Margaret D. Bischel

Hypocalcemic Tetany Due to Sodium Phosphate Ingestion in Acute Renal Failure

The ingestion of a sodium phosphate laxative preparation (Phosphosoda, Fleed) in a patient who had acute renal failure resulted in hypocalcemic tetany primarily due to severe hyperphosphatemia. Hypernatremia and a marked anion gap were present and attributable in part to the sodium phosphate ingestion of this preparation in the presence of renal failure.

Successful Renal Transplantation in Patients Positive for Hepatitis B Antigen

Abstract We examined the effect of hepatitis B antigenemia on the outcome of renal allografts. Sixteen of 116 renal-allograft recipients were hepatitis antigen (HBs Ag) positive before transplantation. These HBs AG-positive patients had a graft survival of 60.3 and 30.2 per cent at one and two years. The mortality in the positive group was 18.9 per cent, and that in the negative patients was 19.8 per cent. The results of post-transplant hepatic tests in the two groups were similar. In seven other patients HBs Ag positivity was detected after transplantation. They did not differ from other patients with transplants in either hepatic or graft function. The mean period of post-transplant HBs Ag positivity was 16.5 months in this group of 23 patients. HBs Ag antigenemia acquired before transplantation or in the post-transplant period could not be correlated with hepatic dysfunction or poor graft survival. (N Engl J Med 291:62–65, 1974)

Hypersplenism in the Uremic Hemodialyzed Patient

A hypersplenic syndrome developed in a group of 15 chronic hemodialysis patients. Splenectomy eliminated or reduced the need for routine transfusion requirements; granulocytopenia, lymphocytopenia and

Copper Accumulation in Patients Undergoing Chronic Hemodialysis. The Role of Cuprophan

After each hemodialysis treatment using ethylene oxide sterilized Cuprophan as the dialysis membrane, plasma copper concentration increases. Blood plasma extracts copper from Cuprophan and liver coppe

Selective splenectomy in chronic renal failure.

Hypersplenism occurred in about 10 per cent of our patienrs with chronic renal failure. Sptenectomy corrected the hematologic abnormalities. Hypersplenic patients have critically impaired azathioprine tolerance. Because there are no significant detrimental effects of splenectomy in patients with allografts, evidence of hypersplenism should be sought and if detected the spleen should be removed prior to renal transprantation.

Phosphate-Binding Properties and Electrolyte Content of Aluminum Hydroxide Antacids

The phosphate-binding capacities of 19 liquid and solid aluminum hydroxide gel antacids were determined in vitro under varying pH conditions. The resulting data provide a basis explaining the phosphate-binding characteristics observed when patients are treated with long-term aluminum hydroxide therapy. No antacid, liquid or solid, showed significant binding at pH 1.0. Maximum phosphate binding (expressed as phosphorus; P) was observed at pH 2.0 and 3.0 for most antacids and decreased markedly at alkaline pH. The liquid antacids showed a significantly greater phosphate-binding capacity than did tablets or capsules (p less than 0.01). At pH 2.0, the liquid antacids bound a mean of 22.3 mg P/5 ml. At pH 8.0 binding was reduced to a mean of 7.3 mg P/5 ml. Significant interbrand differences were observed. At pH 2.0, the solid antacids bound a mean of 15.3 mg P/tablet or capsule. At pH 8.0, binding was reduced to a mean of 5.8 mg P/tablet or capsule. Interbrand differences, while substantial, were less than those observed among the liquid antacids. Variations in sodium and potassium content were clinically insignificant for most of the antacids in this study, while the differences in phosphate-binding properties were sufficient to warrant attention in the patient with renal failure.

T and B Lymphocytes in Uremic Patients with Type B Hepatitis Infection

Peripheral T and B lymphocytes were measured in (1) hepatitis B surface antigen (HBsAg)-positive, (2) HBsAg-negative uremic patients on chronic hemodialysis (CHD) therapy, and (3) patients with type B chronic active viral hepatitis (CAVH). When compared to normals, a decrease in the absolute number of T and B lymphocytes was detected in both CHD groups. CAVH patients had a decrease in the total number of T lymphocytes. When expressed as percentage of T lymphocytes, normals and HBsAg-negative CHD patients had similar values, while a decrease was detected in both HBsAg-positive CHD and CAVH patients. Also, in the latter two groups, hepatitis B virus infection resulted in an increase in the total number and percentage of null cells.

Editorial of the President of the International Society of Nephrology

Editorial of the President of the International Society of Nephrology As of January 1, 1972, the International Society of Nephrology’s Journal will be published by Springer-Verlag of New York, Heidelberg and Berlin. Because of this change, the Journal of the International Society of Nephrology will be called Kidney International after this date. I would like to take this opportunity to thank S. Karger for his help in creating the International Society of Nephrology’s Journal. The present Editors of the Society’s Journal, Dr. G. Richet, Dr. J. Dormont and Dr. G. E. Schreiner, are retiring. The Society is greatly indebted to these three individuals for the work they have put in during the past 8 years in nurturing the Society’s Journal from its beginning to the excellent position it now holds. Dr. Roscoe R. Robinson of Duke University Medical Center, Durham, N.C., will assume the Editorship of Kidney International on January 1, 1972. H. E. de Wardener President of the International Society of Nephrology