Background and objectives: In hemodialysis patients, the hematological response to erythropoietin (epo) is variable and clinical factors that explain this variability are incompletely understood. We tested the hypothesis that the variability in hemoglobin (Hgb) response (epo sensitivity) is determined by key nutritional, inflammation, and oxidative stress markers.Design, setting, participants, & measurements: Eighty-two consecutive patients on hemodialysis had 3 consecutive monthly predialysis evaluations of Hgb, total white blood cell (WBC) count, serum albumin, malondialdehyde (MDA), and monocyte chemoattractant protein-1 (MCP1). We analyzed the time course of Hgb in relationship to serum albumin, WBC, MDA, MCP1, epo and iron administration, and tests of iron sufficiency in a linear growth curve model.Results: Subjects with higher Hgb had a fall in Hgb and vice versa, regressing to a mean Hgb (SD) of 11.8 g/dl (1.8 g/dl). Whereas the average slope of Hgb was flat, the SD of slopes was 0.63 g/dl, which explained 39% of the variance in Hgb. Nonuse of epo was associated with a mean Hgb change of ؊0.18 g/dl (95% confidence interval [CI] ؊0.26 to ؊0.10) per 10,000 IU epo/mo (P < 0.05). Epo use was associated with steeper rate of change at 0.04 g/dl per mo per 10,000 IU (95% CI 0.01 to 0.07) (P < 0.01). Hgb at baseline was 0.73 g/dl higher for each 1-g/dl increase in albumin, and the rate of change increased by 0.49 g/dl per mo for each 1-g/dl increase in albumin concentration. WBC, MDA, or MCP1 had no role in predicting the baseline Hgb or its change over time.Conclusions: Serum albumin concentration is an important predictor of both baseline Hgb and epo sensitivity in chronic hemodialysis patients. Factors that improve serum albumin may also improve Hgb in hemodialysis patients.

This study investigated the communicative activities of 42 dysphasic stroke patients who were living at home. Two aspects of natural communication were surveyed: the conversational communication which occurs with the social contacts of the subject, and the communicative activities of daily living. The two aims of the study were to investigate the relevance of a selection of communicative activities of daily living, and to investigate possible grading of activities so that a representative sample of everyday activities may be used in the assessment and treatment of dysphasia.Individuals showed wide variation in their communicative needs. These needs may not be met in the traditional linguistic speech therapy regimen. It is suggested that the use of an interview schedule like that used in this survey may serve as a starting point in the treatment of functional communication skills in dysphasic adults. Guttman scale analysis showed that communicative activities of daily living do not form a unidimensional scale. A representative sampling of activities, however, may be possible using the hierarchies of familiarity and difficulty obtained.

No abstract

No abstract

No abstract