In rapid accelerated hemodialysis (R-AHD), blood partially recirculates from the venous (outflow) to the arterial (inflow) line through a recirculation line (R) to selectively increase the filter blood flow rate (BFR). R-AHD PR uses two blood pump segments at the patient segment of the arterial line and at (R). To determine the effectiveness of R-AHD with regard to increasing anticoagulation and dialysis efficiency, we studied ten children with end-stage renal disease in two stages: stage 1 with 10 routine heparin R-AHD, then 10 half-dose heparin R-AHD, then 145 routine heparin R-AHD sessions for 1 month and then routine heparin double needle hemodialysis (DNHD) for one month (control). In stage 2, we dialyzed the patients with 10 routine heparin-mixed AHD PR and DNHD sessions, then eight low-dose heparin R-AHD PR" sessions, then one of the children with 10 no-heparin R-AHD PR sessions and then 10 routine heparin DNHD sessions" (control). Signs of blood clotting and dialysis efficiency were monitored. Blood clots appeared in four out of 165 R-AHD 0 (one pump circuit) sessions but in none of the 28 R-AHD PR sessions. In stage 1, the mean urea reduction rate was 0.60, 0.60 and 0.70 for the R-AHD protocols, compared with 0.71 for the control (P >0.05). In stage 2, the arterial blood urea nitrogen was reduced by 0.66 ± 0.15 after an R-AHD PR period, compared with 0.79 ± 0.18 after a DNHD period (P = 0.059). In conclusion, R-AHD PR allowed successful low heparin and no heparin hemodialysis in children without increasing the patients' BFR. However, the technique did not increase the efficiency of dialysis.

The prevalence of hepatitis C virus [HCV] RNA in 80 patients with chronic renal diseases was determined. Two sets of primers from the non-coding region of the hepatitis C virus were used. The products [188 bp] amplified by polymerase chain reaction were visualized by 2% agarose gel electrophoresis stained with ethidium bromide. The patients were classified into four groups. Group I comprised 40 adult patients with end-stage renal disease, 31 of whom were positive for HCV-RNA [77.5%] ; group II, 22 children with glomerulopathies, 15 of whom were positive [68.2%] ; group III, 9 children with chronic renal failure of unverified etiology, 6 of whom were positive [66.6%] ; group IV, 9 children with chronic renal failure due to obstructive uropathy of whom 3 [33.3%] were positive. We conclude that HCV may infect a high percentage of patients with chronic renal failure or renal parenchymatous disease