sodium-dodecyl-sulfate and Kidney-Failure--Chronic

The objective of this study was to evaluate the efficacy of a commercially available anti-itch lotion containing 1% pramoxine hydrochloride versus control lotion in the treatment of uremic pruritus in adult hemodialysis patients.. This was a randomized, double-blind, controlled comparative trial set in a community hemodialysis center. The study population comprised 28 individuals (mean age 53.5) with moderate to severe uremic pruritus who had been receiving hemodialysis for at least 3 months. All participants were recruited from one community hemodialysis center. Topical anti-itch lotion containing 1% pramoxine was applied twice daily to all affected areas of pruritus for 4 weeks. The main outcome measure was a reduction in itch intensity. Secondary outcomes included increases in the investigator's global assessment and improvement in skin hydration.. There was a 61% decrease in itch intensity in the treatment group, whereas a 12% reduction in itch intensity was observed in the control group. The rate of decline in itching was also greater in the treatment arm versus the control arm. No significant differences were displayed in other studied disease-related variables.. Our study shows that individuals using pramoxine 1% lotion experienced a reduction in pruritus to a greater degree than those using the control lotion. This safe, convenient and effective topical lotion may potentially benefit the large number of patients affected by pruritus associated with end-stage renal disease.

Topics: Administration, Topical; Adolescent; Adult; Aged; Dose-Response Relationship, Drug; Double-Blind Method; Drug Administration Schedule; Drug Combinations; Emollients; Female; Follow-Up Studies; Humans; Kidney Failure, Chronic; Male; Middle Aged; Morpholines; Pain Measurement; Patient Satisfaction; Probability; Propylene Glycols; Pruritus; Reference Values; Renal Dialysis; Sensitivity and Specificity; Severity of Illness Index; Sodium Dodecyl Sulfate; Statistics, Nonparametric; Treatment Outcome; Young Adult

Balkan nephropathy (BN) is an endemic disease, which leads to end-stage renal failure and artificial renal replacement therapy. Pathologically it is characterized by progressive interstitial nephritis in a large population of villages situated in the proximity of a bend of the Danube up to a distance of 100 km from the river in several parts of Bulgaria, Romania, and the former Yugoslavia. The urinary proteins of 19 patients with BN from the region of Vratza, Bulgaria were examined using ultrathin layer sodium dodecyl sulfate (SDS) pore-graduated polyacrylamide gel electrophoresis (PAGE) and silver staining. The documentation of urinary proteins pattern was performed using laser densitometry and consecutive electronic processing for the purpose of characterizing and quantifying protein excretion. Our results show that the proteinuria of BN is predominantly tubular, consisting of low molecular weight species (10-65 kilodaltons). The amount of tubular protein changes with the progression of the disease. SDS-polyacrylamide gel electrophoresis (PAGE) is a diagnostic method for early diagnosis of tubular failure in BN. Using our method of SDS-PAGE, tubular failure can be detected even at a total protein concentration below 0.1 g/L and when the serum creatinine concentration is normal. Additionally, our method of SDS-PAGE supports the differentiation of BN from glomerular disease.

Topics: Aged; Aged, 80 and over; Balkan Nephropathy; Blood Proteins; Coloring Agents; Creatinine; Densitometry; Diagnosis, Differential; Electrophoresis, Polyacrylamide Gel; Female; Humans; Kidney Failure, Chronic; Kidney Glomerulus; Kidney Tubules; Lasers; Male; Middle Aged; Molecular Weight; Proteins; Proteinuria; Regression Analysis; Renal Replacement Therapy; Silver; Sodium Dodecyl Sulfate; Surface-Active Agents

Many hormonal, metabolic and enzymatic alterations have been described in patients with chronic renal failure (CRF) after prolonged hemodialysis treatment. This toxicity has been associated with the accumulation of middle molecular weight components, called 'middle molecules', in their blood. To investigate the chemical nature of these molecules, 20 CRF patients were studied and compared with 10 control subjects. Sera from these individuals were treated with molecular exclusion chromatography, the components of high molecular weight were eliminated from the elution peaks, and the remainder was then concentrated by lyophilization. The zones of greatest concentration were fractioned by ionic exchange chromatography and by HPLC in reverse phase. Infrared spectroscopy was also performed on the most relevant zones, as well as SDS/PAGE. Finally, the amino acid sequence of a peak presenting the best conditions was analyzed. The results indicate that the majority of the compounds isolated are peptides, amino acids or amino alcohols, and that many of these 'middle molecules' are joined to trace metals.

Topics: Adult; Amino Acid Sequence; Chromatography, Gel; Chromatography, High Pressure Liquid; Electrophoresis, Polyacrylamide Gel; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Molecular Sequence Data; Molecular Weight; Plasma; Sodium Dodecyl Sulfate; Spectrophotometry, Infrared; Uremia

Of sixty patients with IgA nephritis, none had CRF at first examination, 13 developed CRF with creatinine above 1.6 mg/dl within 6 years. Among these patients who had analysis of proteinuria by sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE), 31 patients had middle molecular weight (MMW) proteinuria alone (pattern 1), 10 had MMW and Low MW (LMW) or tubular proteinuria (pattern 2), 10 had high MW (HMW) and MMW proteinuria (Pattern 3) and 9 had HMW, MMW and LMW proteinuria (Pattern 4). At the end of a follow up period of 6 years (1983-1989) patients with mixed proteinuria had a higher incidence of chronic renal failure (CRF), 11/29 (38%) compared to those with pattern 1 proteinuria, 2/31 (6%) (chi 2 = 8.7, p less than 0.005). Based on the glomerular selectivity index (GSI), 19 patients had nonselective proteinuria but they did not have a higher incidence of CRF. By the selectivity index (SI), 18 patients had nonselective proteinuria and they showed a significantly higher incidence of CRF. Compared to the 41 patients who did not have LMW proteinuria, 19 patients with LMW proteinuria had more severe proteinuria. After a follow-up period of 6 years, patients with LMW proteinuria had a higher incidence of CRF (10% versus 47%, p less than 0.001). The presence of LMW proteinuria indicates a less favourable outcome and the pattern of proteinuria as assessed by the SDS-PAGE appears to be a better prognostic index in IgA nephritis than the SI and the GSI.

Topics: Adult; Electrophoresis, Polyacrylamide Gel; Female; Follow-Up Studies; Glomerulonephritis, IGA; Humans; Incidence; Kidney Failure, Chronic; Male; Molecular Weight; Proteinuria; Sodium Dodecyl Sulfate

Human plasma beta 2-microglobulin was isolated in a good yield (more than 80%) from the haemodialysate (blood ultrafiltrate) of a patient with chronic renal failure. The isolation procedure consisted of Sephadex G-100 gel filtration and two steps of high-performance liquid chromatography: reversed-phase high-performance liquid chromatography and gel permeation chromatography. The purified beta 2-microglobulin was homogeneous by sodium dodecyl sulphate polyacrylamide gel electrophoresis and two-dimensional electrophoresis.

Topics: beta 2-Microglobulin; Blood Proteins; Chromatography, High Pressure Liquid; Electrophoresis, Polyacrylamide Gel; Humans; Immunodiffusion; Kidney Failure, Chronic; Renal Dialysis; Sodium Dodecyl Sulfate; Ultrafiltration