A high incidence (40%) of cardiac arrhythmias was found in patients while on dialysis. This incidence was significantly higher than on nondialysis days. A comparison study of patients with significant cardiac arrhythmia and patients with cardiac arrhythmia was made. There was no difference in the echocardiogram, total body potassium, plasma renin activity, aldosterone, catecholamines, serum sodium, potassium and calcium between the two groups. Significant alkalinization occurred in all patients at the end of dialysis. Blood levels of total PTH and C peptide were higher in the arrhythmic patients versus the nonarrhythmic patients. No explanation was found as to why patients developed arrhythmias or what differentiated the two groups.
Plasma B12, folate, B6 and thiamine, and red blood cell folate, thiamine and niacin levels were monitored for a period of 6 months in 15 clinically stable, chronic hemodialysis patients who were not supplemented with the water-soluble vitamins. Microbiological assays were used to determine the blood levels of the water-soluble vitamins. Over the period of 6 months, none of the patients had plasma or red cell vitamin levels below the normal range. No appreciable changes were observed in the plasma and red blood cell vitamin levels before and after dialysis in 5 patients. This study showed that chronic hemodialysis patients are able to maintain normal plasma and red cell levels of some water-soluble vitamins without daily supplementation.
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