Abstract:
:The purpose of our study was to investigate the feasibility of using lactate as a complete or partial substitute for acetate in hemodialysis solutions. Six patients, each serving as his own control, were dialyzed once against a dialysis solution containing 40 mM acetate, once against a dialysis solution containing 40 mM DL-lactate and once against a dialysis solution containing 20 mM each of acetate and DL-lactate. Six additional patients underwent hemodialysis using acetate + lactate for a 3-week period, and the blood acid-base values during this period were compared to those obtained during periods when acetate was used. All dialysis treatments were well tolerated without hypotension or other clinical manifestations. When acetate + lactate was used, only a slight delay in the correction of acidosis during dialysis occurred and the net change in the plasma bicarbonate value appeared to be comparable to that measured with acetate. On the other hand, when lactate was used, the increase in the plasma bicarbonate level during and immediately after dialysis was reduced. With acetate + lactate, intradialytic blood D-lactate levels remained between 1 and 2 mM and returned promptly to near baseline within 1 h after dialysis. During 3 weeks of dialysis using acetate + lactate, predialysis plasma bicarbonate values were similar to those achieved when using acetate, but with acetate + lactate, the intradialytic plasma acetate levels were reduced by 50%. The results suggest that DL-lactate merits further evaluation as a potential base for hemodialysis solutions, and that both the D- and the L-lactate isomers are metabolized in maintenance hemodialysis patients.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
Nawab ZM,Armstrong MK,Weissberger LE,Ing TS,Hayashi JA,Daugirdas JTdoi
10.1159/000167515subject
Has Abstractpub_date
1987-01-01 00:00:00pages
434-9issue
6eissn
0250-8095issn
1421-9670journal_volume
7pub_type
临床试验,杂志文章abstract::The pathogenesis of calciphylaxis, a potentially life-threatening condition, is not well understood. Several factors such as end-stage renal disease (azotemia), hyperparathyroidism, hyperphosphatemia, hypercalcemia, a high calcium-phosphate product, and the use of steroids and cytotoxic drugs after kidney transplantat...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000169021
更新日期:1996-01-01 00:00:00
abstract::Two patients with a long-standing history of familial Mediterranean fever were found to have both microscopic hematuria and proteinuria during the acute attacks. Kidney biopsies from both patients revealed diffuse mesangial proliferative glomerulonephritis with intense mesangial IgA and C3 deposits and no evidence of ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167628
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND/AIMS:Patients on chronic hemodialysis have a high prevalence of heart disease and poor self-reported physical function. The association between structural heart disease and self-reported physical function in patients on hemodialysis is unknown. METHODS:We studied the association between elevated pulmonary a...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000431334
更新日期:2015-01-01 00:00:00
abstract::The relationship between abnormalities in nocturnal penile tumescence (NPT) and autonomic function, measured by the Valsalva maneuver, was evaluated in 25 uremic patients and 22 normal subjects. NPT in uremic patients (45 +/- 6.8 min/night) was lower (p less than 0.01) than in normals (85 +/- 10.4 min/night). Valsalva...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166629
更新日期:1982-01-01 00:00:00
abstract:BACKGROUND:Serum phosphorus concentrations reflect a dynamic balance between generation, exchanges, and removal. Time-averaged phosphorus concentrations (TAC(phos)) reflect the overall exposure better than single time-point concentrations, especially in dialysis patients treated with an intermittent modality. The prese...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000336308
更新日期:2012-01-01 00:00:00
abstract::Five patients with the clinical patterns of Bartter's syndrome underwent a series of clearance studies in order to characterize the underlying tubule defect. Free water generation during maximal water diuresis (CH2O), expressed as percentage of the distal delivery (CH2O + CCl), was lower in the patients (72.5 +/- 3.2%...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168451
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:We hypothesized that the difference between the prescribed end-dialysis body weight, defined end-dialysis over-weight (edOW; kg), and the body weight which is actually attained could impact survival in hemodialysis (HD) patients. The aim of this prospective observational study was to evaluate if edOW could i...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000349931
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND/AIMS:Living donor nephrectomy can be associated with increases in blood pressure several years following the procedure, but the best method to assess blood pressure during the living donor evaluation process is unclear. METHODS:Living kidney donors underwent casual clinic and ambulatory blood pressure monit...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000335070
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Pulmonary arterial hypertension (PAH) may lead to right heart failure and subsequently alter glomerular filtration rates (GFR). Chronic kidney disease (CKD, GFR <60 mL/min/1.73 m2) may also adversely affect PAH prognosis. This study aimed to assess how right heart hemodynamics was associated with reduced est...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000487198
更新日期:2018-01-01 00:00:00
abstract::This study was carried out to find out whether Ramadan fasting would affect the renal function in kidney transplant recipients with normal or impaired graft function. Twenty-three transplant recipients, 17 with a normal function and 6 with an impaired but stable function with plasma creatinine levels not exceeding 300...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013316
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND/AIMS:The elderly are the fastest growing subpopulation with end-stage renal disease. The goal of our study was to define characteristics of elderly patients who were considered ineligible for transplantation compared to those who were listed. METHODS:984 patients were referred for evaluation during a 2-year...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000354483
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Elderly patients with cardiovascular comorbidities are more likely to die before progressing to the need for undergoing hemodialysis; so deferring their predialysis vascular access (VA) surgery has been suggested. However, recent declines in cardiovascular mortality in the US population may have changed this...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000446159
更新日期:2016-01-01 00:00:00
abstract::Recent studies have focused attention on the possible role of zinc depletion in the pathogenesis of uremic symptoms such as dysgeusia and impotence. The present studies were undertaken to evaluate the prevalence of zinc deficiency and abnormalities of zinc metabolism in patients with end-stage renal disease. A total o...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167247
更新日期:1986-01-01 00:00:00
abstract::Administration of a single dose of 1,25-OH(2)D(3) can lower PTH levels for up to 4 days in chronic hemodialysis patients. Our purpose was to verify the effects of the same weekly dose of calcitriol per os given in one, two or three administrations, to patients on dialysis with secondary hyperparathyroidism. Thirty pat...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1159/000046197
更新日期:2000-11-01 00:00:00
abstract::This report reviews the features of 149 cases of renal allograft rupture, while adding a detailed description of 3 more cases to the English literature. From November, 1973 to November, 1979, 3 cases of renal allograft rupture occurred in 100 renal transplants performed at Research Medical Center, Kansas City, Mo., an...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166577
更新日期:1982-01-01 00:00:00
abstract::Accelerated atherosclerosis is both a cause and a consequence of chronic renal failure. Vascular smooth muscle cells (VSMCs) are an important component of atherosclerotic plaques, responsible for promoting plaque stability in advanced lesions. In contrast, VSMC apoptosis has been implicated in a number of deleterious ...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000097815
更新日期:2006-01-01 00:00:00
abstract::The treatment of the bleeding diathesis of renal failure remains unsatisfactory. 1-Deamino-8-D-arginine vasopressin (DDAVP) has recently been shown to shorten the prolonged bleeding time of renal failure and may as a result diminish the risk of clinical hemorrhage. We describe 2 cases where DDAVP was used successfully...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166773
更新日期:1984-01-01 00:00:00
abstract:BACKGROUND:African Americans (AAs) suffer the widest gaps in chronic kidney disease (CKD) outcomes compared to Caucasian Americans (CAs) and this is because of the disparities that exist in both health and healthcare. In fact, the prevalence of CKD is 3.5 times higher in AAs compared to CAs. The disparities exist at al...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000479481
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:There is a higher risk of gastrointestinal (GI) bleeding in patients treated with dabigatran versus warfarin. We analyzed the impact of renal function on the relative risk of bleeding in patients converted to dabigatran. METHODS:Patients aged ≥65 years who received anticoagulation with warfarin for a minimu...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000446848
更新日期:2016-01-01 00:00:00
abstract::Berengario da Carpi was magister of anatomy and surgery at the University of Bologna from 1502 to 1527. Eustachio and Falloppia defined him as 'the restaurator of anatomy'. He was a great surgeon, anatomist and physician of illustrious patients including Lorenzo II dei Medici, Giovanni dalle Bande Nere, Galeazzo Palla...
journal_title:American journal of nephrology
pub_type: 传,历史文章,杂志文章
doi:10.1159/000013452
更新日期:1999-01-01 00:00:00
abstract::Percutaneous angioplasty was attempted in 5 patients with acute renal failure due to occlusion of the artery to a solitary functioning kidney. Angioplasty was technically successful in all patients. Renal function was completely restored in 3 and renal perfusion improved in 1 patient. In the fifth patient, renal funct...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167517
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:Growth hormone (GH) resistance in CKD is partly due to increased expression of SOCS2, a GH signaling negative regulator. In SOCS2 absence, body growth is exaggerated. However, GH overexpression in mice causes glomerulosclerosis. Accordingly, we tested whether lack of SOCS2 improves body growth, but accelerat...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000508224
更新日期:2020-01-01 00:00:00
abstract::Both the Old Testament and the Talmud contain a great deal of information on medicine, nephrology, health and disease. The basic premise of early Jewish medicine is based on the notion that disease is due to structural changes in internal organs. This is in contrast to the mythical dogma of humoralism as the basis of ...
journal_title:American journal of nephrology
pub_type: 传,历史文章,杂志文章
doi:10.1159/000169107
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Medullary sponge kidney (MSK) is characterized by malformation of the terminal collecting ducts and is associated with an increased risk of nephrolithiasis, nephrocalcinosis, urinary tract infections, renal acidification defects, and reduced bone density. It has been historically diagnosed with intravenous p...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000358496
更新日期:2014-01-01 00:00:00
abstract::Radioisotopic methods for the determination of the glomerular filtration rate (GFR) are highly accurate but require the collection of multiple blood and urine samples and are costly to perform due to personnel, material, and analysis costs. Nonradioactive methods of GFR determination have the potential of minimizing p...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168985
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Interest in nephrology careers is declining, possibly due to perceptions of the field and/or training aspects. Understanding practices of medical schools successfully instilling nephrology interest could inform efforts to attract leading candidates to the specialty. METHODS:The American Society of Nephrolog...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000501058
更新日期:2019-01-01 00:00:00
abstract::A young woman presented with nephrotic syndrome due to membranous nephropathy and a localized form of giant lymph node hyperplasia (Castleman's disease) occurring as a large intra-abdominal mass. Five months after surgical removal of the mass, only mild proteinuria persisted. Twenty months later a second kidney biopsy...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000168127
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND/AIMS:Insulin is synthesised as a pro-hormone with an interconnecting C-peptide, cleaved during post-translational modification. This review discusses growing evidence which indicates that C-peptide is biologically active, benefiting microvascular complications associated with diabetes. METHODS:To explore th...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000289864
更新日期:2010-01-01 00:00:00
abstract::The removal of phenytoin by plasmapheresis in a patient with compromised renal function is described. The results indicate that plasma concentrations of total phenytoin increase after plasmapheresis, while unbound phenytoin plasma concentrations and free fraction decrease. The amount of phenytoin removed was 36 mg and...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167179
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:Chronic metabolic acidosis is a common metabolic disturbance and its clinical impact can be severe and extensive. The role and the change of the intrarenal renin-angiotensin system (RAS) during metabolic acidosis are uncertain, and whether acidosis can evoke inflammation remains unclear. METHODS:Male Spragu...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000328742
更新日期:2011-01-01 00:00:00