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Biomedical subjects

L Cioni

Publications and source records attributed to L Cioni.

29 records · Page 2Linked to original sources

Clinical experience with a new hemodiafiltration (HDF) system.

Purity of reinfusion fluid and dialysate is mandatory in high flux, high efficiency substitutive treatments for chronic uremia, particularly when using bicarbonate concentrates. Bags of sterile and pyrogen free substitution fluid are in part responsible for the high costs of these treatments. In order to overcome these problems, the authors tested a new monitoring system (MPS-10, Gambro) for high efficiency hemodiafiltration (HDF) in which the reinfusion fluid was prepared from bicarbonate dialysate by filtration. During 5 months time, 96 on-line HDF treatments were performed in five chronic uremic patients. We found the infusion fluid and dialysate containing bicarbonate free from bacteria and endotoxins, with a correct weight balance obtained by the monitoring system. The authors believe that MPS-10 is a safe and adequate system for the production of sterile, pyrogen free dialysate and reinfusion fluid for on-line HDF, hemodialysis (HD), and hemofiltration (HF).

Bacteria↗

IgA nephropathy (Clinical, pathological and immunological findings).

Seventy-five biopsy samples from patients with chronic renal disorders were examined by the usual techniques of light microscopy and immunofluorescence; in fifteen patients IgA nephropathy was found. These patients were young adults; the onset of the disease was characterized by macrohematuria, and recurrent episodes of hematuria were observed. Histological examination revealed proliferative endothelio-mesangial glomerulonephritis at various stages of development with focal or diffuse patterns; immunofluorescence revealed constant and intense positive reactions for IgA mainly in association with C3. It is assumed that there is a relationship connecting the more advanced histological changes, a more severe clinical course and the presence of IgM deposits.

Adolescent↗

Automatic continuous venovenous hemodiafiltration in cardiosurgical patients.

Intermittent substitutive treatments in severely ill patients with acute renal failure are difficult or not suitable because of technical problems and/or hemodynamic instability. Continuous venovenous hemodiafiltration allows an adequate, slow removal of fluid, electrolytes, and waste products by combining diffusive and convective solute transport. Eight patients with acute renal failure, after cardiovascular surgery and cardiogenic shock, were treated by continuous venovenous hemodiafiltration. An automatic system (Equaline System, Amicon Division, USA) was employed. Venous accesses (femoral or subclavian) were used with double lumen catheters. A polysulfone filter (0.4 m2) was used in the study. Blood flow was 30 ml/min and dialysate flow rate 16.6 ml/min. Sterile pyrogen-free hemofiltration substitution fluid was used as dialysate. Mean duration of treatment was 10.3 +/- 3.2 days. After 72 hours blood urea nitrogen levels dropped from 136 +/- 46.13 to 53.5 +/- 12.3 mg/dl and creatinine levels dropped from 6.9 +/- 1.7 to 2.6 +/- 0.9 mg/dl. A controlled steady-state was then maintained. Mean urea clearance was 21 +/- 5.3 ml/min; mean ultrafiltration rate was 20.3 +/- 4.1 L/day. Continuous venovenous hemodiafiltration, with the Equaline System, is effective for the clearance of waste products and is able to maintain perfect fluid balance in catabolic patients with acute renal failure and multiple organ failure.

Acute Kidney Injury↗