Piperacillin pharmacokinetics in subjects with chronic renal failure.

The pharmacokinetic parameters of piperacillin sodium were studied in eight volunteer subjects with chronic renal failure. Subjects were given a single 30-min intravenous infusion of 70 mg/kg (lean body weight) on their off-dialysis day. Blood was drawn from the contralateral arm at 15 and 30 min and 1, 3, 6, 9, and 12 h from the start of the infusion. Kinetic parameters were determined during the elimination phase with a one-compartment open model for linear kinetics. The following pharmacokinetic parameters (mean +/- standard deviation) were determined for the eight subjects: elimination half-life = 3.33 +/- 0.99 h, elimination rate constant = 0.22 +/- 0.06 h-1, apparent volume of distribution = 0.18 +/- 0.05 liters per kg, and total body clearance = 0.041 +/- 0.019 liters per kg/h. The mean peak serum concentration was 372 +/- 125 microgram/ml, and mean trough at 12 h was 39 +/- 27 microgram/ml. A dose of 70 mg/kg (lean body weight) or a dose of 4 g appears to provide adequate serum concentrations against susceptible organisms for a 12-h interval. No adverse reactions were noted in any subject throughout the study

Reduced taste function and taste papillae density in children with chronic kidney disease

Background: Taste loss may contribute to the loss of appetite in children with chronic kidney disease (CKD) and other serious medical conditions that result in malnutrition. Traditional methods for measurement of taste loss commonly use aqueous tastant solutions that can induce nausea, vomiting, or even pain in the mouth. An alternative is to measure fungiform papillae density on the anterior tongue since this correlates with taste sensitivity. Here we aimed to develop a non-invasive method for assessing papillae density on the anterior tongue and to use the method to determine if CKD patients [estimated glomerular filtrate (eGFR 89 ml/min/1.73 m2). Methods: Thirty-five healthy adults participated in the development of a method, which was assessed by 24 children, 12 of whom were CKD patients and 12 were clinical controls. Results: Similar papillae densities were found using invasive and non-invasive methods (F(1,34) = 0.647, p = 0.427). The CKD group had a significantly lower papillae density (X2 = 7.17, p = 0.007) and poorer taste sensitivity than the CC group (p = 0.0272), and the density correlated significantly with eGFR (r = 0.56, p < 0.01). Conclusions: Loss of taste in children with CKD is due to the reduced number of papillae and their taste-sensing receptor cells

Eletrencefalograma antes e após hemodiálise, diálise peritoneal e transplante renal: estudo de correlações da atividade de fundo com a bioquímica plasmática

Estudamos as correlações entre atividade de fundo no EEG e anormalidades bioquímicas do plasma em 49 pacientes com insuficiência renal crônica. Foi realizado estudo do EEG e bioquímico antes e após hemodiálise em 20 pacientes, antes e após diálise peritoneal em 14 e antes e após transplante renal em 15 pacientes. Observamos piora do EEG após hemodiálise e diálise peritoneal e melhora do EEG após transplante, sugerindo que em nossos pacientes as alterações da atividade de fundo induzidas pela uremia crônica eram reversíveis. Com base em nossos resultados, consideramos difícil estabelecer correlações entre o EEG e alterações da bioquímica plasmática. Entretanto, há correlação estatística entre hipernatremia, melhora da acidose metabólica, aumento da relação zinco/cobre e piora da atividade de fundo no EEG