BACKGROUND Identification of the underlying causes of secondary hyperparathyroidism (SHPT) in individual patients on hemodialysis (HD) is hampered by the lack of clinically reliable information on calcium balance. The aim of this study was to assess calcium balance during HD sessions with a method that is applicable in day-to-day practice. METHODS Plasma ionized calcium (pCa2+) and parathyroi...

makes multiple tracer studies more complicated." In reply to their query the method used to measure the loss of potassium from the dialysate, which was 150 mEq in my series', was a direct measurement. The statement by them that: "there is a wide range of potassium status in patients with chronic renal failure being maintained with haemodialysis" contradicts their next statement that: "The absen...

The cirrhotic patient with ascites presents unique challenges to the renal caregiver. This patient population has relative contraindications both to hemodialysis (HD) and to peritoneal dialysis (PD). Challenging hemodynamics and the bleeding risk from acquired coagulopathy make HD problematic. In PD, tense ascites can increase the risk of early catheter leak and complicate the initial instillat...

A 24-year-old woman who had sustained serious injuries in a road traffic accident required renal dialysis daily and was fed intravenously with a solution containing 25% dextrose. Subsequently insulin had to be added to the parenteral fluid to maintain blood glucose concentrations at physiological values. On one occasion parenteral feeding was continued until dialysis was started; she became com...

BACKGROUND Nocturnal hemodialysis (NHD) is an alternative to conventional three times per week hemodialysis (CvHD) and has been reported to improve several health outcomes. To date, no randomized controlled trial (RCT) has compared NHD and CvHD. We have undertaken a multi-center RCT in hemodialysis patients comparing the effect of NHD to CvHD on left ventricular (LV) mass, as measured by cardia...

BACKGROUND The feasibility of anticoagulating the extracorporeal circuit during haemodialysis using a simple citrate-enriched dialysate was evaluated in a prospective, randomised, cross-over study of 24 patients who were at high risk for bleeding. METHODS A dialysate, with a citrate level of 3 mEq/L (1 mmol/L), was generated by adding citrate to the conventional liquid 'bicarbonate concentrat...

BACKGROUND Haemodialysis with the Hemocontrol biofeedback system (HHD) is associated with improved haemodynamic stability compared with standard haemodialysis (HD) (SHD). Although the beneficial effect of HHD on haemodynamic stability is generally explained by its effect on blood volume, we questioned whether additional factors could play a role. Since HHD is associated with higher initial dial...

The intended function of dialysate fluid is to correct the composition of uraemic blood to physiologic levels, both by reducing the concentration of uraemic toxins and correcting electrolyte and acid-base abnormalities. This is accomplished principally by formulating a dialysate whose constituent concentrations are set to approximate normal values in the body. Sodium balance is the cornerstone ...