The purpose of this study was to determine if a relationship existed between the change in serum osmolality in the chronic renal failure patient on hemodialysis and the number of clinical symptoms of the dialysis disequilibrium syndrome experienced during hemodialysis. The study was conducted at the Renal Dialysis Unit of an urban medical center located in a southeastern city. Data were collected from May 25, 1978 to June 30, 1978. Data were obtained during 28 hemodialysis procedures performed on 11 subjects. Serum osmolality measurements were collected prior to initiation of the dialysis procedure, at half-hour intervals during dialysis, and prior to termination of dialysis. Clinical symptoms which occurred during dialysis were recorded by the patients and nursing personnel. The hypothesis was that the number of clinical symptoms of the dialysis disequilibrium syndrome experienced by the chronic renal failure patient during hemodialysis will increase as the serum osmolality decreases.

MMed (Paediatrics), Faculty of Health Sciences, University of the Witwatersrand / This prospective observational study analysed iron studies and vitamin C levels in patients with chronic kidney disease attending Johannesburg Hospital Paediatric Nephrology Clinic. The rationale behind this study was to determine the extent of iron deficiency among patients in chronic renal failure. Vitamin C deficiency is common among dialysis patients, it is easy to test for and easy to prevent. This study may assist in guiding future management with regards to vitamin C supplementation in patients with chronic renal insufficiency on dialysis. The study contained 45 patients of which 27 (60 %) were male and 18 (40 %) were female. The ages of the children varied from 2 years 1 month to 19 years and 7 months. The study included patients from all ethnic groups; 9 were Caucasian, 33 African, 2 Indian and 1 Coloured. Two male patients did not have Vitamin C levels analyzed. The patients were divided into 3 distinct groups; firstly those patients on haemodialysis (12 patients), those on peritoneal dialysis (22 patients) and those not yet dialysed (11 patients). In all patients who were not yet on dialysis the GFR ranged between 18.1 and 45 ml/min/1.73m2. There were no statistically significant differences between the three groups when the results of the iron studies were analysed. However, despite iron treatment 26.6 % of patients were iron deficient as indicated by their transferrin saturation which was less than 20 %. Vitamin C levels were also analysed in this study. Forty one percent of children in chronic renal failure were vitamin C deficient. There was no statistically significant variability among the three groups. Two patients (4.6%) were noted to be Vitamin C toxic. One of these patients was haemodialysed; the other was not yet on dialysis. Vitamin C deficiency in chronic renal insufficient patients on dialysis is easily correctable when identified. Vitamin C in specific well documented doses is safe to administer to this group of patients. It will also enhance the absorption of iron and thereby have an indirect effect on anaemia.

BACKGROUND: Patients receiving haemodialysis (HD) treatment experience a significant symptom burden and their needs are multifaceted. In HD unit, patients receive treatment in a diverse cultural and open ward setting. However, patients‟ experiences of receiving HD treatment in an open ward setting are not known. OBJECTIVES: The central aim of this study was to explore and describe the experiences of patients receiving HD treatment in an open setting environment at an academic hospital in Johannesburg. DESIGN: A qualitative, exploratory and descriptive study was conducted at a public, tertiary level academic hospital in Johannesburg after obtaining ethical approval from Wits University and relevant authorities. SETTING: The research setting for this study was an adult Chronic Renal Dialysis Unit. POPULATION: Sixteen adult (age 18 and above) patients receiving chronic HD treatment were recruited purposively in this study. INTERVENTIONS: An in-depth semi-structured interview was conducted either before or after receiving HD treatment, which was audio-recorded, transcribed then analysed by using Giorgi Phenomenological method. FINDINGS: A mood enhancer appeared a major theme as participants positively valued the open setting environment for their overall and psychological well-being. Participants expressed by being with others and sharing experiences, a sense of community likened to a family developed. Common to all participants‟ language was the use of the “we” in relation to being in the open setting environment. This expression of the “we” by participants was interpreted as a community concept. The use of “we” associated with the concept of community described as a space to which every patient receiving HD belonged. They described their experiences in a collective manner. This was evident in repetitive reference to their common space, being together, sharing experiences, and finding identity from one another, being understood and a sense of being protected with personal relations that extend beyond 10 years for some. This open space contributed to shaping their perception of body image and illness. The nurse‟s role in timeously providing HD care was appreciated by many. However, being exposed to multiple situations of chronic illness and treatment a sense of fear developed. Any negative event experienced, watched, observed, or heard in the HD unit triggered fear in the patients. Two common fears were of HD complications and the constant threat of death. Complications such as clotting, muscle cramps and collapsing because of hypotension as well as watching somebody dying on the machine were all reported in this study and so psychological counselling was felt to be very important. CONCLUSION The recommendations proposed in this study hopefully will assist HD staff to intervene and make adjustments to support patients‟ holistic needs. Further studies into patients receiving HD in open settings and mixed-gender space are required for diversity of experiences and knowledge from different settings. Keywords: Haemodialysis, hospital environment, open setting, patient experiences

by Leung Cheuk Wa. / Thesis (M.Sc.)--Chinese University of Hong Kong, 1994. / Includes bibliographical references (leaves 97-106). / ACKNOWLEDGEMENTS --- p.i / LIST OF FIGURES --- p.v / LIST OF TABLES --- p.vi / SUMMARY --- p.1 / Chapter 1. --- INTRODUCTION --- p.3 / Chapter 2. --- BASIC ASPECTS OF CARNITINE / Chapter 2.1 --- BIOSYNTHESIS OF CARNITINE --- p.5 / Chapter 2.2 --- CARNITINE TRANSPORT --- p.8 / Chapter 2.3 --- THE ROLE OF CARNITINE IN INTRACELLULAR METABOLISM --- p.10 / Chapter 2.4 --- THE ROLE OF KIDNEY IN CARNITINE METABOLISM --- p.16 / Chapter 3. --- CARNITINE DEFICIENCY --- p.18 / Chapter 3.1 --- PRIMARY CARNITINE DEFICIENCY --- p.20 / Chapter 3.1.1 --- MYOPATHIC CARNITINE DEFICIENCY --- p.21 / Chapter 3.1.2 --- SYSTEMIC CARNITINE DEFICIENCY --- p.21 / Chapter 3.2 --- SECONDARY CARNITINE DEFICIENCY --- p.22 / Chapter 4. --- CARNITINE METABOLISM IN SELECTED DISEASES / Chapter 4.1 --- CARDIOMYOPATHY --- p.23 / Chapter 4.2 --- ORGANIC ACIDURIAS --- p.24 / Chapter 4.3 --- VALPROIC ACID THERAPY --- p.26 / Chapter 4.4 --- RENAL DIALYSIS ANDTRANSPLANTATION --- p.28 / Chapter 5. --- ANALYTICAL METHODS FOR CARNITINE ASSAYS --- p.30 / Chapter 6. --- DETERMINATION OF TOTAL AND FREE CARNITINE / Chapter 6.1 --- PRINCIPLE OF THE ASSAYS --- p.32 / Chapter 6.1.1 --- FREE CARNITINE DETERMINATION --- p.32 / Chapter 6.1.2 --- TOTAL CARNITINE DETERMINATION --- p.33 / Chapter 6.2 --- INSTRUMENTATION --- p.34 / Chapter 6.3 --- PREPARATION OF REAGENTS AND STANDARDS --- p.36 / Chapter 6.4 --- SPECIMEN COLLECTION --- p.42 / Chapter 6.5 --- SAMPLE PREPARATION --- p.43 / Chapter 6.6 --- ASSAY PROTOCOL FOR FREE CARNITINE --- p.44 / Chapter 6.7 --- ASSAY PROTOCOL FOR TOTAL CARNITINE --- p.46 / Chapter 6.8 --- FACTORS AFFECTING THE PERFORMANCE OF ASSAYS --- p.48 / Chapter 6.9 --- EVALUATION OF FREE AND TOTAL CARNITINE ASSAYS --- p.50 / Chapter 7. --- RESULTS OF EVALUATION OF TOTAL AND FREE CARNITINE ASSAYS / Chapter 7.1 --- CALIBRATION --- p.52 / Chapter 7.2 --- PRECISION --- p.55 / Chapter 7.3 --- LINEARITY RANGE --- p.56 / Chapter 7.4 --- RECOVERY --- p.58 / Chapter 7.5 --- INTERFERENCE OF ACETYLCARNITINE ON FREE CARNITINE ASSAY --- p.59 / Chapter 7.6 --- DISCUSSION --- p.59 / Chapter 8. --- STUDY IN NORMAL SUBJECTS / Chapter 8.1 --- SUBJECTS --- p.61 / Chapter 8.2 --- RESULTS OF THE NORMAL SUBJECTS --- p.61 / Chapter 8.3 --- DISCUSSION --- p.63 / Chapter 9. --- PATIENTS STUDY / Chapter 9.1 --- PATIENTS WITH CARDIOMYOPATHY / Chapter 9.1.1 --- SUBJECTS --- p.66 / Chapter 9.1.2 --- RESULTS OF THE STUDY --- p.66 / Chapter 9.1.3 --- DISCUSSION --- p.69 / Chapter 9.2 --- PATIENTS WITH METABOLIC DISEASES / Chapter 9.2.1 --- SUBJECTS --- p.71 / Chapter 9.2.2 --- RESULTS OF THE STUDY --- p.71 / Chapter 9.2.3 --- DISCUSSION --- p.74 / Chapter 9.3 --- PATIENTS ON VALPROIC ACID THERAPY / Chapter 9.3.1 --- SUBJECTS --- p.75 / Chapter 9.3.2 --- RESULTS OF THE STUDY --- p.75 / Chapter 9.3.3 --- DISCUSSION --- p.77 / Chapter 9.4 --- PATIENTS ON RENAL DIALYSIS AND AFTER TRANSPLANTATION / Chapter 9.4.1 --- SUBJECTS --- p.79 / Chapter 9.4.2 --- RESULTS OF THE STUDY --- p.79 / Chapter 9.4.3 --- DISCUSSION --- p.81 / Chapter 10. --- GENERAL DISCUSSION --- p.84 / Chapter 11. --- REFERENCES --- p.97

Renal failure uremia occurs when the kidneys fail to function properly. Despite being the main treatment, dialysis and other therapeutic approaches are not only associated with numerous long-term adverse complications often leading to morbidity and mortality events, but are also not affordable. Orally administrating Alginate-Poly-L-Lysine-Alginate microcapsules entrapping live yeast cells to treat renal failure uremia has not yet been investigated. In this thesis, the growth and microencapsulation of yeast were optimized. The efficacy of these microcapsules in removing unwanted electrolytes was tested in vitro in simulated gastro-intestinal media, in vitro in a column bioreactor and in vivo in an uremic rat model. Results showed that these novel microcapsules can not only maintain morphological stability and membrane integrity under gastro-intestinal environments and mechanical stresses, but also, preserve the viability of yeast. These microcapsules were successful in reducing urea concentrations while not harming the human GI tract's microbial flora.

Diss. (sammanfattning) Göteborg : Göteborgs universitet , 2007. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2001. / Härtill 5 uppsatser.

Thesis (M.C.T.M. (Clinical Tropical Medicine))--Mahidol University, 2002.

Thesis (M.H.S.A.)--University of Michigan, 1976.

Thesis (M.H.S.A.)--University of Michigan, 1976.