Renal failure patients, chronic

Ali, A. A. Ali, K.E. Fadlalla, A. Khalid, K.E. (2008). The effects of GA oral treatment on the metabolic profile of chronic renal failure patients under regular haemodialysis in Central Sudan. Natural Product Research, Vol.22, No.l, (January 2008), pp.12-21, ISSN 1478-6419. 

Bliss, D.Z. Stein, T.P. Schleifer, C.R. Settle, R.G. (1996). Supplementation with G A fiber increases fecal nitrogen excretion and lowers serum urea nitrogen concentration in chronic renal failure patients consuming a low-protein diet. The American Journal of Clinical Nutrition, Vol. 63, No.3, (March 1996), pp. 392-398, ISSN 0002-9165. 

Slow IV injection In chronic renal failure patients, iron sucrose may be administered by slow IV injection into the dialysis line at a rate of 1 ml (20 mg iron) undiluted solution per minute (ie, 5 min/vial) not exceeding 1 vial of iron sucrose (100 mg elemental iron) per injection. Discard any unused portion. 

Many chronic renal failure patients experience cramps, pain, nausea, rash, flushing, and pruritus. 

Clinical pharmacology Erythropoietin is instrumental in the production of red cells from the erythroid tissues in the bone marrow. The majority of this hormone is produced in the kidney in response to hypoxia, with an additional 10% to 15% of synthesis occurring in the hver. Erythropoietin functions as a growth factor, stimulating the mitotic activity of the erythroid progenitor cells and early precursor cells. Chronic renal failure patients often manifest the sequelae of renal dysfunction, including anemia. Anemia in cancer patients may be related to the disease itself or the effect of concomitantly administered chemotherapeutic agents. 

Drug interactions No formal drug interaction studies of darbepoetin with other medications commonly used in chronic renal failure patients have been performed. 

Anemia of chronic renal failure patients, zidovudine-treated HIV-infected patients and cancer patients on chemotherapy reduction of allogeneic blood transfusion in surgery patients... 

P. Z. lungers, A. Massy, T. K. Nguyen, C. Fumeron, M. Labrunie, B. Lacour, B. Descamps-Latscha and N. K. Man, Incidence and Risk factors of Atherosclerotic Cardiovascular Accidents in Predialysis Chronic Renal Failure Patients A Prospective Study, Nephrology Dialysis and Transplantation 12 (1997) 2597- 2602. 

Approval has been obtained for Phase II trials in chronic renal failure patients to use o-Raff-Hb (Hemo-sol) as an adjunct to erythropoietin. To date, no preliminary reports are available. 

Terawaki H, Suzuki T, Yoshimura K, Hasegawa T, Takase H, Nemoto T, Hosoya T. [A case of allopurinol-induced muscular damage in a chronic renal failure patient.] Nippon Jinzo Gakkai Shi 2002 44(l) 50-3. 

Netter P, Kessler M, Burnel D, Hutin MF, Delones S, Benoit J, Gaucher A. Aluminum in the joint tissues of chronic renal failure patients treated with regular hemodialysis and aluminum compounds. J Rheumatol 1984 ll(l) 66-70. 

To which extent techniques such as on-line he-modiafiltration and biofdtration or sorbent charcoal-based ultrafiltrate regeneration may alter trace metal levels in chronic renal failure patients is not yet clear and can only be evaluated by long-term longitudinal monitoring. 

Epoetin is indicated to treat anemia of chronic renal failure patients, anemia in /.idovudinc-treated HfV-infected patients. and in cancer patients taking chemotherapy. The results in these cases have been dramatic most patients respond with a clinically significant increase in hematocrit. 

Massy ZA, Khoa TN, Lacour B, Descamps Latscha B, Man NK, lungers P. Dyslipidaemia and the progression of renal disease in chronic renal failure patients. Nephrol Dial Transplant 1999 14 2392-7. 

The major effects of hyperphosphatemia are related to the development of hypocalcemia (caused by phosphate inhibition of renal la-hydroxylase) and its related consequences, as well as vascular and organ damage resulting from the deposition of calcium-phosphate crystals. Extravascular calcification can result in band keratopathy, red eye, pruritus, and periarticular calcification, especially in renal failure patients (see Chap. 44). In addition, soft-tissue calcifications in the conjunctiva, skin, heart, cornea, lung, gastric mucosa, and kidney have been observed, primarily in chronic renal failure patients." Hyperphosphatemia associated with chronic renal disease may result in renal osteodystrophy because of overproduction of parathyroid hormone. This condition is discussed in detail in Chap. 44. 

Soroka N, et al. Comparison of a vegetable-based (soya) and an animal-based low-protein diet in predialysis chronic renal failure patients. Nephron 1998 79 173-180. 

Frank T, et al. Assessment of thiamin status in chronic renal failure patients, transplant recipients and hemodialysis patients receiving a multivitamin supplementation. Int J Vitam Nutr Res 2000 70 159-166. 

Clinicians rely mainly on blood urea nitrogen (BUN) and serum creatinine measurements to evaluate patients with renal failure. Yet the correlation between symptoms and blood levels is at best approximate. In acute renal failure the underlying disease and its associated complications often dominate the clinical picture and determine the prognosis, and it is unclear at what level of nitrogen retention symptoms may be attributed to uremia. Clinicians generally institute dialysis when the BUN exceeds 100 mg/dl or the serum creatinine exceeds 10 mg/dl, but sometimes earlier or later, and early dialysis has not been shown to confer distinct benefits. In chronic renal failure, patients may be quite asymptomatic despite very high BUN and serum creatinine levels. Many so called uremic symptoms may be more properly attributed to anemia, heart failure, nephrotic edema and hypoproteinemia, hypertension, malnutrition, or uncontrolled diabetes or its complications, such as gastroparesis, diarrhea, and neuropathy. 

Adler AJ and Berlyne GM (1986) Silicon metabolism. Renal handling in chronic renal failure patients. Nephron 44 36-39. 

N. Selvaraj, Z. Bobby, A. K. Das, R. Ramesh, and B. C. Koner, An evaluation of level of oxidative stress and protein glycation in nondiabetic undialyzed chronic renal failure patients, Clin. Chim. Acta, 324 (2002) 45-50. 

Sekkarie MA. Torsades de pointes in two chronic renal failure patients treated with cisapride and clarithromycin. Am J Kidney Dis (199 30, 437-9. 

Chronic renal failure patients on hemodialysis and peritoneal dialysis are at risk for thiamine deficiency due to inadequate nutrition in part and possible thiamine loss during the dialysis process. Renal failure patients are often on a diet restricted in protein and potassium, which increases the risk of thiamine deficiency (Masud, 2002 Piccoli et al, 2006). Studies with detailed dietary surveys have shown poor oral intake of thiamine in chronic renal failure patients (Hung et al., 2001). There is no convincing evidence that thiamine levels are significantly altered by either hemodialysis or peritoneal dialysis (Reuler et al, 1985). DeBari et al (1984) measured thiamine levels of granulocytes, erythrocytes and plasma. They found no significant differences in thiamine levels in dialysis patients compared to controls. Further research in this area would benefit chronic renal failure patients and help determine possible need for supplementation of water-soluble vitamins. 

Kazi TG, Jalbani N, Kazi N, Jamali MK, Arain BM, Afridi HI, Kandhro A, Pirzado Z. Evaluation of toxic metals in blood and urine samples of chronic renal failure patients before and after dialysis. Ren Fail 2008 30 737 5. 

Respiratory In a single-centre institutional case series over a 6-month period a total of 67 supraclavicular blocks in patients with renal failure for arteriovenous graft formation were performed, and 3 cases of respiratory arrest occurred (4.5% incidence) [6 ]. The authors conclude that ipsidiaphragmatic paresis, a known complication of supraclavicular block and its associated drop in forced vital capacity is poorly tolerated by some chronic renal failure patients and contributed to the respiratory arrests. Underlying respiratory diseases in chronic renal failure patients such as sleep apnoea, pulmonary oedema and pleural effusions are potential risk factors and put this subset of patients at increased risk for respiratory failure following supraclavicular block. 

The H NMR spectra of the blood plasma from patients with chronic renal failure during dialysis, patients in the early stages of renal failure and normals have also been analysed. For patients on acetate dialysis, the method clearly showed how the acetate was accumulated and metabolized during the course of the dialysis, as well as allowing changes in the relative concentrations of endogenous plasma components to be monitored. A subsequent H, and N NMR study of the plasma and urine from chronic renal failure patients showed that the plasma levels of trimethylamine-N-oxide (TMAO) correlated with those of urea and creatinine, suggesting... 

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