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Background: There is controversy as to whether haemodialysis-membrane biocompatibility (ie, the potential to activate complement and neutrophils) influences mortality of patients with acute renal failure. We did a prospective randomised multicentre trial in patients with dialysis-dependent acute renal failure treated with two different types of low-flux membrane., Methods: 180 patients with acute renal failure were randomly assigned bioincompatible Cuprophan (n=90) or polymethyl-methacrylate (n=90) membranes. The main outcome was survival 14 days after the end of therapy (treatment success). Odds ratios for survival were calculated and the two groups were compared by Fisher's exact test. Analyses were based on patients treated according to protocol (76 Cuprophan, 84 polymethyl methacrylate)., Findings: At the start of dialysis, the groups did not differ significantly in age, sex, severity of illness (as calculated by APACHE II scores), prevalence of oliguria, or biochemical measures of acute renal failure. 44 patients (58% [95% CI 46-69]) assigned Cuprophan membranes and 50 patients (60% [48-70]) assigned polymethyl-methacrylate membranes survived. The odds ratio for treatment failure on Cuprophan compared with polymethyl-methacrylate membranes was 1.07 (0.54-2.11; p=0.87). No difference between Cuprophan and polymethyl-methacrylate membranes was detected when the analysis was adjusted for age and APACHE II score. 18 patients in the Cuprophan group and 20 in the polymethyl-methacrylate group had clinical complications of therapy (mainly hypotension)., Interpretation: There were no differences in outcome for patients with dialysis-dependent acute renal failure between those treated with Cuprophan membranes and those treated with polymethyl-methacrylate membranes.

Unlabelled: Bacterial endocarditis (BE) is one of the most severe complications of hemodialysis (HD). The aim of the study was to analyse frequency and severity of BE in patients treated with HD in our dialysis unit. During the period 1969-1993276 patients were treated with HD in Gdańsk. In 23 cases (9F, 14M) HD treatment was complicated with BE. Patients were divided into two groups on basis of diagnostic criteria: I-13 patients (5F,8M) with BE diagnosed by means of clinical picture and positive blood culture.; II-10 (4F, 10M) with diagnosis additionally confirmed by echocardiography. In patients from group I BE was observed more often during the first 2 years of HD. In group II during 3-5 years of dialysis therapy, gram negative microorganisms were the most frequent etiological factors. The mean period of antibiotic therapy was 35 days. In all patients from group II changes in the bicuspid valve, in 60% of them additionally in aortic valve and in one patient also in the tricuspid valve were observed. In five patients changes in the parietal endocardium were also present. Development of organic valvular changes was observed in nine patients. Seven of 22 patients died during the acute phase of BE and two others from complications connected with BE. The longest survival of patients after BE was over 10 years., Conclusions: 1. The threat of BE in patients treated with HD decreased between 1987 and 1993 in comparison with the initial period of our HD station operations.(ABSTRACT TRUNCATED AT 250 WORDS)

Recent observations indicate quite high incidence of tuberculosis (tbc) in haemodialysis population. But there are really only few reports of arthritis the infection. Mycobacterial process in this location may imitate many other pathological states. Our report refers to 45-year-old man with right knee the infection and the peri-arthritic tissue, which developed after 8 years of renal replacement treatment. No evidence of the was noted before. Chronic pain, swelling and instability of the knee led finally to surgical extraction of diagnostic material, which contributed to final diagnosis. We consider this report to be important because of only few reported cases of the arthritis. Additionally unnecessary delay in commencement of treatment may lead to bone destruction.