Journal of nephrology
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Journal of nephrology · Jan 2005
Case Reports Clinical TrialGabapentin in the treatment of uremic itch: an index case and a pilot evaluation.
The prevalence of renal itch in patients on dialysis is approximately 30%, but its treatment is often ineffective. We describe an index case of a hemodialysis (HD) patient suffering from painful diabetic neuropathy (PDN) treated with gabapentin; the first administration of the drug led to the complete remission of the concomitant uremic pruritus. Subsequently, we report the results of a pilot evaluation aimed at testing the effectiveness and safety of low gabapentin doses in HD patients with uremic pruritus. ⋯ Although a double-blind placebo-controlled clinical trial should be conducted to better elucidate the efficacy and toxicity of gabapentin in patients with uremic itch, our data suggest that gabapentin could be considered an effective and safe alternative treatment for uremic pruritus.
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Triage, the sorting of patients according to the severity of their injuries and the need for urgent surgery was a concept developed by Dr. Larrey, a military surgeon in Napoleon's army. ⋯ Triage in civilian practice first became a serious issue with the development of dialysis for chronic renal failure in the 1960s and the problem of the allocation of this scarce and very expensive treatment. With new developments in organ transplantation and technology it continues to be an issue today.
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Journal of nephrology · May 2004
Effect of gender on various parameters of crush syndrome victims of the Marmara earthquake.
Detailed analyses on crush syndrome resulting from earthquakes is scarce. This study aimed to analyze the effect of gender on clinical course of the renal victims of the catastrophic Marmara earthquake that struck Northwestern Turkey in 1999. ⋯ Although males are characterized by more severe laboratory abnormalities of rhabdomyolysis, more frequently suffer from sepsis and need more intensive dialysis support, gender is not a prognostic indicator of final outcome in the renal victims of disasters.
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Journal of nephrology · Jan 2004
Extracorporeal management of valproic acid overdose: a large regional experience.
Valproic acid intoxication is common in North America. Although extra-corporeal therapy has been proposed as beneficial in managing significant exposures, evidence to support its use is limited to isolated case reports. A systematic review has not been performed. ⋯ Hemodialysis and hemoperfusion are safe, effective adjuncts in the management of serious valproic acid intoxication and should be considered for patients with hemodynamic or neurological instability. Further study is needed to determine whether hemodialysis alone versus combined hemodialysis-hemoperfusion is more effective for this condition.