Tuesday, September 28, 2010

IN THE NEWS- Intestinal Dialysis

Recently in Connecticut, a whale was dialyzed and acute renal failure treated with intestinal dialysis. No catheter was needed. Mannitol was used and BUN and Crt came down.


You can check it out at the following website.
http://today.uchc.edu/features/2010/may10/whale.html

We think of mostly three modalities when it comes to Renal Replacement Therapy( HD, PD and Transplantation).  In some countries, they still use an another option as mentioned above. Intestinal dialysis, the patient is given soluble fibers such as mannitol, charcoal, acacia gum which then leads to increased nitrogenous fecal wasting leading to decreasing BUN and Crt.  One study in Argentina 
studied the combination of a low protein diet and oral activated charcoal to reduce serum urea and crea­tinine levels in very old ESRD patients who had refused to start chronic dialysis. Nine lucid, very old > 80 years, ESRD patients who had refused to start dialysis were prescribed a treatment based on a combination of a very low protein diet and oral activated charcoal (30 gram/day). None of the patients had anuria, oliguria, edema, significant metabolic acidosis or hyperkalemia. None of them had significant gastrointestinal symptoms. After one week and ten months of charcoal use signi ficant decrease in blood urea and creatinine levels was observed.  

Interesting that we don't offer this to someone with potential not wanting dialysis as a resort.
This should be looked into further.

Take a look at these references:

http://www.ncbi.nlm.nih.gov/pubmed/20061701
http://biomed.uninet.edu/2008/n1/musso-carta-en.html
Image source: Allrefer.com

1 comment:

  1. Right colon is the place where the action is. Select dietary fibers which works best in right colon. Lower, right colon pH with GDL. pH is now less favorable for proteolytic enzyme which deconstructs bacteria. This will promote more bacterial growth and reduce bacterial deaths. Net lower balance of nitrogen, urea and other toxins are achieved. With larger stools get rids of Fecal bacteria and nitrogen..

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