The effect of aldosterone on water and electrolyte composition of incubated rat diaphragms.
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Adrenalectomy↗
Biomedical subjects
V S Lim
Publications and source records attributed to V S Lim.
Protein intake in patients with renal failure: comments on the current NKF-DOQI guidelines for nutrition in chronic renal failure.
The National Kidney Foundation Clinical Practice Dialysis Outcomes Quality Initiative (DOQI) guidelines recently recommended dietary protein intake for patients with chronic renal failure as follows: predialysis patients should receive 0.60 g/kg/day of protein and increase intake to 0.75 g/kg/day for subjects who cannot follow such a diet. For stable maintenance hemodialysis patients, the recommended protein intake is 1.2 g/kg/day, and for chronic peritoneal dialysis patients, 1.2-1.3 g/kg/day. We differ with these recommendations and believe that a dietary protein intake of 0.8 g/kg/day is appropriate for the predialysis population; an intake of 0.9-1.0 g/kg/day and 1.0-1.1 g/kg/day for maintenance hemodialysis patients and peritoneal dialysis patients, respectively, should be adequate. The rationale and the evidence supporting our arguments are outlined and discussed.
Clinical Trials as Topic↗
Tidal peritoneal dialysis. Urea and total nitrogen losses.
Tidal dialysis urea [NU] and total nitrogen [NT] clearances were obtained from nine patients, weighing 15-79 kg. Clearances normalized to a 70 kg body weight [nClr in ml/min/70 kg] increased with dialysate flow normalized to body weight [nFlow in ml/hr/kg]. The nClr [NU] = 6.862 + 0.352 x nFlow (r = 0.641, p less than or equal to 0.01). The nClr [NT] = 15.815 + 0.431 x nFlow (r = 0.460, p less than or equal to 0.01). Dialysate non-urea nitrogen [NT - NU] losses were 44.63 +/- 2.79 mg/kg daily, and these were altered minimally by the dialysate flow rate.
Adult↗
Is 8 hours of nightly peritoneal dialysis enough?
Eight hours of nightly tidal peritoneal dialysis (TPD) theoretically can provide uremia control equal that of continuous cyclic peritoneal dialysis (CCPD). To assess the in vivo validity of this prediction, six patients underwent mass transfer area coefficient (MTaC) measurements and dialysis using CCPD and TPD. CCPD consisted of five nighttime exchanges of 40 ml/kg and a daytime exchange of 20 ml/kg. TPD used an initial fill of 40 ml/kg and hourly tidal flows of 30 or 50 ml/kg. The nocturnal portion of CCPD lasted 9.7 hr (range 9.5-10 hr). TPD lasted 8.5 hr (range 8-9 hr) and was devoid of daytime dialysis. The patients consumed a diet containing 1.2 +/- 0.07 g protein/kg body weight (range 0.7-1.7 g/kg) and had a pre dialysis blood urea nitrogen concentration of 52 mg/dl (range 18-82 mg/dl). The dialysate clearances of urea and creatinine were indexed to patient size and extrapolated to weekly values. CCPD provided a weekly creatinine clearance of 50 L/1.73 m2 and a Kt/Vurea of 2.06. TPD with an hourly dialysate flow of 30 ml/kg achieved a weekly creatinine clearance of 42.8 L/1.73 m2 and a Kt/Vurea of 1.73. When the hourly dialysate flow was increased to 50 ml/kg, these values improved to 53.3 L/1.73 m2 and 2.15, respectively. Dialysis efficiency equal to that of CCPD can be obtained using 8 hr of TPD when membrane characteristics (mass transfer area coefficient) and dialysate flow rates are appropriate. Patients with normal or above normal mass transfer area coefficients can obtain a weekly Kt/Vurea exceeding 2.0 using nightly high flow TPD.
Creatinine↗