the rate of filtration. In prolonged anuria filtration procedures not less than 2 times a week were considered optimum.

Acute Kidney Injury↗