The aim of this study was to estimate the incidence of COVID-19 disease in the French national population of dialysis patients, their course of illness and to identify the risk factors associated with mortality. Our study included all patients on dialysis recorded in the French REIN Registry in April 2020. Clinical characteristics at last follow-up and the evolution of COVID-19 illness severity over time were recorded for diagnosed cases (either suspicious clinical symptoms, characteristic signs on the chest scan or a positive reverse transcription polymerase chain reaction) for SARS-CoV-2. A total of 1,621 infected patients were reported on the REIN registry from March 16th, 2020 to May 4th, 2020. Of these, 344 died. The prevalence of COVID-19 patients varied from less than 1% to 10% between regions. The probability of being a case was higher in males, patients with diabetes, those in need of assistance for transfer or treated at a self-care unit. Dialysis at home was associated with a lower probability of being infected as was being a smoker, a former smoker, having an active malignancy, or peripheral vascular disease. Mortality in diagnosed cases (21%) was associated with the same causes as in the general population. Higher age, hypoalbuminemia and the presence of an ischemic heart disease were statistically independently associated with a higher risk of death. Being treated at a selfcare unit was associated with a lower risk. Thus, our study showed a relatively low frequency of COVID-19 among dialysis patients contrary to what might have been assumed.

Dialysis patients exhibit an inverse, L- or U-shaped association between blood pressure and mortality risk, in contrast to the linear association in the general population. We prospectively studied 9333 hemodialysis patients in France, aiming to analyze associations between predialysis systolic, diastolic, and pulse pressure with all-cause mortality, cardiovascular mortality, and nonfatal cardiovascular endpoints for a median follow-up of 548 days. Blood pressure components were tested against outcomes in time-varying covariate linear and fractional polynomial Cox models. Changes throughout follow-up were analyzed with a joint model including both the time-varying covariate of sequential blood pressure and its slope over time. A U-shaped association of systolic blood pressure was found with all-cause mortality and of both systolic and diastolic blood pressure with cardiovascular mortality. There was an L-shaped association of diastolic blood pressure with all-cause mortality. The lowest hazard ratio of all-cause mortality was observed for a systolic blood pressure of 165 mm Hg, and of cardiovascular mortality for systolic/diastolic pressures of 157/90 mm Hg, substantially higher than currently recommended values for the general population. The 95% lower confidence interval was approximately 135/70 mm Hg. We found no significant correlation for either systolic, diastolic, or pulse pressure with myocardial infarction or nontraumatic amputations, but there were significant positive associations between systolic and pulse pressure with stroke (per 10-mm Hg increase: hazard ratios 1.15, 95% confidence interval 1.07 and 1.23; and 1.20, 1.11 and 1.31, respectively). Thus, whereas high pre-dialysis blood pressure is associated with stroke risk, low pre-dialysis blood pressure may be both harmful and a proxy for comorbid conditions leading to premature death.

Background Citric acid–based bicarbonate haemodialysis (CIT-HD) has gained more clinical acceptance over the last few years in France and is a substitute for other acidifiers [e.g. acetic acid (CH3COOH) and hydrochloric acid (HCl)]. This trend was justified by several clinical benefits compared with CH3COOH as well as the desire to avoid the consequences of the corrosive action of HCl, but a nationwide clinical report raised concerns about the long-term safety of CIT-HD. The aim of this study was to assess the long-term effects of CIT-HD exposure on patient outcomes in western France. Methods This is a population-based retrospective multicentre observational study performed in 1132 incident end-stage kidney disease patients in five sanitary territories in western France who started their renal replacement therapy after 1 January 2008 and followed up through 15 October 2018. Relevant data, collected prospectively with the same medical software, were anonymously aggregated for the purposes of the study. The primary goal of this study was to investigate the effects of citrate exposure on all-cause mortality. To provide a control group to CIT-HD one, propensity score matching (PSM) at 2:1 was performed in two steps: the first analysis was intended to be exploratory, comparing patients who received citrate ≤80% of the time (CIT-HD ≤80) versus those who received citrate >80% of the time (CIT-HD >80), while the second analysis was intended to be explanatory in comparing patients with 0% (CIT-HD0) versus 100% citrate time exposure (CIT-HD100). Results After PSM, in the exploratory part of the analysis, 432 CIT-HD ≤80 patients were compared with 216 CIT-HD >80 patients and no difference was found for all-cause mortality using the Kaplan–Meier model (log-rank 0.97), univariate Cox regression analysis {hazard ratio [HR] 1.01 [95% confidence interval (CI) 0.71–1.40]} and multivariate Cox regression analysis [HR 1.11 (95% CI 0.76–1.61)] when adjusted for nine variables with clinical pertinence and high statistical relevance in the univariate analysis. In the explanatory part of the analysis, 316 CIT-HD0 patients were then compared with 158 CIT-HD100 patients and no difference was found using the Kaplan–Meier model (log-rank 0.06), univariate Cox regression analysis [HR 0.69 (95% CI 0.47–1.03)] and multivariate Cox regression analysis [HR 0.87 (95% CI 0.57–1.33)] when adjusted for seven variables with clinical pertinence and high statistical relevance in the univariate analysis. Conclusions Findings of this study support the notion that CIT-HD exposure ≤6 years has no significant effect on all-cause mortality in HD patients. This finding remains true for patients receiving high-volume online haemodiafiltration, a modality most frequently prescribed in this cohort.

Quantitative Bestimmung des Antip yrins durchGleichstrom polarographie 847Ruckstand mit Athano1 und kristallisiert aus Chloroform niit wenig Athanol um. ubereinstimmung mit der nach a) erhaltenen Substanz. 3-Benzoyl-1 -m e t h y l -1 -m e t h o x y h a r n s t o f f (17)1,22 g (0,02 Mol) N,O-Dimethylhydroxylamin(-Base) in 20 ml absol. Ather versetzt man unter Riihren und Kiihlen tropfenweise mit 3,0 g (0,02 Mol) Benzoylisocyanat in 30 ml absol. Ather, erhitzt 30 Min. zum RuckfluS, entfernt das Losungsmittel, verreibt den Ruckstand rnit Petrolather und laBt in der Kalte Verfestigung eintreten. Man erhiilt eine farblose Masse, die aus Chloroform mit Petrolather umgefiillt wird und im Tiefkiihlschrank lange Kristallnadeln bildet, die man scharf absaugt und mit Petrolather wascht. An der Luft farben sie sich gelblich. Schmp. 66-69'; A(,,,o) 5,73 + 5,95 p ; Ausbeute 4,O g (95% d. Th.). CDas polarographisch inaktive Antipyrin lLSt sich bei Raumtemperatur mit einem Trifluoressigsaure-S a l p e~r s a~-G e m i s c h durch nitrosierende Nitrierung quantitativ in 4-Nitroantipyrin uberfuhren, das in einer sechs-elektronigen Stufe an der Hg-Tropfelektrode reduziert wird. Determination of Antippine by Direct Current PolarographyIn a mixture of trifluoroacetic acid and nitric acid a t room temperature antipyrine, nonreducible a t the dropping mercury electrode, is converted quantitatively to 4-nitroantipyrine via nitrosation followed by oxidation. This product shows a single six-electron reduction wave.Mehr als 40 in der BRD im Handel befindliche Arzneimittelkombinationen enthalten Antipyrin (I). Eine spezielle Indikation hat es als schmerzlindernder, sedierender und die Lungenventilation verbessernder Zusatz in Asthmamitteln (Ahpent@, Asthminm, CCA-Pulver, Priatanm) gefunden'). *) Herrn Prof. Dr. Dr. h. c. J . Biichi, Ztirich, anliiBlich der Vollendung des 65. Lebensjahres I ) H. Her.zheimer und E. Stresemann, Nature [London] 192, 1089 (1961). gewidmet. O s l s c h l a g e r und HameL Arhiv der PharmazieEine quantitative I-Bestimmung ist mit verschiedenen Verfahren moglich. Sehr geringe Einwaagen werden fiir kolorimetrische Verfahren (naoh Zusatz von FeC1J2) und die polarometrische Titration mit Phosphorwolfra&uresiiure5) benotiigt. Einwaagen von 0 , 1 4 4 2 g erfordert das in viele Arzneibiicher aufgenommene jodometrische Verfahren. In Arzneimittelkombinationen ist I ohne vorhergehende Isolierung kaum quantitativ zu erfassen: es wird deshalb im allgemeinen durch SC oder DC abgetrennt und spektrofotometrisch bestimmt') 6 ) .E k e polarographische Antipyrinbestimmung wurde bereits 1955 von K. Matsumoto6) beschrieben. Da I an der Hg-Tropfelektrode nicht reduzierbar ist, wird es mit salpetriger SBure in das polarographisch aktive 4-Nitrosoantipyrin (11) iibergefiihrt. Der Autor verwendet eine in der Polarographie unublich groae Depolarisatorkonzentration (2,5 * m). Infolge des groBen iR-Abfalles in der Lijsung resultiert eine flach ansteigende i-E-Kurve, deren Grenzstrom nach unseren Befimden durch ein Maximum 11. Art verzerrt wi...

In Asthmapulvern l d t sich Phenazon iiber das 4-Nitroderivat in Gegenwart von Atropin, Ephedrin, Coffein und kleinen Mengen Orciprenalin polarographisch bestimmen. Determination of Phenazone in Asthma Powders by PolarographyIn asthma powders phenazone can be determined by polarography of 4-nitro-phenazone in presence of atropine, ephedrine, caffeine and small amounts of orciprenaline.Phenazon wird nicht nur wegen seiner antipyretischen, analgetischen und antiphlogistischen Eigenschaften geschatzt, sondern auch wegen seiner Wirkung bei Bronchialasthma. Diese 1aBt sich durch die Steigerung der Vitalkapazitat um etwa 11 76 und die Abnahme der dynamischen Widerstande beim Atmen nachweisen') 2 ) . Wahrscheinlich beruht dieser Effekt beim Menschen auf einem unspezifischen dilatatorischen Angriff an der Bronchialmuskulatur2-4) und nicht wie beim Meerschweinchen auf einem Antogonismus zum bronchokonstriktorisch wirkenden Bradykinins) oder SRS-A6). Daher wird Phenazon in Asthmapulvern zusiitzlich mit spezifisch wirksamen Bronchodilatatoren und Broncholytika, z. B. Orciprenalin, Ephedrin, Atropin und dem zentral angreifenden Coffein kombiniert. standig an Bedeutung. Die bereits beschriebene polarographische Bestimmung des Phenazon uber sein 4Nitrosoderivatl) hat sich jedoch wegen der schlecht vermeBbaren i-E-Kurve nicht durchgesetzt. Dagegen resultiert eine gut ausgebildete 6-elektronige Stufe bei der Reduktion des 4-Nitro-phenazon, das bei Raumtemperatur durch nitrosierende Nitrierung ails Phenazon leicht erhaltlich is@) 9). Da zwischen der Stufenhohe und der Konzentration des Depolarisators eine Linearbeziehung besteht, eignet sich diese Methode zur Gehaltsbestimmung von Phenazon. 1 H.

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