Muscle Water and Electrolytes in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

ABSTRACT. Muscle water and electrolytes were determined in percutaneous muscle biopsy material from m. quadriceps femoris in 33 uremic patients undergoing continuous ambulatory peritoneal dialysis (CAPD) for 1–38 months, and in 34 normal subjects. The patients showed increased muscle contents of water, sodium, and chloride relative to fat-free solids (FFS); both intra- and extracellular water contents were increased. The total water content was inversely correlated with the duration of CAPD. The muscle potassium content was increased, both relative to FFS and to magnesium, whereas the intracellular potassium concentration was normal. Despite hypermagnesemia, the muscle content of magnesium was normal and the intracellular concentration was even slightly decreased due to the increase in intracellular water. We conclude that muscle water and electrolyte status is abnormal in CAPD patients, but the alterations appear to be less marked than in uremic patients undergoing other forms of therapy.     

骨化三醇对腹透患者钙磷代谢及T淋巴细胞亚群的影响

目的 :了解骨化三醇 (1 ,2 5 (OH) 2 D3 ,罗钙全 )对腹膜透析患者钙磷代谢及免疫功能的影晌。方法 :观察 3 7例腹膜透析 (PD)患者服用骨化三醇前后血清T细胞亚群、IL 8以及血免疫反应甲状旁腺激素 (iPTH)、钙、磷水平变化。结果 :用药前PD组血清T淋巴亚群的CD4/CD8低于正常对照组 (P<0 .0 5 ) ,服用骨化三醇 4wk后 ,CD4/CD8从 0 .5 6±0 .1 0升至 0 .79± 0 .1 2 ;而iPTH显著降低 ,血钙显著升高 ,血磷明显下降。结论 :骨化三醇能改善PD患者钙磷代谢 ,进而改善其免疫功能     

In vivo release of cholecystokinin-like immunoreactivity in rat frontal cortex under freely moving conditions

Release of cholecystokinin-like immunoreactivity (CCK-LI) was measured in rat medial prefrontal cortex in vivo by brain dialysis and enzyme immunoassay under freely moving condition. Perfusion of 50 mM K⁺ resulted in the increase of CCK-LI in the dialysate. The data on high-performance liquid chromatography (HPLC) of the dialysate showed that the increase of the CCK-LI was mainly due to the increase of CCK octapeptide sulfate itself. In the preliminary experiments, we applied this brain dialysis method for determination of CCK-LI release with drug treatment. After treatment with sulpiride (i.p.), a D₂ dopamine receptor antagonist, a significant increase of CCK-LI was observed, indicating that this brain dialysis technique is applicable to detect change in the level of CCK-LI release after a certain drug treatment.     

An automated flow injection-serial dynamic dialysis technique for drug-protein binding studies

The interface of an automated flow injection analyzer with a dialysis unit to study drug-protein interactions using flow injection serial dynamic dialysis (FISDD) procedure is described. The method is based on the study of the kinetics of dialysis of the ligand in the absence and presence of protein. A study of the binding of sulfamethoxazole. sulfamethizole and sulfisoxazole to bovine serum albumin by means of such an automated system was undertaken to investigate the utility of FISDD technique for protein binding studies. The determination of dialysable sulfonamides was performed automatically by the FIA analyser. The influence of ionic strength and viscosity on the rate of dialysis was investigated. It was found that both variables did not affect the kinetic profile. Binding by the cellophane membrane was not encountered as a problem with the compounds studied. Binding parameters estimated for sulfamethoxazole were found to agree well with those reported in the literature. The Scatchard plots for the binding of sulfamethizole and sulfisoxazole with bovine serum albumin, revealed two classes of binding sites for each sulfonamide. The system was also used for the calculation of the dialytic rate constants. Experimental variables can be readily controlled to yield favoured conditions to study the protein binding phenomenon.     

应用IL-1β抗体预防术后腹腔粘连实验研究

目的 :研究白细胞介素 - 1β(IL - 1β)抗体预防小鼠术后腹腔粘连的能力。 方法 :以BALB/c小鼠为动物模型 ,经过同一标准的腹膜损伤手术后 ,30只BALB/c小鼠随机分为两组 :IL - 1β抗体治疗组 ,生理盐水对照组 ,分别在关腹前腹腔内灌注IL -1β抗体及生理盐水。术后 2 0d将小鼠处死 ,观察腹腔内粘连的情况 ,通过对粘连的程度、位置以及粘连类型的综合评价得出粘连分数。结果 :IL - 1β抗体治疗组的平均粘连分数 (1.2 2± 0 .35 )明显低于对照组 (2 .31± 0 .5 7) (P <0 .0 1) ,2～ 3级粘连发生率(2 2 .6 % )比对照组 (78.3% )亦有明显减低 (P <0 .0 1) ,无 1例小鼠出现腹壁切口疝。结论 :IL - 1β抗体能够预防术后腹腔粘连形成     

老年血液透析患者血压升高的机制及促红细胞生成素的影响

目的　探讨老年血液透析患者血压升高的机制以及基因重组促红细胞生成素(rHuEPO ,EPO)对维持性血液透析患者血管活性介质的影响。　方法　 5 2例老年血液透析患者 ,合并高血压者 2 3例 (HBP组 ) ,正常血压者 2 9例 (NBP组 )。检测血中血管活性介质 :内皮素 (ET)、肾素活性 (PRA)、醛固酮 (PA)、血管紧张素Ⅰ (AⅠ )、血管紧张素Ⅱ (AⅡ )、多巴胺 (DA)、肾上腺素 (E)和去甲肾上腺素 (NE)。NBP组中 15例静脉 1次注射EPO 30 0 0U(EPO组 ) ,14例作为对照 (NS组 )静脉注射生理盐水。均于注射后第 1、3、6、9、12、18、2 4、30、4 4h动态检测血中EPO和上述血管活性介质。　结果　 (1)与NBP组较比 ,HBP组DA (346 0 6± 137 12 )pmol/L、E (6 0 0 0 0± 4 36 36 )pmol/L和NE(4789 90± 1892 31)pmol/L明显增加 (P <0 0 5 ) ;(2 )与NS组相比 ,EPO组ET一过性升高 ,而DA、E和NE进行性升高 (P >0 0 5 )。　结论　老年血液透析患者血压升高和EPO引起的血压升高的机制可能与血中DA、E和NE增多有关。     

腹膜透析治疗肾功能衰竭28例

腹膜透析治疗急性肾功能衰竭5例,慢性肾功能衰竭23例。急性肾衰平均透析12天,2例痊愈;23例慢性肾衰采用不卧床持续性腹膜透析疗法,3例肾功能恢复,4例做家庭透析,13例仍在住院透析,3例因腹膜炎改做血透。267个透析病人月中,最短者56天,最长者5年半。腹膜炎发生率为4.6个病人月一次,平均每日蛋白质丢失11克。不卧床持续性腹膜透析,清除中分子物质清除率较血液透析高,病人感觉良好。     

肾脏透析对凝血和纤溶功能的影响

目的 评价肾脏透析对机体凝血和纤溶功能的影响。方法 30例慢性肾功能衰竭行维持性血透患者,于透析前1小时,透析开始后1小时,透后1小时、透后3天,分别检测:血小板计数(PLT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fib)、组织纤溶酶原激活物(t-PA)、D-二聚体(D-D)。结果透析开始后PLT下降(P<0.05),PT延长(P<0.05),APTT显著延长(P<0.01),术后恢复,透析后t-PA和D-D增高(P<0.05)。结论 肾脏透析可启动患者内源性凝血途径和继发性纤溶。     

Psychosocial adjustment and adherence to dialysis treatment regimes

Sixty children and adolescents in end-stage renal failure who were undergoing either haemodialysis or continuous ambulatory peritoneal dialysis at one of five United Kingdom dialysis centres were assessed on psychosocial adjustment and adherence to their fluid intake, diet and medication regimes. Parental adjustment was also measured and data on sociodemographic and treatment history variables collected. A structured family interview and standardised questionnaire measures of anxiety, depression and behavioural disturbance were used. Multiple measures of treatment adherence were obtained, utilising children's and parents' self-reports, weight gain between dialysis, blood pressure, serum potassium level, blood urea level, dietitians' surveys and consultants' ratings. Correlational analyses showed that low treatment adherence was associated with poor adjustment to diagnosis and dialysis by children and parents (P<0.01), self-ratings of anxiety and depression in children and parents (P<0.001), age (adolescents tended to show poorer adherence than younger children,P<0.001), duration of dialysis (P<0.05), low family socioeconomic status (P<0.05) and family structure (P<0.01). These findings demonstrate the importance of psychosocial care in the treatment of this group of children. Future research should develop and evaluate psychosocial interventions aimed at improving treatment adherence.     

Nutritional management in a child on chronic peritoneal dialysis: a team approach

The nutritional management of a child on chronic peritoneal dialysis (CPD) requires considerable dietetic input as frequent adjustments are necessary to account for growth and changes in biochemical parameters. The progress is described of a 6-year-old boy with chronic renal failure (CRF) from birth due to renal dysplasia. In contrast to the relative ease of overnight dialysis, feeding problems have been the major source of stress for the family. Management involves constant support using a multidisciplinary team approach. A recent renal transplant has resolved many of the problems.