The impaired immune reactivity of hemodialysis patients has been reported to interfere with adequate antibody responses to standard doses of hepatitis B vaccine. In 22 hemodialysis patients, however, a 92% conversion rate could be obtained by administering multiple doses of plasma-derived MSD-vaccine. As the cost of such an amplified vaccination schedule is still lower than the cost of one dialysis treatment, this active vaccination policy for highly susceptible patients appears financially justified.

To investigate the origin of the prorenin peak that occurs during the normal menstrual cycle, plasma lcvels of prorenin, renin, oestradiol, progexteronc, LH and FSH were measured serially in a nephrectomized woman having regular hacmodialysis. The prorenin peak coincided with the LH surge and precericd the riw of progesterone, whereas renin was below the detection limit during the whole cyclc. T h e x findings indicate that the rise in prorenin during the menstrual cycle is not of rcnal origin but is probably due to increased production by the ovary and supports the increasing evidence for the existence of a local renin-angiotensin system in the ovary.Prorenin is an enzymatically inactive precursor form of renin. Under normal conditions the plasma level of prorenin is about 10 times higher than that of renin itsell (Sealey el al. 1980; Schalekamp & Derkx 1981). The kidncy is by far the most important, if not thc only, source of renin in plasma but a substantial proportion of the prorenin in plasma is of extra-renal origin. The ovary has been suggested to be the main source of the grossly clcvated ( 4 4 times normal) plasma prorenin in pregnant women (Sealey et al. 1985a; Dcrkx et ul. 1986) and in women who are hyperstimulated with human menopausal and human chorionic gonadotrophin (Itskovitz

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