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350 times of hemodialysis were performed at Department of Urology, Hiroshima University Hospital during two years period, April 1967 to March 1969, with a modified Kiil dialyzer. Dialysis methods consisted of two-layer dialysis, two-layer dialysis with infusion of hypertonic solution, and one-layer dialysis. Clinical disequilibrium syndrome observed under the above methods was studied in conjunction with pre-and postdialysis BUN, serum osmolar changes, amount of water extraction and changes in acid-base balance.

1) EX-01 disposable dialyzer cartridge is a no-blood prime cuprophan dialyzer and cheape than Kolff's twin coil dialyzer. EX-01 dialyzer is better than dialyzer of other types with regard to dialysance, acid-base balance, ultrafiltration and effect on hematocrit. 2) We used 1% xylitol solution as a solution of dialysate. This is useful for diabetic renal failure, but care should be taken about various intestinal disorders. 3) Using EX-01 dialyzer, the Kolff type artificial kidney is well utilized even under today's Japanese medical situation in which shortness of hospital workers is a big problem.

Intermittent peritoneal dialysis with solution made by OTSUKA Seiyaku Co. was done on 5 patients with acute renal insufficiency and on 9 patients with chronic renal insufficiency. A total of 20 intermittent peritoneal dialysis was attempted and its results were discussed. An average decrease of 18.1 mg/dl of serum urea-N, 2.5 mg/dl of serum creatinine, 1.0 mEq/L of serum potassium and 2.7 mEq/L of serum phosphorus were found with one course of intermittent peritoneal dialysis. The average number of frequency, duration of dialysis and amount of solution used per one course were 16 times, 31 hours and 19 liters respectively. Serum sodium and chlorine were also improved. From the results, the intermittent peritoneal dialy s is appears to be inferior than Kolff Twin-Coil artificial kidney on dialytic efficiency of Urea-N and creatinine. It compares, however, favourably with the artificial kidney on the improvement of serum electrolytes, and it also gives less damage to patients and it has an advantage of simplicity of use on severe patients. The clinical use of intermittent peritoneal dialysis for the patient with renal insufficiency seems to be valuable.

The report deals with clinical experiences on blood dialysis performed at 78 times in 47 cases using the Kolff's twin coil kidney during the period of recent 6 years. 1) Analysis was made on the results obtained from 64 times of blood d ialysis performed in 35 cases in which clinical and laboratory findings were clarified. 2) Products of nitrogen metabolism in serum, such as NPN, creatinine, uric acid, BUN and amino-N were determined before, during and following dialysis. None of them showed separate and specific reduction. 3) In order to evaluate t h e effect of dialysis, dialysance was measured on serum NPN, creatinine and uric acid. At the mean blood flow rate of 200 cc/min., the mean dialysances for NPN, creatinine and uric acid were 120 cc/min., 100 cc/min. and 80 cc/min. respectively, indicating excellent dialytic efficiencies. 4) The dialysance relate d not only to blood flow rate but also to blood concentration of the substances, so that it reduced with lowering their blood levels. With long term blood dialysis, each substance was able to be decreased down to the normal range. 5) Determination of serum electrolites, such as Na, K, Ca, Cl and P disclosed that their levels normalized after blood dialysis for 4 hours. 6) Before and after blood dialysis, venous C O 2-combining power was measured which showed excellent effect on metabolic acidosis. 7) In all cases, increases in h e matocrit and decreases in serum protein level were demonstrated after blood dialysis. 8) For cases with ma r ked edema and anemia, use of high osmotic dialysate to remove excess water along with administration of blood transfusions resulted in readily correction of circulating blood volume and red cell volume. 9) Anemia in renal insufficiency wa s closely related to renal functions. Immoderate correction of anemia might results in acceleration of red cell destruction with marked azotemia. 10) The proper level of red cell count in anuric state was found to be around 2 to 2.5 milion per cubic milimeter. 11) Effect of low-K dialysate for hyperpotassemia appeared within a short period of dialysis with dramatic clinical improvements. However, in cases on digitalis it was necessary to remove the serum potassium rather slowly. 12) Intense and prolonged dialysis, such as with 200 cc/min. of blood flow rate for 10 hours, was feasible to perform. Appearance of myocard ischemic pattern in ECG during dialysis disappeared in about 30 minutes after discontinuation of dialysis. 13) For dialysis disequilibrium, use of high osmotic dialys a te was proved to have preventive effect. 14) An A-V shunt of our own made of siliconized polyethylen tube could be used for a long period up to 5 months, if it kept maintained good condition. 15) Using two apparatuses of infusion pump, the re g ional heparinization was performed. A prolonged blood dialysis was able to perform with small amount of hepa r in, 1, 000 units per hour, and amount of protamin sulfate. 16) The survival rate of our series o f 47 patients showed 25 % for the first half of 20 cases and 41 % for the latter half of 27 cases. It was confirmed that the earlier performance of blood dialysis is necessary to obtain the better prognosis.

Three patients with acute renal failure and 9 patients with chronic renal failure were treated by hemodialysis with the Kiil-type artificial kidney. During 2 year-period of April 1967 to March 1969, 350 hemodialyses in total were performed. Two of these patients with acute renal failure were relieved and 4 patients with chronic renal failure are still now being treated by hemodialysis. From these experiences, we investigated 1) method of dialysis, 2) efficiency of dialysis, 3) complications during dialysis, 4) suitability of dialysate.

1) Hemodialysis should be conducted with much less cost and personal labor under today's Japanese medical and social situation. 2) It was speculated that improvement of the carbohydrate metabolism during hemodialysis is related with escape of insulin antagonists and autoregulation of body fluid of uremic patients.

350 times of hemodialysis were performed at Department of Urology, Hiroshima University Hospital during two years period, April 1967 to March 1969, with a modified Kiil dialyzer. Dialysis methods consisted of two-layer dialysis, two-layer dialysis with infusion of hypertonic solution, and one-layer dialysis. Clinical disequilibrium syndrome observed under the above methods was studied in conjunction with pre-and postdialysis BUN, serum osmolar changes, amount of water extraction and changes in acid-base balance.

1) Hemodialysis should be conducted with much less cost and personal labor under today's Japanese medical and social situation. 2) It was speculated that improvement of the carbohydrate metabolism during hemodialysis is related with escape of insulin antagonists and autoregulation of body fluid of uremic patients.

1) EX-01 disposable dialyzer cartridge is a no-blood prime cuprophan dialyzer and cheape than Kolff's twin coil dialyzer. EX-01 dialyzer is better than dialyzer of other types with regard to dialysance, acid-base balance, ultrafiltration and effect on hematocrit. 2) We used 1% xylitol solution as a solution of dialysate. This is useful for diabetic renal failure, but care should be taken about various intestinal disorders. 3) Using EX-01 dialyzer, the Kolff type artificial kidney is well utilized even under today's Japanese medical situation in which shortness of hospital workers is a big problem.

Three patients with acute renal failure and 9 patients with chronic renal failure were treated by hemodialysis with the Kiil-type artificial kidney. During 2 year-period of April 1967 to March 1969, 350 hemodialyses in total were performed. Two of these patients with acute renal failure were relieved and 4 patients with chronic renal failure are still now being treated by hemodialysis. From these experiences, we investigated 1) method of dialysis, 2) efficiency of dialysis, 3) complications during dialysis, 4) suitability of dialysate.

Intermittent peritoneal dialysis with solution made by OTSUKA Seiyaku Co. was done on 5 patients with acute renal insufficiency and on 9 patients with chronic renal insufficiency. A total of 20 intermittent peritoneal dialysis was attempted and its results were discussed. An average decrease of 18.1 mg/dl of serum urea-N, 2.5 mg/dl of serum creatinine, 1.0 mEq/L of serum potassium and 2.7 mEq/L of serum phosphorus were found with one course of intermittent peritoneal dialysis. The average number of frequency, duration of dialysis and amount of solution used per one course were 16 times, 31 hours and 19 liters respectively. Serum sodium and chlorine were also improved. From the results, the intermittent peritoneal dialy s is appears to be inferior than Kolff Twin-Coil artificial kidney on dialytic efficiency of Urea-N and creatinine. It compares, however, favourably with the artificial kidney on the improvement of serum electrolytes, and it also gives less damage to patients and it has an advantage of simplicity of use on severe patients. The clinical use of intermittent peritoneal dialysis for the patient with renal insufficiency seems to be valuable.

The report deals with clinical experiences on blood dialysis performed at 78 times in 47 cases using the Kolff's twin coil kidney during the period of recent 6 years. 1) Analysis was made on the results obtained from 64 times of blood d ialysis performed in 35 cases in which clinical and laboratory findings were clarified. 2) Products of nitrogen metabolism in serum, such as NPN, creatinine, uric acid, BUN and amino-N were determined before, during and following dialysis. None of them showed separate and specific reduction. 3) In order to evaluate t h e effect of dialysis, dialysance was measured on serum NPN, creatinine and uric acid. At the mean blood flow rate of 200 cc/min., the mean dialysances for NPN, creatinine and uric acid were 120 cc/min., 100 cc/min. and 80 cc/min. respectively, indicating excellent dialytic efficiencies. 4) The dialysance relate d not only to blood flow rate but also to blood concentration of the substances, so that it reduced with lowering their blood levels. With long term blood dialysis, each substance was able to be decreased down to the normal range. 5) Determination of serum electrolites, such as Na, K, Ca, Cl and P disclosed that their levels normalized after blood dialysis for 4 hours. 6) Before and after blood dialysis, venous C O 2-combining power was measured which showed excellent effect on metabolic acidosis. 7) In all cases, increases in h e matocrit and decreases in serum protein level were demonstrated after blood dialysis. 8) For cases with ma r ked edema and anemia, use of high osmotic dialysate to remove excess water along with administration of blood transfusions resulted in readily correction of circulating blood volume and red cell volume. 9) Anemia in renal insufficiency wa s closely related to renal functions. Immoderate correction of anemia might results in acceleration of red cell destruction with marked azotemia. 10) The proper level of red cell count in anuric state was found to be around 2 to 2.5 milion per