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Query: UMLS:C0035078 (renal failure)
 31,970 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Nutritional assessment was performed on 47 patients admitted to a nephrology service; renal failure was present in 39 of the 47 patients. Values for serum albumin, total iron binding capacity, arm muscle circumference, triceps skin fold, and percent of ideal body weight for height and sex were determined. The 25 patients who had low serum albumin values at admission stayed in the hospital significantly (P less than 0.025) longer than those who had normal serum albumin values. No other abnormal nutrition-related finding or combination of findings was associated with a significantly (P less than or equal to 0.05) longer hospital stay. Low serum albumin values were also found in 11 of the 15 patients with infection. Low serum albumin values were far and away the most common abnormal nutrition-related findings in these infected patients in addition to the finding significantly (P less than 0.025) associated with a longer hospital stay.
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PMID:The utility of serum albumin values in the nutritional assessment of hospitalized patients. 680 97

Serum ferritin and bone marrow haemosiderin iron was studied in 50 non-dialysis patients with chronic renal failure, and in 53 healthy subjects. S-ferritin was correlated to marrow iron both in patients with renal failure and in healthy subjects (P less than 0.001). Geometric-mean S-ferritin in patients with 0- (1+) marrow iron was 33 micrograms/l, 1+ marrow iron 166 micrograms/l, and 2+ marrow iron 519 micrograms/l. Healthy subjects with 0- (1+) marrow iron had a mean S-ferritin of 16 micrograms/l and those with 1+ marrow iron a value of 65 micrograms/l. S-ferritin levels were higher in patients than in healthy subjects at all marrow iron grades (P less than 0.001). Healthy subjects with S-ferritin less than 15 micrograms/l had absent or reduced marrow iron, while those with S-ferritin greater than 30 micrograms/l had normal marrow iron. Using a critical S-ferritin value of less than or equal to 20 micrograms/l, the diagnostic efficiency in terms of diagnosing absent or reduced marrow iron was 0.90 (PV pos = 0.85, Pv neg = 0.91). In patients with renal failure S-ferritin less than 60 micrograms/l indicated absent or reduced marrow iron, while values greater than 80 micrograms/l were associated with normal marrow iron. The diagnostic efficiency of S-ferritin using a critical value of less than or equal to 60 micrograms/l was 0.94 (PV pos = 0.93, PV neg = 0.97). S-ferritin is a useful indicator of marrow iron stores in patients with chronic renal failure.
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PMID:Serum ferritin in non-dialysis patients with chronic renal failure: relation to bone marrow iron stores. 685 49

Forty-six patients marked renal failure and anemia underwent androgen therapy (up to 500 mg/week), as well as intravenous injections of iron preparations (600-800 mg/month) and hemotransfusions (2500 ml/month) for 4 month. Ferrokinetic indices, total marrow cellularity and erythrocyte and hemoglobin levels were determined at the end of therapy. Androgens were responsible for the increase in Hb level by 1.2 g%. High total bone marrow cellularity was observed in these patients (27.4 +/- 3.2 X 10(9) cells/kg, compared with 14.1 +/- 1.4 X 10(9) cells/kg in normal individuals). Hemotransfusions resulted in a decrease of Hb level by 1.3g% and total bone marrow cellularity to 8.3 +/- 2.2 X 10(9) cells/kg. Ferrokinetic indices became poor. The data obtained are discussed.
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PMID:Androgen therapy for anemia in renal failure. 722 71

Some of the toxic and nutritional aspects of trace elements in patients with renal failure are reviewed. Data are presented that tend to disprove the hypothesis that aluminum poisoning alone is responsible for dialysis encephalopathy. Possible dietary restrictions imposed in uremic patients may impair iron, zinc, copper, manganese, or chromium nutritive.
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PMID:Trace elements in uremia and hemodialysis. 739 73

Avoidance of homologous blood products and patients' demand for preoperative autologous blood donation programs are increasing. As many of these patients are older, with a compromised cardiovascular system and a slow response of the erythropoietic system when anemia occurs, the feasibility and benefit of autologous blood donation is often limited. Augmentation of preoperative blood donation by therapy with recombinant human erythropoietin (rHuEPO) has been described in animal models and in patients. METHODS. In a multicenter, controlled, randomized trial, 49 patients scheduled for orthopaedic or vascular surgery received 0 (control group, n = 9), 200 (n = 10), 300 (n = 11), 400 (n = 10) or 500 (n = 9) U/kg rHuEPO (Erypo, Cilag, Sulzbach, distributor Fresenius, Oberursel, Germany) subcutaneously twice a week for 3 weeks while every week 450 ml blood was collected. Iron sulphate 100 mg was prescribed orally twice a day. Patients were ineligible if they had uncontrolled hypertension, recent myocardial infarction, haematological disorders or a history of seizures. Blood donation had to be cancelled if the haematocrit was below 30%. RESULTS. There was a significant (ANOVA) drop of the haematocrit value only in the control group, and end-point values for haematocrit and haemoglobin were significantly elevated in the 400 and 500 U/kg groups compared with the control group (Table 9). DISCUSSION. The erythropoietic stimulus of phlebotomy for autologous blood donations is often not efficient enough to guarantee a constant haematocrit. Lowering of the preoperative haematocrit jeopardizes the aim of avoidance of homologous blood transfusions. rHuEPO increased the efficiency of autologous blood collections, as predonation haematocrit values could be preserved in the high-dosage groups. As a consequence, homologous transfusions could be avoided. However, there were broad interindividual differences in the erythropoietic response, possibly due to limitations in iron availability. Adverse effects of rHuEPO therapy, such as hypertension, thrombosis or neurologic disorders, are mostly reported in patients with terminal kidney failure. No such disturbances were observed in the present study. CONCLUSION. rHuEPO ameliorates the preoperative decrease of haemoglobin and haematocrit values due to autologous blood donations in a dose-related fashion. The individually adjusted dosage of rHuEPO and iron supplementation merits further investigation.
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PMID:[Erythropoietin therapy during frequent autologous blood donations. Dose-finding study]. 748 23

In nephrotic syndrome, iron is presented to the tubule fluid in a nonreactive form in association with transferrin as a result of the glomerular protein leak. At an alkaline pH, iron remains bound to transferrin throughout the nephron and is excreted as such in the urine. As urine pH decreases below 6, iron is dissociated from transferrin. In the dissociated form, iron exists in the urine in a soluble, ultrafiltrable, and labile state. It is suggested that iron is maintained in this state by chelation to a relatively small organic compound, such as citrate. This non-transferrin-bound iron is capable of catalyzing bleomycin degradation of DNA, suggesting that this labile form of iron is able to catalyze free radical formation and cause tubule cell injury. Urine from proteinuric states represents one of the few, if not only, biologic fluids containing large amounts of reactive iron species. This may explain the mechanism by which proteinuric states cause tubulointerstitial disease and renal failure.
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PMID:Urinary iron speciation in nephrotic syndrome. 753 96

The changes were compared of the iron curve in children with chronic renal failure and with terminal renal failure after oral loading dose of ferrous sulphate. Flat curve of absorption was found in both groups of patients with increased stores of systemic iron and high values of transferrin saturation index (TSI). Steep iron curve and very good absorption were found in all children with decreased serum level of ferritin and decreased TSI. The curves of iron absorption at serum ferritin level 250-500 ng/ml pointed to impaired absorption and depended on the initial TSI value and initial iron level in the serum. No significant differences were found in the shape of iron curve depending on dialysing methods. Studying of the iron curve and values of TSI in certain patients makes easier the decision of administration of treatment with oral iron preparations even with increased values of TSI and ferritin in the serum.
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PMID:[Assessment of iron absorption in children with chronic renal insufficiency]. 757 14

The ferroxidase activity of caeruloplasmin (EC 1.16.3.1) is an important antioxidant defence mechanism in man. In chronic renal failure proteins become carbamylated as a result of reactions with urea-derived cyanate. We have therefore investigated the effects of carbamylation on the ferroxidase activity of caeruloplasmin. Increasing degrees of carbamylation produce a progressive impairment of ferroxidase activity measured using o-dianisidine as substrate, and the ability of caeruloplasmin to load ferrous iron onto ovotransferrin is reduced. Carbamylation of caeruloplasmin may contribute to reduced antioxidant capacity in patients with renal failure.
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PMID:Carbamylation inhibits the ferroxidase activity of caeruloplasmin. 757 12

A 3-year-old female had fulminant hepatic and renal failure due to massive iron ingestion, despite gastric lavage, deferoxamine administration, hemodialysis and continuous arteriovenous hemofiltration. She underwent a successful emergency liver transplantation on 5th day after ingestion and was discharged 25 days later with excellent liver and renal function.
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PMID:Hepatic failure due to massive iron ingestion successfully treated with liver transplantation. 759 7

Administration of recombinant human erythropoietin (r-HuEPO) in uraemic pre-dialysis patients is both effective and safe. The benefits are similar to those in dialysis patients: a marked increase in subjective wellbeing and ability to perform physical work. There is a strong argument for treating on the basis of anaemic symptoms, rather than on absolute haematocrit or haemoglobin. Some 30-40% of r-HuEPO-treated pre-dialysis patients may need initiation of, or an increase in, antihypertensive therapy. Provided blood pressure is carefully controlled, r-HuEPO does not appear to accelerate the progression of renal failure, and there is preliminary evidence that it may even delay the need for dialysis in children and possibly in adults. Subcutaneous self-administration is convenient for most pre-dialysis patients; once weekly administration can yield effective results and may enhance patient compliance. As in dialysis patients, detection and correction of iron deficiency play an essential role in maximizing the success of r-HuEPO administration. For most pre-dialysis patients, oral iron administration is convenient, and absorption is satisfactory.
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PMID:Starting r-HuEPO in chronic renal failure: when, why, and how? 764 5


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