Renal failure
-
Comparative Study
Does the choice of the halogenated anesthetic influence renal function during hemorrhagic shock and resuscitation?
Halogenated anesthetics can cause changes in the variables that modify the cardiac output necessary to maintain renal hemodynamic during hemorrhagic shock and resuscitation. However, halogenated anesthetics seem to protect against renal ischemia-reperfusion injury. In a model of pressure-guided hemorrhagic shock in dogs, we studied the comparative effects of three halogenated anesthetics-halothane, sevoflurane, and isoflurane-at equipotent concentrations on renal responses after resuscitation. ⋯ We conclude that no difference could be detected between choosing equipotent doses of halothane, sevoflurane, or isoflurane in relation to renal variables in dogs submitted to pressure-adjusted hemorrhagic shock and resuscitation.
-
A 66-year-old diabetic man presented with severe right thigh swelling and pain together with acute renal failure. At autopsy, this was found to be due to disseminated high grade B cell lymphoma invading the psoas muscle and multiple organs, including the kidneys. The unique presentation of this case emphasizes the need for increased awareness of the variety of ways in which lymphoma can manifest itself.
-
Ischemia-reperfusion (I-R) injury remains the leading cause of acute renal failure. The purpose of this experimental study was to determine the role of dexmedetomidine on histologic alterations induced by renal I-R in rats. In the present study, thirty male Sprague-Dawley rats weighing 200-220 g were randomly assigned into three groups: the sham-control group (group 1, n = 10), the R/untreated group (group 2, n = 10), and the I-R/dexmedetomidine-treated group (group 3, n = 10). ⋯ In the I-R/untreated group rats, kidneys of untreated ischemia rats showed tubular cell swelling, cellular vacuolization, pyknotic nuclei, medullary congestion, and moderate to severe necrosis. Treatment with dexmedetomidine shows normal glomeruli and slight edema of the tubular cells. These findings provide the first evidence that dexmedetomidine can reduce the renal injury caused by I-R of the kidney, and may be useful in enhancing the tolerance of the kidney against renal injury.
-
Comparative Study
Renal anemia: comparing current Eastern and Western European management practice (ORAMA).
The Optimal Renal Anaemia Management Assessment trial prospectively examined the impact of implementing European Best Practice Guidelines on outcomes in the management of renal anemia. Baseline data give an insight to standards of clinical care and provide a basis for a future comparison of guideline target attainment with final results. Fifty-three centers from eight European countries enrolled 739 patients with stage II-V chronic kidney disease who were either anemic (hemoglobin <11 g/dL) or treated with erythropoiesis-stimulating agents and/or iron supplementation. ⋯ The guideline ferritin target was achieved by 85% of dialysis and 52% of non-dialysis patients; 81% of dialysis and 78% of non-dialysis patients attained the transferrin saturation target. Most patients (96%) were receiving erythropoiesis-stimulating agents. Anemia management in patients with chronic kidney disease shows considerable regional differences across Europe, and target attainment remains suboptimal in many European nephrology centers after the revised 2004 guidelines.
-
Comparative Study
Adjuvant hyperbaric oxygen therapy in the treatment of hemodialysis patients with chronic osteomyelitis.
Hemodialysis dependence is an independent risk factor for hematogenous complication, including distant metastatic infection and osteomyelitis. Chronic osteomyelitis is a serious disease that fails to respond to aggressive medical and surgical treatment. Hyperbaric oxygen therapy has been proved to enhance bone and soft tissue healing in many studies. This article presents the preliminary result of hyperbaric oxygen therapy in hemodialysis-dependent patients with chronic osteomyelitis. ⋯ Hyperbaric oxygen is effective as an adjunct to aggressive medical and surgical treatment in chronic refractory osteomyelitis among hemodialysis-dependent patients.