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Certain amino acids such as glycine, L-aspartic acid, L-glutamic acid, L-glutamine, L-histidine and L-arginine taken orally by normal adults or patients with renal failure increase glomerular filtration rate (GFR). Twelve nondiabetic patients suffering from glomerulonephritis confirmed by renal biopsy previously, with creatinine clearances ranging from 15 to 24 ml minute/1.73, and on low protein diet 0.6 g/kg/day, received an amino acid supplement daily in 2 or 3 doses for 1 year. At 4, 8 and 12 months creatinine clearance increased slightly (NS, NS, NS), 24 hour urine volume increased (P ≤ 0.001, 001, 0.001), 24 hour albuminuria decreased (P < 0.001, 0.001, 0.001), serum urea increased (NS, NS, NS) serum albumin increased (NS, 0.05, 0.05), total cholesterol decreased slightly (NS, NS, 0.01), HDL increased slightly (0.05, 0.05, 0.05), LDL decreased (NS, 0.001, 0.001) triglycerides decreased (0.001, 0.001, 0.001), Apo B remained unchanged (NS, NS, NS), ROS/H2O2 decreased (0.001, 0,001, 0.001), Hct increased (NS, 0.01, 0.01) Hb increased (0.05, 0.05, 0.05) and serum phosphate decreased (0.01, 0.01, 0.01). After removal of supplements at the end of the year all parameters remained unchanged. We believe that a large controlled study should be undertaken to confirm these most encouraging findings. © 2004 Kluwer Academic Publishers.

In two earlier publications we reported excellent therapeutic results in patients with recurrent calcium nephrolithiasis, using oral or intravenous i.v. sodium thiosulfate on the one hand, and on treatment of tumorus-soft periarticular tissues calcifications on the other. Thus, we considered useful to measure endogenous thiosulfaturia, using a specific HPLC method, in 25 healthy adult males and 25 patients with recurrent calcium nephrolithiasis. Healthy adult males excreted between 11 and 16 μ M/24 hour of endogenous thiosulfate, while patients with recurrent calcium nephrolithiasis excreted significantly lower amounts of 6 and 10 μ M/24 hour, except one patient, who did not excrete endogenous thiosulfate, reflecting probably a genetic abnormality. Thiosulfate is a unique agent for treatment of recurrent calcium nephrolithiasis as well as some other abnormal calcium depositions. Two doses of 5 mM sodium thiosulfate daily are therapeutically sufficient. © 2004 Kluwer Academic Publishers.

Urinary calcium excretion increases by 1-2-fold during gestation in normal, uncomplicated pregnant women. Hypercalciuria occurs in all trimesters and elevates urine supersaturation with regards to calcium oxalate. However, crystalluria has not been a frequent clinical finding and stone formation is not a common complication of pregnancy. To elucidate this discrepancy we measured various chemical entities (i.e. calcium, oxalate, uric acid, phosphorous, magnesium, citrate, sulfate and thiosulfate) in urine at the end of each trimester of 25 pregnant women. Twenty-five healthy women served as controls. Our observations show that endogenous thiosulfate, a natural component of urine, increased considerably during pregnancy to approximately 36, 38 and 40 μ M/24 hour at the end of each three trimesters. One month after delivery, endogenous thiosulfaturia and hypercalciuria, in parallel, returned to initial normal values. Consequently, it seems that gestational hyperthiosulfaturia protects hypercalciuric normal pregnant women from the risk of nephrolithiasis. © 2004 Kluwer Academic Publishers.

A specified stable bicarbonate/glycylglycine dialysate for hemodialysis (HD) analogous to those introduced by us for continuous ambulatory peritoneal dialysis (CAPD) is described. HD with this single dialysate is simple, easy, safe and of reasonable cost. Results obtained from 6 HD patients proved its superiority against acetate dialysate. Bicarbonate/glycylglycine dialysate is also more stable, harmless and easier to use than bicarbonate dialysate prepared on-line.

Five patients on maintenance hemo dialysis for more than five years, who had tumoral calcifications, were treated by sodium thiosulfate for three to IS months. Four patients with periarticular and soft-tissue calcifications achieved regression of varying degrees and the motion of the adjacent joints was considerably improved. The fifth patient had calcification of penis; sodium thiosulfate produced early relief of symptoms and later complete disappearance of the calcification.

In 32 patients undergoing continuous ambulatory peritoneal dialysis (CAPD) and in 56 healthy subjects, ferroxidase I (ceruloplasmin) and ferroxidase II activity were estimated in serum; in 12 of the 32, it was also measured in peritoneal fluid. Serum ferroxidase I was normal, while ferroxidase II was significantly increased. Peritoneal fluid contains appreciable amounts of ferroxidase I, but no ferroxidase II. The serum ferroxidase profile of patients on CAPD differs from that of hemodialysis (HD) patients; in the latter, both ferroxidases are significantly increased. This difference could be accounted by the loss offerroxidase I in the peritoneal fluid.

To the Editor.— We had the opportunity to observe a case of extremely severe barbiturate poisoning characterized by the early appearance of multiple bullous lesions on the ocular conjunctiva and skin. We were not able to find a previous report of bullous lesions on the ocular conjunctiva. The patient was a 23-year-old man. Ten hours after taking 17.5 gm of phenobarbital he was in profound coma with shallow respiration and cyanosis, with a temperature of 37.8 C; pulse rate, 120 beats per minute; and blood pressure, 100/80 mm Hg. Corneal, tendon reflexes, and reaction of the pupils to light were absent. There was no response to painful stimuli and no bowel sounds were heard. The eyelids were swollen. There were bullae of considerable size on the ocular conjunctiva (Figure). Similar lesions developed on the skin of the heels four to eight hours later. Details of treatment, clinical course, and laboratory