, Min A Park, Myung Jae Park, So Young Park, Seung Hyeun Lee Uremic pleuritis is a fibrinous pleuritis of unknown pathogenesis in patients with chronic kidney disease. Although it responds to regular dialysis or repeated thoracentesis, cases that are refractory to those therapies have been reported. We report a case of uremic pleuritis which showed marked improvement following corticosteroid therapy. The effusion was exudate, and negative in cytology and microbiology. Pleural biopsy revealed chronic inflammation with fibrosis. The pleural effusion did not respond to chest tube drainage and continuance of hemodialysis. With a diagnosis of refractory uremic pleuritis, we started methylprednisolone. The pleural effusion responded to the treatment and resolved without complication.
Citations
Patients receiving hemodialysis have been shown to be carnitine deficient due to many causes. Tissues, especially the skeletal muscle and myocardium, require carnitine for the production of energy. This study was performed to find out the effects of L-carnitine supplementation on muscular symptoms and cardiac functions in dialysis patients.
Among 72 hemodialysis patients, 40 patients who showed decreased free carnitine levels were selected to receive L-carnitine intravenously after each hemodialysis session for 6 months. Before and after supplementation, echocardiography, various neurologic examinations and questionnaires were obtained.
After carnitine treatment for 6 months (1~1.5 g per every hemodialysis session), the blood level of carnitine was increased more than 10 times (19.04±7.12 µmol/L
Regular L-carnitine supplementation on hemodialysis patients can improve their left ventricular ejection fraction and some parts of functionality.
, Duk Hee Kang, Gyu Bok Choi, Kyun Ill Yoon Patients undergoing maintenance hemodialysis(HD) potentially have an increased risk of exposure to viral hepatitis. The reported prevalence of antiHCV in hemodialysis patients varied widely form 7.6-54% according to dialysis center and there were there were many reports that showed the correlation between the prevalence of antiHCV and duration of HD or transfusion amount.
Fifty-four patients on regular hemodialysis at our hospital were evaluated for the presence of hepatitic C antibody(antiHCV) with the comparison of various parameters such as duration of HD, amount of transfusion, past history of hepatitis, serologic markers of hepatitis B and current liver function. AntiHCV using second-generation enzyme linked immunosorbant assay were found in six of 54HD patients(11.1%). Among six antiHCV(+) percent four patients were found to have HCV-RNA in their plasma detected by PCR. The percent of male patients were significantly higher in antiHCV(+) group(66.7 vs 31.3%, p<0.05). The positivity of antiHCV did not correlated with the duration of HD and amount of transfusion(p>0.05), but prevalence increased over 2 years (5.9% in 1991, 11.1% in 1993) and HBsAg prevalence remained unchanged(9.8% in 1991, 9.3% in 1993).
Therefore, regular follow-up of liver function test and use of separate machine for antiHCV positive patients may be needed to prevent the transmission of the hepatitis C virus during the hemodialysis process itself.
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