Renal failure
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Hemothorax is a recognized complication of central line insertion into the jugular or subclavian vein. We describe a case of hemothorax consequent upon acute dialysis catheter insertion, which resulted in spinal cord infarction and quadriplegia. We postulate that the extensive mediastinal shift induced after insertion of the catheter resulted in stretching of the veins draining the cord with a resultant drop in perfusion pressure and infarction. This case highlights a hitherto unreported complication of this procedure.
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A recent report demonstrated that the presence of left ventricular hypertrophy was an independent predictor of mortality in patients with coronary artery bypass grafting (CABG) severely depressed left ventricular function. However, the impact of left ventricle (LV) mass index on the renal and patient outcomes in such patients with CABG has previously not been addressed. The present study thus considers this group of patient and uses LV mass index to assess renal and patient outcomes for these patients. ⋯ Of all patients, 72.7% had severe echocardiographic LVH. The echocardiographic data of both dialysis and non-dialysis groups showed no difference with respect to echocardiographic findings. Histories of myocardial infarction were more frequent in the severe LVH group that in the mild LVH group. As for pre-operative systolic blood pressure and diastolic blood pressure, mean systolic and diastolic blood pressure values were significantly lower in the severe LVH group. Ejection fraction was also significantly lower in the severe LVH group than in the mild LVH group. The patients in the severe LVH group were significantly more likely to have received hemodialysis following CABG surgery (62.5% vs. 33.4%, p < 0.05). Mortality was higher in the higher LV mass index group that in the lower LV mass index group (56.2% vs. 25%, p < 0.05). CONCLUSION; Patients with a significantly higher LV mass index usually manifest lower pre-operative blood pressure and poor cardiac function. Consequently, these patients will have a poor renal outcome and higher mortality.
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Nephrolithiasis is an infrequent complication following renal transplantation and acquisition of a stone with the donor kidney is rare. Indeed only a few cases of donor stones causing renal failure have been reported. ⋯ Identification of the precise cause is critical in order to avoid inappropriate therapy. We present our experience of two renal transplant patients who developed obstructive uropathy by stones originating from the donor kidneys.
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Comparative Study
Effects of gentamicin on mouse immortalized mesangial cells (MIMC).
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Comparative Study Clinical Trial
Acute renal failure in medical and surgical intensive care units--a one year prospective study.
The spectrum of acute renal failure is different in intensive care unit (ICU) vs. non-ICU population. This one year prospective study carried out in medical and surgical intensive care units showed an incidence of 8.6% of acute renal failure. The incidence of acute renal failure was highest in medical ICU (17.2%) followed by burns ICU (5.3%), pulmonary ICU (5.2%), stroke ICU (4.4%), surgical ICU (3.1%) and least in coronary ICU (1.3%). ⋯ Approximately 40% required dialysis. The mortality of acute renal failure was 62% and the mortality was correlated with the number of organ system failures, presence of oliguria and septicemia. The mean ICU stay was significantly shorter in the non-survivors.