低钙透析液及盐酸米多君对血液透析患者血压的影响

目的研究低钙离子浓度1郾25mmol/L透析液(DCa1郾25),及盐酸米多君对血透患者血压的影响。方法将透前或透后高钙血症的血透患者的透析液从DCa1.5换DCa1.25,如为出现低血压则透前停服降压药;如仍低血压或原透前未服降压药者给予盐酸米多君2.5mg或5mg。观察不同钙浓度透析及加用盐酸米多君后血压和血容量变化。所有病例检测超声心动图,以及立卧位血压和持续握力试验用以反映自主神经功能。结果本组患者共21例,男9例,女12例,年龄(54.4±14.2)岁,透析龄(33.04±30.1)月。换用DCa1.25后,9(42.9%)血例压稳定,例10(47.6%)透析中出现头晕、出汗或抽搐伴随低血压;1例仅下肢抽搐;1例心前区不适。低血压组立卧位血压实验阳性者比例显著高于血压稳定组(50%比0%,P<0.05),而超滤率、白蛋白、血红蛋白、并发症、心脏收缩舒张功能及左室肥厚比例均无显著差异。低血压组的10例患者中,停服降压药仍低血压或原未服药者共例,透析前530min予盐酸米多君2.5或5mg。DCa1.25透用析时血容量较DCa1.5明显下降[(81.6±2.09)%比(86.18±2.38)%,P<0.05),盐酸米多君可提升单用DCa1.25透析时血容量[(85.96±3.10)%,P<0.05]。结论本组使用DCa1.25的患者中约50%出现低血压,与其自主神经功能低下有关。出现低血压者可停服透前降压药,无效者或     

不同钙离子浓度透析液对血液透析患者钙平衡及甲状旁腺素的影响

目的研究不同钙离子浓度透析液对维持性血液透析(MHD)患者透析过程中钙平衡及全段甲状旁腺激素(iPTH)的影响,为透析患者个体化选择透析液钙离子浓度提供理论依据.方法 12例血钙正常的稳定的MHD患者分别使用钙离子浓度为1.25 mmol/L(DCa1.25)、1.5mmol/L(DCa1.5)和1.75 mmol/L(DCa1.75)的透析液进行血液透析(透析液其他成分不变),每次透析4 h.检测透析前后血清总钙(tCa)、离子钙(iCa)、iPTH及透析废液的iCa和磷(P),并对血压进行监测.结果使用DCa1.25时,患者体内丢失的钙平均为5.03mmol,但透后血iCa和tCa浓度与透前相比无明显变化,iPTH透后较透前显著升高(P＜0.05).使用DCa1.5时,患者体内钙的蓄积平均为1.4 mmol,透后血iCa和tCa浓度与透前相比明显升高(P＜0.01),其中25%的患者发生透后高血钙,iPTH较透前无明显变化;使用DCa1.75时,患者体内钙的蓄积平均为3.3 mmol,透后血iCa和tCa浓度比透前明显升高(P＜0.01),其中83.3%的患者发生透后高血钙,iPTH较透前明显降低(P＜0.01).3种透析液对血磷的清除无明显差异(P＞0.05).结论对于透前血钙水平正常的患者,DCa1.75的透析液明显增加了患者的钙负荷,增加了透后高钙血症的发生.DCa1.25的透析液能够明显减轻钙负荷,但长期使用应注意监测iPTH水平.对于透前轻度低血钙或在正常值低限的患者,DCa1.5的透析液是适用的,如果发生透后高钙血症,则应改用DCa1.25的透析液.     

含糖透析液对维持性血液透析患者血糖、血压及代谢的影响

目的 探讨含糖透析液对维持性血液透析(maintenance hemodialysis,MHD)患者血糖、血压及代谢的影响.方法 选择西安交通大学医学院第一附属医院血液净化科MHD患者50例,采用数字表法随机分为无糖透析液组、含糖透析液组,血液透析(hemodialysis,HD)时分别使用无糖透析液和葡萄糖浓度为5.5 mmol/L的含糖透析液,持续观察3个月,并检测患者每次透析开始、透析2h、透析结束时血糖和血压,及观察期前后的血清白蛋白、糖化血红蛋白、血脂等指标.结果 无糖透析液组低血糖和低血压的发生率均高于含糖透析液组(P＜0.05),两组患者透析各时间点血糖水平差异无统计学意义(P＞0.05).两组患者在观察期前与观察期结束后血清白蛋白水平、糖化血红蛋白、血脂等差异无统计学意义(P＞0.05).结论 维持性血液透析患者应用葡萄糖浓度为5.5 mmol/L的含糖透析液能降低透析过程中低血糖和低血压的发生率,且不影响血清白蛋白、糖化血红蛋白、血脂等指标,具有安全性、可靠性.     

不同钙离子浓度透析液对单次血液透析钙平衡的影响

目的观察三种不同钙离子浓度透析液对维持性血液透析患者单次透析过程中血钙的影响,为透析液钙离子浓度的个体化选择提供理论参考。方法选择2014年1月在哈尔滨医科大学附属第一医院血液净化中心接受维持性血液透析治疗的患者80例为研究对象,随机分为3组,根据使用不同钙离子浓度分别为1.25 mmol/L(DCa 1.25组)、1.5 mmol/L(DCa 1.50组)和1.75 mmol/L(DCa 1.75组)的透析液进行单次血液透析治疗,每次透析4 h,3组所用透析液除钙离子浓度不同外,其他透析液主要成分组间无差别。分别检测每组透析前、后及下一次透析前的血肌酐(SCr)、尿素氮(BUN)、血白蛋白(albumin,Alb)、血钙、血磷等生化指标,同时监测单次透析前后患者的血压变化。结果对患者透析前基线数据初步分析结果表明,透析前iPTH水平为(458.7±408.2)ng/L、血钙(2.2±0.2)mmol/L、血磷(2.1±0.6)mmol/L、钙磷乘积(57.4±18.9)。iPTH、血钙、血磷达标率分别为53.8%、46.3%,25.0%;透析患者普遍伴有低钙血症(占48.8%)、高磷血症(占71.3%)和高甲状旁腺素血症(占23.8%)。单次透析治疗结束后的血钙水平分别为DCa 1.25组(2.27±0.20)mmol/L、DCa 1.50组(2.53±0.21)mmol/L、DCa 1.75组(2.51±0.20)mmol/L,组间比较差异有统计学意义(F=12.52,P0.01)。与透析前相比较,3组透析后血钙浓度较透析前均有所增加;协方差分析结果表明,在扣除透析前血钙浓度的影响因素后,DCa 1.25组血钙平均增加量最小。单次透析结束后血钙达标率分别为65.4%(DCa 1.25组)、48.1%(DCa 1.50组)、58.8%(DCa1.75组);透析结束后高钙血症的发生率DCa 1.75组(占41.2%)与DCa 1.50组(占51.9%)明显高于DCa 1.25组(占19.2%)。三种透析液对透析患者的血磷、血压影响差异均无统计学意义(P0.05)。结论单次使用钙离子浓度为1.25 mmol/L的透析液治疗,对透析后血钙浓度的影响最小、血钙达标率最高、高钙血症的发生率最低;与钙离子浓度分别为1.50 mmol/L和1.75 mmol/L透析液比较,钙离子浓度1.25 mmol/L更接近人体生理离子钙浓度。     

观察长期使用不同钙浓度透析液对维持性血液透析患者PTH和血压的影响

目的 观察长期使用不同钙浓度透析液对维持性血液透析(HD)患者PTH和血压的影响.方法 将36例慢性肾功能衰竭维持性血透(MHD)患者随机分为两组,A组18例患者使用钙浓度为1.5 mmol/L的透析液,B组18例患者使用钙浓度为1.75mmol/L的透析液,观察透析36个月后患者血清离子钙(iCa)、磷(P)、甲状旁腺激素(PTH)及平均动脉压(MAP)的水平和临床表现.结果 B组有3例患者因高血压不能耐受试验退出.长期治疗后A组患者血清离子钙(iCa)、MAP明显降低(P＜0.05),血P无明显变化(P＞0.05),血PTH明显升高(P＜0.05);B组患者血清iCa、MAP明显升高(P分别＜0.001和＜0.01),血P无明显变化(P＞0.05)、血PTH明显降低(P＜0.05).两组患者中骨痛发生率A组为55.56％,B组为20％,部位多见于脚后跟和脚底,其次为膝关节;心律失常发生率A组为11.11％,B组为46.67％,心率失常的类型以阵发性房性期前收缩多见,其次为阵发性心房纤颤以及室性期前收缩.结论 维持性血液透析患者长期使用1.5mmol/L钙浓度的透析液后血离子钙明显下降,出现低钙血症,血PTH明显增高,肾性骨痛发病率增加,患者MAP下降;长期使用1.75 mmol/L钙浓度的透析液后血PTH明显下降,血清离子钙和MAP明显升高,骨痛发生率下降,但心律失常的发生率增加.     

探讨透析液钙浓度对血液透析患者血压及血清钙磷变化的影响

目的观察不同钙离子浓度的透析液对血液透析患者血压及血清钙磷代谢的影响,为血液透析患者的高血压及高钙血症的防治提供参考。方法选取我院血液净化中心维持性血液透析患者15例,采取自身对照的方法,先后应用钙浓度为1．75mmol／L（dCa2＋1．75）及1．50mmol／L（dCa2＋ 1．5）的透析液各连续进行35次透析,记录每次透析上机前、1h、2h、3h及透析结束后的血压,并分别于第1次及第35次透析前后观察一般临床指标及血清总钙、磷、钙磷乘积、甲状旁腺素及碱性磷酸酶的变化。结果两种透析液一般指标差异无显著性（P〉O．05）。与采用dCa2＋ 1．75相比,采用dCa2＋ 1．5进行透析,患者的血压降低,尤其在透析3h及透析结束后,差异有显著性（P〈0．05或P〈0．01）,透析后磷升高,差异有统计学意义（P〈0．05）,其他指标变化无显著性（P〉0．05）。结论透析液钙离子浓度与血液透析患者血压呈正相关,低钙透析液透析有助于维持性血液透析患者高血压的控制,但本研究未观察到其对血清钙浓度的影响。     

不同钙浓度透析液对血液透析患者钙磷代谢的影响

终末期肾衰竭伴有甲状旁腺功能亢进患者常常使用大剂量含钙的磷结合剂，应用高钙（1．75mmol／L）透析液等治疗，导致钙负荷增高，引起软组织、血管和心脏钙化，增加患者死亡率。孙鲁英等曾报道单次使用低钙（1．25mmol／L）透析液的疗效，但长期使用低钙透析对患者的影响报道甚少。为此，我们连续6个月分别使用两种钙浓度的透析液，观察其对患者血压、钙、磷和PTH的影响。     

低钙透析液治疗对维持性血液透析期间高血压患者的影响

目的：观察低钙透析治疗对维持性血液透析（ MHD）期间高血压患者的影响。方法：将61例维持性血液透析期间合并高血压的患者分为两组,对照组30例,为常规钙透析液组（1.75%）;治疗组31例,为低钙透析液组（1.25%）;记录患者在透析前及透析结束并静息30 min后的血压,研究期间对透析液钙离子浓度进行监测。在研究开始前及开始后对患者透析前后血钙及血磷情况每月进行检测,观察有无严重钙磷代谢紊乱情况,研究前后检测患者透析前后甲状旁腺激素（ PTH）水平。结果：不同透析液钙离子浓度对MHD期间血压的影响：两组治疗前,其收缩压及舒张压分别比较,差异无统计学意义（P〉0.05）;经过3个月的治疗观察,治疗组与对照组治疗后收缩压比较（134±13.2 vs 150±19.5）,P〈0.05,且舒张压比较（77±15.7 vs 89±19.2）,P〈0.05,说明不同透析液钙离子浓度对MHD期间高血压具有一定的治疗作用。不同透析液钙离子浓度对钙磷及PTH水平的影响：两组治疗前,其血钙、血磷及PTH分别比较,差异无统计学意义（P〉0.05）;经过3个月的治疗观察,治疗组与对照组治疗后血钙比较（1.9±0.13 vs 1.8±0.15）,P〉0.05;血磷比较（1.92±0.89 vs 1.89±0.99）,P〉0.05;PTH比较（267±44 vs 260±53）,P〉0.05,说明不同透析液钙离子浓度对MHD期间钙磷代谢及PTH水平无明显的影响。结论：低钙透析治疗对维持性血液透析（ MHD）期间高血压具有一定的治疗作用。     

生理浓度钙透析液对伴低甲状旁腺素水平血液透析患者矿物质及骨代谢的影响

目的观察生理浓度钙透析液对伴低甲状旁腺素水平血液透析患者矿物质及骨代谢的影响。方法将48例血清iPTH(65～150pg/ml)伴校正钙水平≥2.37mmol/L患者按使用透析液钙浓度不同随机分为:透析液钙浓度1.50mmol/L(DCa-1.50)与1.25mmol/L(DCa-1.25)两组;两组内按是否口服骨化三醇随机分为两亚组:口服骨化三醇(+Calcitriol)与非口服骨化三醇(-Calcitriol)组;治疗6个月。每3个月检测透前血清Ca,P,iPTH,ALP及BGP指标。结果观察结束时,DCa-1.5-Calcitriol,DCa-1.25+Calcitriol及DCa-1.25-Calcitriol组血清iPTH及BGP水平升高(P<0.05);DCa-1.25+Calcitriol及DCa-1.25-Calcitriol组血清Ca水平降低(P<0.05),Ca×P水平降低(P<0.05);DCa-1.5+Calcitriol组血清较同期DCa-1.25-Calcitriol组水平Ca水平增高(P<0.05);透前血清iPTH与BGP水平呈正相关(r=0.181,P<0.05)。结论生理浓度钙透析液能够减轻高钙负荷,持续有效刺激甲状旁腺素分泌及改善受抑制的骨代谢。联合骨化三醇及定期监测上述指标,可以安全有效的维持甲状旁腺素在适当水平不引发骨质疏松。     

低钙透析液对血液透析伴继发性甲状旁腺功能减退患者的临床研究

目的：探讨应用含钙1.25mmol／L浓度透析液进行血液透析对维持性血液透析（MHD）伴相继发性甲状旁腺功能减退患者的钙磷代谢和甲状旁腺功能的影响。方法：选择MHD6个月以上、病情稳定、连续2次血iPTH〈100pg／ml的患者60例,随机分为对照组（含钙1.5mmol／L透析液）和治疗组（含钙1.25mmol／L透析液）,每组各30例,观察时间6个月。观察并记录研究前、研究后l、3、6个月等不同时期患者血iPTH、血清校正钙、磷、钙磷乘积等指标的变化以及相关不良反应。另外,选择使用含钙浓度1.5mmol／L和1.25mmol／L透析液进行MHD的患者各20例,检测单次透析前、透析结束时以及下次透析前的血清校正钙、磷和iPTH浓度。结果：（1）治疗组单次透析后血清校正钙、磷和钙磷乘积均较透析前明显下降,iPTH浓度较透前明显升高,P〈0.01;而对照组上述血钙和iPTH浓度无明显变化;（2）透析后治疗组血清校正钙和钙磷乘积较对照组明显下降,血iPTH浓度较对照组明显升高,P〈0.01;两组血磷浓度差异无统计学意义。（3）治疗组1个月后血清校正钙、磷和钙磷乘积较治疗前开始下降,3个月后进一步下降,P〈0.05,6个月后各项指标趋于稳定;iPTH水平1个月后较治疗前明显升高,并随着治疗时间的延长,逐渐升高,P〈0.01。（4）对照组治疗后1、3、6个月上述指标与治疗前比较差异无统计学意义。（5）两组透析过程中出现的不良反应差异无统计学意义。结论：对于血iPTH〈100pg／ml MHD患者应用含钙1.25mmol／L透析液进行血液透析能较好地控制其血清校正钙、磷、钙磷乘积水平,有效地改善被过度抑制的甲状旁腺功能,并且安全性良好。     

低钙透析液对血液透析患者钙磷代谢及骨质重塑的影响

目的比较低钙透析液对长期血液透析患者钙磷代谢及骨重塑的影响。方法45例血清矫正钙≥9.5mgdl且iPTH≤150pgml患者随机分为透析液钙浓度1.25、1.5及1.75mmolL3组透析治疗3个月,观察3组患者血清Ca、P、Ca×P、iPTH、BGP、IGF1及IGFBP3水平差异。结果观察结束时,DCa1.5与DCa1.75组,血清Ca×P水平DCa1.5组无变化、DCa1.75组升高(P<0.05),IGF1水平2组均保持稳定;iPTH及BGP水平DCa1.5组升高(P<0.05)及DCa1.75组降低(P<0.05)。DCa1.25组血清Ca×P及IGF1水平明显降低(P<0.01),iPTH及BGP水平有显著升高(P<0.01)。透析前血清iPTH及BGP水平呈正相关(r=0.155,P<0.05)。结论低钙透析液可在有限时间内有效降低钙负荷及改善骨代谢。长期应用低钙透析液很可能通过增加iPTH、BGP水平及降低IGF1水平引发骨质疏松。     

Calcium balance and serum ionized calcium fluctuations in on-line haemodiafiltration in relation to ultrafiltration rate and dialysate calcium concentration

The use of high ultrafiltration rates in haemodiafiltration(HDF) has been suggested for improving the clearance of smalland large molecules. This strategy has become economically applicablewith the development of safe techniques for on-line productionof sterile infusate from dialysate, which enables us to infuselarge substitution fluid volumes without further increasingthe cost of the sessions. The effect of increasing the ultrafiltrationrate in HDF on electrolyte balance has not yet been evaluated.The aim of this study was to evaluate the effects of variationsof the ultrafiltration rate on calcium kinetics in HDF usingthree different dialysate calcium concentrations. Since theincrease in ultrafiltration rate augments the convective calciumloss, variations of intrasession calcium balance could resultfrom modifications of the ultrafiltration rate. In the present study we found no significant variations in calciumbalance and serum ionized calcium (iCa) levels during on-lineHDF treatment when increasing the mean ultrafiltration ratefrom 60 to 100 ml/min in the presence of an adequate and correspondingincrease in the infusion rate (from 2.5 to 5 l/h). During thebalance studies, pretreatment serum iCa was on the average 1.32mmol/l and weight loss 3.2 kg. Mean calcium loss during treatmentwas 2.8 and 3.3 mmol at infusion rates of 2.5 and 5 l/h with1.63 mmol/l of calcium in both the dialysate and infusate; calciumloss rose to 5.9 and 11.2mmol at infusion rates of 2.5 l/h andto 5.7 and 14.2 mmol at infusion rates of 5 l/h when the dialysateand infusate calcium was reduced respectively to 1.5 and 1.25mmol/l. Serum iCa significantly increased at the end of thesession with the higher dialysate concentration, while it decreasedto 1.28 mmol/l and 1.20 mmol/l with the lower two concentrations.Linear regression ana lysis showed no variation in serum iCaduring treatment when the iCa concentration in the dialysatewas equal to pretreatment serum iCa. A neutral calcium balancewould be expected using 1.75 mmol/l of calcium in the dialysate. In conclusion, increasing the ultrafiltration rate from 60 to100 ml/min did not significantly affect calcium kinetics inon-line HDF. The main factors affecting calcium mass transferand serum iCa fluctuation during treatment were the dialysatecalcium concentration and the iCa gradient between dialysateand pretreatment serum levels.     

Effect of gradually lowering dialysate sodium concentration on the interdialytic weight gain,blood pressure,and extracellular water in anuric hemodialysis patients

Background: The majority of hemodialysis (HD) patients are overhydrated and have high interdialytic weight gain (IDWG) which induces increased blood pressure (BP). The positive sodium balance resulting from a high sodium diet, a high dialysate sodium concentration (DNa), or a combination of both is major causes of this disease. We evaluated the effects of lowering DNa on IDWG, BP, and volume status in anuric HD patients with dietary sodium restriction. Methods: Thirty-two patients were enrolled in this study and the period was divided by phase 1 and 2 according to DNa which decreased from 140 to 135 mEq/L at a rate of 1 mEq/L per month; phase 1, 140 mEq/L; phase 2, 135 mEq/L. We compared the IDWG, BP, volume status measured by multifrequency bioimpedance spectroscopy, and adverse events such as intradialytic hypotension, cramps, and headache of both phases. Results: The IDWG was significantly reduced by 0.39?±?0.38?kg (p?=?0.000). Pre-dialysis BP showed significant reduction (systolic pressure 146?±?18 vs. 138?±?22?mmHg; p?=?0.012, diastolic pressure 80?±?10 vs. 75?±?11?mmHg; p?=?0.008). Pre-dialysis extracellular water (ECW) was reduced significantly by 0.13?±?2.22 L (p?=?0.02). There was no significant increase in adverse events (all p?>?0.05). Conclusions: This study showed that gradually lowering DNa could bring a significant reduction in pre-dialysis IDWG, BP, and ECW without increased adverse events. Large and crossover designed study will be needed to demonstrate the clear causal relationship.     

全血预冲血液灌流联合血液透析治疗重症心力衰竭合并肾功能衰竭患者的临床研究

目的 探讨重症心力衰竭合并肾功能衰竭应用全血预冲透析管路后血液灌流联合血液透析治疗后的疗效.方法 选择2007年6月至2009年6月牡丹江市第一人民医院肾内科和心内一科重症心力衰竭合并肾功能衰竭患者48例.应用全血预冲透析管路后血液灌流联合血液透析治疗.每天1次,连续3 d.每次治疗前、后分别观察患者动脉血气分析(碳酸氧根离子、pH值、动脉血氧饱和度、动脉血氧分压、肾功能(血尿素氮、血肌酐)、血红蛋白、呼吸、心率、平均动脉压、中心静脉压水平.治疗前和第3次治疗后分别观察患者腩钠素、肿瘤坏死因子α水平及左室舒张未期内径、左室收缩末期内径、左室射血分数.结果 治疗过程中患者生命指标和血流动力学稳定.全部患者在治疗期间无一例死亡.治疗过程中生命指征平稳,第1次治疗后呼吸、心率、血红蛋白、中心静脉压、碳酸氢根离子、pH值、动脉血氧饱和度、动脉血氧分压、血尿素氮、血肌酐指标比较差异有统计学意义(P＜0.05);平均动脉压治疗前、后比较差异无统计学意义(P＞0.05);肺部湿啰音明显减少,尿最逐渐增加.经3次治疗后脑钠素、肿瘤坏死因子α水平显著下降,左室舒张末期内径、左室收缩末期内径、左室射血分数显著改善(P＜0.01).结论 血液预冲透析管路(血液灌流联合血液透析)治疗重症心力衰竭合并肾功能衰竭患者临床疗效好,安全性高.疗效观察指标容易采取且简便易行.     

Long-term effect of uninephrectomy on serum creatinine concentration and arterial blood pressure

Medical records of patients having unilateral nephrectomies done between 1953 and 1978 at a university hospital were reviewed after 5 to 30 years of follow-up to determine if this procedure causes insidious renal insufficiency. Forty patients (selected from 571) ranging in age from 20 to 72 years met the following criteria for inclusion in the study: subject over 20 years of age at nephrectomy; initial serum creatinine concentration less than 1.6 mg/dL; normal arterial blood pressure (less than 150/90 mm Hg); absence of risk factors for chronic renal disease, eg, systemic lupus erythematosis, diabetes mellitus, chronic glomerulonephritis; an initial and a follow-up serum creatinine level; at least 5 years of follow-up. After a mean follow-up of 11.8 years, paired analysis of changes in serum creatinine concentrations showed insignificant differences between pre- and post-nephrectomy levels (0.19 +/- 0.11 mg/dL +/- SEM). Only one patient had a post-nephrectomy serum creatinine level above 2.0 mg/dL. Six patients (four women, two men) developed hypertension (15%) after uninephrectomy, an incidence of hypertension not greater than that found in the population at large. We conclude that uninephrectomy at ages older than 20 years does not lead to renal insufficiency or hypertension in adult patients with normal prenephrectomy serum creatinine and blood pressure levels.     

Thresholds of serum calcium oxalate supersaturation in relation to renal function in patients with or without primary hyperoxaluria

Systemic oxalosis is a constant feature in patients with primaryhyperoxaluria type 1 (PH1) and chronic renal failure (CRF) andis not prevented by regular dialysis (RDT), because removalcannot keep up with retention and overproduction of oxalate.These patients are candidates to kidney and/or liver transplantation,which should be ideally planned prior to the development ofoxalosis. However, methods to detect the presence and extentof oxalosis are invasive and poorly reproducible, and only indirectapproaches are feasible. Because supersaturation of body fluidsis an essential condition for oxalotic deposits to form, wehave assessed serum calcium oxalate saturation (ß_Caox)in 12 patients with PH1 and 26 with PH1-unrelated renal diseasesand varying degrees of CRF. Nineteen healthy individuals weretaken as controls. ß_Caox was closely dependent onoxalate serum levels. Serum oxalate and ß_Caox wereincreased in patients with CRF as compared to controls, andwere inversely related to GFR, assessed as creatinine clearance.However, at any level of GFR, both were always greater in PH1patients. From the slopes of the regression of ß_Caoxover CICr, saturation was predicted to be obtained at CICr ranging24–34 and 8–11 ml/min/1.73 m² in PH1 and non-PH1patients respectively. Based on the dependence of ß_Caoxon oxalate, saturation was associated with serum oxalate between44 and 46 µmol/l, irrespective of either the prevailingGFR or the underlying disease. These simple procedures representa valuable non-invasive tool to define the risk of systemicoxalosis and may assist in timing of transplantation.