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Biomedical subjects

M Feriani

Publications and source records attributed to M Feriani.

97 records · Page 6Linked to original sources
PubMedDate not supplied

Total solute extraction versus clearance in the evaluation of standard and short hemodialysis.

The authors compared the efficiency of standard HD (t = 240 minutes, Qb = 300 ml/min, Qd = 500 ml/min) with short HD (t = 150 minutes, Qb = 500 ml/min, Qd = 700 ml/min). The study was carried out in 11 patients in two sequential dialysis sessions, utilizing the same high surface area hollow fiber dialyzers, after a 2 day interdialytic period. With short HD, as expected, the clearance (Cl) of BUN, creatinine (Cr), and phosphates (P) was significantly higher than in standard HD:Cl BUN = 331 vs. 225, Cl Cr = 286 vs. 193, and Cl P = 231 vs. 176 ml/min. No significant difference in the total BUN extraction (measured on the total amount of exhausted dialysate) was found between the two techniques. As to Cr and P, despite higher Cl in short HD, the total extractions were significantly lower. In conclusion, in the evaluation of short HD efficiency, instantaneous Cl can be adequate for small molecules, while for larger solutes, other parameters, such as total extraction, must be considered.

Blood Flow Velocity↗
PubMedDate not supplied

Factors affecting bicarbonate transfer with bicarbonate-containing CAPD solution.

OBJECTIVE: To evaluate bicarbonate fluxes across the peritoneal membrane and bicarbonate gain in patients treated with continuous ambulatory peritoneal dialysis (CAPD) using dialysis solutions with different bicarbonate concentrations. PATIENTS AND DESIGN: Ninety-seven exchanges, using different dwell times and glucose and bicarbonate concentrations were performed in 43 stable CAPD patients. Dialysate effluent bicarbonate concentration and volumes were measured at different dwell times. Net dialytic bicarbonate gain was calculated. Patients' acid-base status was determined at the middle of the dwell. RESULTS: In prolonged dwells (6-12 hours) the dialysate effluent bicarbonate concentration correlated with arterial plasma bicarbonate concentration (F = 129, p < 0.0001), but not with ultrafiltration rate or dialysis solution bicarbonate concentration. In 4-hour dwells, effluent bicarbonate concentration correlated with both plasma bicarbonate concentration and ultrafiltration rate (F = 32.52, p < 0.0001 and F = 4.4, p < 0.05, respectively). The effluent bicarbonate concentration may be predicted from the patient's plasma bicarbonate concentration and net ultrafiltration rate for either a 4-hour or prolonged (6-12 hours) dwell time. Net bicarbonate gain by the patient correlated with ultrafiltration rate, plasma bicarbonate, and dialysis solution bicarbonate concentration (F = 100.56, p < 0.0001 at 4 hours and F = 108.08, p < 0.0001 at 6-12 hours), with the ultrafiltration rate being the predominant parameter. CONCLUSIONS: The effluent bicarbonate concentration is related to plasma bicarbonate concentration, with ultrafiltration playing a marginal role only during short dwells. However, the ultrafiltration rate has a profound effect on net patient bicarbonate gain. Multiple linear regression analysis allows the prediction of the effect of acid-base status, ultrafiltration, dwell time, and dialysis solution bicarbonate content on net patient bicarbonate gain. It seems that bicarbonate content in the CAPD dialysis solution should be progressively increased with increasing solution osmolality.

Acid-Base Equilibrium↗
PubMedDate not supplied

Clinical experience with a 39 mmol/L bicarbonate-buffered peritoneal dialysis solution.

OBJECTIVE: To investigate the effect on the patient's acid-base status of a 39 mmol/L bicarbonate-buffered continuous ambulatory peritoneal dialysis (CAPD) solution. DESIGN: This was an open, controlled, cross-over, two-center study in 9 patients. After three months of treatment with a 34 mmol/L bicarbonate-buffered solution (t0) patients were switched to a 39 mmol/L bicarbonate-containing solution for four weeks. At the end of the study period (t4) patients were again treated with a 34 mmol/L bicarbonate-buffered CAPD solution for one month (t8). RESULTS: Mean venous plasma bicarbonate level significantly increased during the study and decreased at the baseline level during the control period (t0 = 22.94 +/- 2.54, t1 = 26.74 +/- 3.07, t2 = 28.47 +/- 2.68, t3 = 28.11 +/- 3.56, t4 = 28.71 +/- 3.27, t8 = 24.94 +/- 2.56). Arterial blood pH and plasma bicarbonate significantly increased during the study and significantly decreased at the end of the control period (pH: t0 = 7.37 +/- 0.04, t4 = 7.42 +/- 0.04, t8 = 7.37 +/- 0.06. Bicarbonate: t0 = 21.97 +/- 2.57, t4 = 25.85 +/- 2.02, t8 = 21.87 +/- 2.89). The changes in plasma bicarbonate during the study period were inversely correlated with the metabolic acid production calculated from the protein catabolic rate and with the apparent distribution space for bicarbonate (ABS) of patients. CONCLUSIONS: The 39 mmol/L bicarbonate-buffered CAPD solution improved the patient's acid-base status. Potential undesirable metabolic alkalosis could be prevented by analyzing the ABS and the metabolic acid production of patients.

Acid-Base Equilibrium↗