Joseph M. Letteri

Current Status of Renal Replacement Therapy for Acute Renal Failure

Although the management of acute renal failure (ARF) constitutes a major component of the activities of practicing nephrologists, minimal information is available on the dialysis techniques utilized to treat ARF in the USA. It is evident from several recent publications that there are wide variations in the dialytic and nondialytic management of ARF. In order to obtain a better understanding of the current practice for dialytic management of ARF, the National Kidney Foundation (NKF) Council on Dialysis commissioned a survey of NKF members. This article describes the results of this survey and provides a snapshot of the current management practices for ARF. It is our hope that this information will provide a baseline for further research in this area.

Phenylalanine Metabolism in Chronic Renal Failure

Fasting and 1 - 2-, 3- and 4-hour plasma phenylalanine levels following 50 mg/kg oral phenylalanine administration were increased above normal values in uremic patients. Plasma tyrosine concentrations, however, were not significantly different from normal values. The rate of plasma disappearance of phenylalanine was significantly longer in nondialyzed patients when compared to normal subjects and dialyzed uremics. These observations indicate that phenylalanine metabolism is altered in uremia.

Determinants of Oxygenation during Hemodialysis and Related Procedures

A decrease in arterial oxygen tension during hemodialysis has been attributed to a number of factors. In order to more completely define these factors, we studied respiratory gas exchange, arterial bl

Waldenström’s Macroglobulinemia, Mesangio-Capillary Glomerulonephritis, Angiitis and Myositis

This is a case report of Waldenstrom’s macroglobulinemia associated with mesangio-capillary glomerulonephritis, angiitis and myositis. The renal lesion was a major problem. The confinement of lymphade

Doxycycline (Vibramycin) in Chronic Renal Failure

Pharmacokinetics of doxycycline (DOX) were studied in patients with severe renal insufficiency. Plasma DOX, 2–6 h after ingestion of the drug, was no higher in uremic patients ingesting 200 mg daily t

Skeletal mass in long term hemodialysis patients.

Histomorphometric analyses of bone, bony radiographic analysis, bone densitometry and total body mineral content in hemodialyzed patients indicate that skeletal mass is quite variable in patients receiving hemodialysis for one to three years.1’2’3 No long term studies of skeletal mass are available in patients receiving hemodialysis treatments for five to ten years. This study estimates skeletal mass by measurements of total body calcium by neutron activation analysis.

The Pathogenesis, Treatment, and Possible Prevention of Uremic Bone Disease

Uremic bone disease can be classified into three major types based on histomorphometric analysis of double tetracycline labeling of iliac crest bone obtained by trephine (Table I). Type I consists of patients with high-turnover bone disease. Type II consists of patients with high-turnover bone disease in which the major manifestation of the abnormal mineral metabolism associated with uremia is metastatic calcification. Type III consists of patients with low turnover bone disease.