Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
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Nephrol. Dial. Transplant. · Jan 1996
Vena cava diameter measurement for estimation of dry weight in haemodialysis patients.
A correct estimation of volume status and so-called dry weight in dialysis patients remains a difficult clinical problem. Clinical status and chest X-ray are not sensitive enough, while invasively measured central venous pressures are not routinely available. Recently, the sonographic determination of the diameter and collapse of the inferior vena cava (IVC) has been proposed as a noninvasive method for estimating intravascular volume. ⋯ Intravascular volume changes are reflected by IVC measurements, as shown by the correlation to other indices of intravascular volume, such as CVP and alpha-hANP. IVC sonography is noninvasive and easily available; serial measurements allow an estimation of changes of intravascular volume in patients without cardiac filling impairment. However, unlike with body impedance, interstitial volume is not reflected by IVC diameters.
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Nephrol. Dial. Transplant. · Jan 1996
Withdrawal of renal replacement therapy in Newcastle upon Tyne: 1964-1993.
Termination of renal replacement therapy (RRT) is common in North America and Australia but is considered to be rare in Europe. ⋯ Death from dialysis termination is a relatively common cause of death in RRT patients in Newcastle upon Tyne. These patients are older with a higher prevalence of diabetes. In 89% of cases the decision to stop treatment was related to multiple medical problems with a recent deterioration. Physicians raised the issue of withdrawal in the majority of cases and most patients subsequently received terminal care in hospital.
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Nephrol. Dial. Transplant. · Jan 1996
ReviewAutosomal dominant polycystic kidney disease--the patient on renal replacement therapy.
In Europe approximately 6% of all patients on chronic renal replacement therapy suffer from polycystic kidney disease. Survival of patients with polycystic kidney disease on renal replacement therapy is better than for other primary renal diseases, despite a similar cardiovascular risk profile. ⋯ There is no increased risk of renal cell carcinoma in patients with autosomal dominant polycystic kidney disease. Polycystic patients on dialysis should be followed for cardiac valve abnormalities and cerebral aneurysms.
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Nephrol. Dial. Transplant. · Oct 1995
Randomized Controlled Trial Comparative Study Clinical TrialGranulocyte sequestration in dialysers: a comparative elution study of three different membranes.
The present study was designed to investigate the expression of activation markers on polymorphonuclear cells (PMN) in peripheral blood and dialyser eluates, comparing three different membranes. ⋯ Dialyser eluates of all three dialysers consisted mainly of PMN. Based on the relatively modest cell numbers and the expression of the activation markers described, our results suggest primarily degranulation within the dialyser. Apart from differences in cell numbers, CTA yielding the highest cell counts, no differences between CTA, CU, and PS could be demonstrated in dialyser eluates.
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Nephrol. Dial. Transplant. · Jan 1995
The renal manifestations and outcome of thrombotic thrombocytopenic purpura/hemolytic uremic syndrome in adults.
Thrombotic thrombocytopenic purpura/Hemolytic uremic syndrome (TTP/HUS) is generally regarded to be a rare disease. The present study was undertaken to identify presenting features, prognostic variables, pathological features and outcome associated with TTP/HUS. The present study is a retrospective chart review of 68 patients treated with plasmapheresis for TTP/HUS at a single tertiary referral medical institution from 1980-1992. ⋯ Despite the use of plasmapheresis, mortality during the initial hospital admission was almost 25%. In retrospect prognosis could not be predicted based on admission biochemical or clinical variables. The majority of patients who developed acute renal failure and survived to hospital discharge recovered renal function and became independent of dialysis.