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Query: UMLS:C0028961 (oliguria)
 1,847 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The classic criteria utilizing preoperative clinical evaluations and laboratory tests for predicting risk and long-term survival in cirrhotic patients under-going portacaval shunting still appear to be the most useful. Analysis of the factors that could be determinant in separating patients who are going to survive a portacaval shunt for five or more years from the short-term survivors revealed the former group had a lesser incidence of preoperative encephalopathy, ascites, malnutrition, and hypoalbuminemia. None of the intraoperative factors were found to be decisive. However, the prompt and uncomplicated postshunt recovery was an accurate prediction for long-term survival. This could be explained by the assumption that these patients had a better hepatic functional reserve at the time of portal-systemic shunting. The early appearance in the postoperative period, of fluid retention, azotemia, oliguria, inability to eat, and the early appearance of the symptoms of portal encephalopathy were premonitory of short-term survival. Return to alcohol ingestion was also associated with short-term survival. The hepatorenal syndrome was usually the cause of death in the short-term survivors whereas nonhepatic disease was the cause of demise in the long-term survivors. The operative mortality for all patients undergoing portacaval shunting during an eight year period was 10.7 per cent. Of the patients who left the hospital alive, 16.1 per cent died within the subsequent twelve months, 53 per cent survived from thirteen to fifty-nine months after their operation, and 19.6 per cent survived sixty or more months.
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PMID:Comparative group study between patients surviving five or more years after portacaval shunt procedure and those surviving less than one year. 29 93

Patients with refractory ascites and HRS should be considered to present an urgent indication for peritoneovenous shunting. The shunt offers a method of continuous reinfusion of ascitic fluid which corrects avid sodium retention, oliguria and azotemia. Severe encephalopathy, jaundice or peritoneal sepsis--common complications of cirrhosis--contraindicate installation of the shunt before improvement occurs. Associated cardiac disease does not contraindicate the use of the shunt provided that ascitic fluid is removed at the time of operation and large amounts of diuretics are used. This operation has also proved useful in ascites attributed to causes other than cirrhosis. The main complications include disseminated intravascular coagulopathy, hepatic coma and sepsis in a few patients. Results of a randomized prospective study indicate that the shunt should probably be considered in patients with diet-resistant massive ascites even before they prove to be refractory to diuretic therapy.
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PMID:Ascites: its correction by peritoneovenous shunting. 37 15

The relationship between the degree of oliguria following severe birth asphyxia and outcome at 12 months was examined in 31 infants. All 31 infants developed encephalopathy following severe birth asphyxia and 25 had oliguria for 24 h or more following delivery. Eighteen had persistent oliguria (i.e. greater than 48 h) and the remaining seven had transient oliguria (between 24 and 48 h). Poor outcome (death or neurological abnormality at 12 months) was significantly associated with the degree of oliguria. Encephalopathy, however, was found to be more closely correlated with poor outcome rather than duration of oliguria and a stepwise regression model confirmed that encephalopathy was the more powerful predictor of poor outcome. In those situations where an infant's degree of encephalopathy can not be assessed accurately (e.g. muscle relaxant use) the duration of oliguria may prove a useful prognostic indicator.
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PMID:Birth asphyxia associated oliguria: relationship to outcome at 1 year. 193 Dec 23

The study was undertaken to evaluate the occurrence of renal failure following perinatal asphyxia in the newborns. Thirty newborns with severe birth asphyxia were included in the study along with 30 normal newborns who comprised the control group. Any neonate presenting with oliguria or blood urea more than 40 mg/dl or creatinine more than 1 mg/dl was subjected to a fluid and diuretic challenge. If oliguria or renal dysfunction persisted then the child was labelled as renal failure and these subjects were further investigated. It was observed that 43% of asphyxiated babies developed acute renal failure (ARF); 69.2% babies had oliguric renal failure. While no significant correlation could be seen between Apgar scores at 5 and 10 min and development of ARF, a significant relationship was seen between hypoxic-ischemic encephalopathy and ARF. Patients with oliguric ARF carried a poorer prognosis as compared to non-oliguric ARF.
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PMID:Acute renal failure in asphyxiated newborns. 205 7

This prospective study involved 102 patients who had acute renal failure and were treated at Aleppo University Hospital during the period 1980-1986. Acute renal failure in this group was categorized, according to the aetiology, into 12 causes. Obstructive uropathy, surgery, and crush injuries constituted 64% of all cases in males. In females, 56% of all cases were due to obstetrical trauma, acute glomerulonephritis and eclampsia. Haemodialysis was used for the treatment of 77 patients, with 65% cure, and 33% mortality. Conservative treatment was adopted for 21 patients with 62% cure, and 38% mortality. Four patients were treated by peritoneal dialysis, and they all survived. The prognosis in the studied group depended on the aetiology of acute renal failure, and accompanying risk factors such as infection, electrolyte disturbances, encephalopathy, failure of other end organs, etc. It was also found that patients presenting with anuria or oliguria had worse prognosis when compared with patients who had normal urine output.
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PMID:Acute renal failure among a Syrian population. Incidence, aetiology, treatment and outcome. 261 75

The systemic manifestations of "asphyxia" were evaluated prospectively in 35 consecutively intubated term newborn infants. The following systemic organ injuries were identified most often: (1) renal, ie, oliguria less than 1 mL/kg per hour for at lest 24 hours (40%), an elevated urinary beta-2-microglobulin concentration (57%), azotemia (11%), and an elevated serum creatinine level (17%); (2) central nervous system, ie, hypoxic-ischemic encephalopathy (including seizures) (31%) or an abnormal cranial ultrasound scan, ie, diffuse parenchymal echogenicity, slitlike ventricles, and poor visualization of the sulci, and/or intracranial hemorrhage (26%); (3) cardiovascular, ie, an abnormal echocardiogram (25%) or abnormal electrocardiogram (11%); (4) pulmonary complications, including persistent pulmonary hypertension (23%); and (5) gastrointestinal complications, which were rare. Traditional markers of fetal distress were not related to the frequency and/or distribution of systemic organ injury. An important implication of this study relates to the recognition of the extent and distribution of organ injury in the "asphyxiated" infant.
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PMID:Acute systemic organ injury in term infants after asphyxia. 271 98

The relationship of renal and central nervous system injury was prospectively evaluated in 120 asphyxiated infants. Renal evaluation findings were considered abnormal if there was oliguria (urine output less than 1 ml/kg/hr), which was designated transient if present in the first 24 hours only and persistent if present for at least 36 hours, or if the urinary beta 2-microglobulin concentration from first-void urine was elevated: (1) Thirteen infants had persistent oliguria; the urinary beta 2-microglobulin level was elevated in all. The six term infants had clinical signs consistent with hypoxic-ischemic encephalopathy (HIE); all six had ultrasonographic abnormalities. The outcome was poor (i.e., death or long-term neurologic deficits) in five of six infants. The seven preterm infants with persistent oliguria had clinical evidence of HIE, and three infants had intraventricular hemorrhage; all seven infants died. (2) Fifteen infants had transient oliguria (beta 2-microglobulin level was elevated in eight infants). Two of the eight term infants had evidence for HIE; the cranial ultrasound scan was normal in all. At follow-up, seven term infants are normal and one is abnormal. Six of the seven preterm infants with transient oliguria had clinical evidence of HIE; three infants had intraventricular hemorrhage. Three infants died, and the four survivors are normal at follow-up. (3) Ninety-two infants had normal urine output. Of the 22 term infants, two developed signs of HIE, and the ultrasound scan was abnormal in three infants. Of the 70 preterm infants, eight (11%) had clinical signs consistent with HIE, the ultrasound scan was abnormal in 20 of 64 (31%) infants scanned, and 14 (20%) infants died. Most of the followed infants are normal. Thus oliguria was significantly associated with clinical signs of HIE, including seizures, death (specifically in the premature infant), and long-term neurologic deficits. These data suggest that oliguria in the perinatal period is a sensitive indicator of infants at risk for long-term neurologic deficits.
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PMID:Renal injury in the asphyxiated newborn infant: relationship to neurologic outcome. 305 34

Hemolytic uremic syndrome (HUS) is defined as microangiopathic hemolytic anemia, thrombocytopenia and uremia. It is an important cause of acute renal failure (ARF) in children all over the world. The present study was carried out to assess the incidence, clinical presentation, hematological and biochemical profile of children presenting with HUS from 1987 to 1990. Out of the 100 cases who presented with ARF 22 had HUS. A majority of these children were males below 1 year of age, and had a prodromal phase of mainly gastrointestinal manifestations lasting for about a week. Anemia was a constant feature followed by bleeding diathesis, mainly melena and purpura. Neurological manifestations included altered sensorium, irritability, coma, hypertensive encephalopathy and convulsions. Renal problems mainly included oliguria, hypertension, hematuria and edema. Investigations revealed thrombocytopenia and microangiopathic hemolytic anemia in all cases. Evidence of disseminated intravascular coagulation (DIC) was observed in 3 cases as decreased fibrinogen levels, increased fibrinogen degradation products and deranged clotting studies. Blood biochemistry revealed azotemia in all cases, hyponatremia in 5 cases, hypernatremia in 3 cases and hyperkalemia in 12 cases. Stool culture showed the presence of Shigella in 8, E. coli in 6 and Klebsiella in 4 cases. Out of 22 cases of HUS, 15 were treated conservatively; of these 2 died. Both of these deaths were due to DIC 7 children were put on peritoneal dialysis; only 1 child died in this group. Factors affecting the outcome were duration of oliguria, levels of blood urea and presence of encephalopathy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A clinico-hematological profile of hemolytic-uremic syndrome. 788 99

This study addresses the dilemma of whether to attempt resuscitation of the previously undiagnosed fresh stillborn infant and evaluates factors predictive of survival and long-term outcome. We reviewed the clinical spectrum, immediate complications and long-term outcome of 45 successfully resuscitated apparently stillborn infants (34 term, 11 preterm) who were admitted to the Intensive Care Nursery. Significant obstetric and intrapartum events were identified in 34 (75%) infants while 11 (25%) had no apparent risk factors. Of the 39 infants with neonatal complications, 37 had hypoxic-ischaemic encephalopathy (HIE: Sarnat stage 1 in 5, stage 2 in 15, stage 3 in 17); 12 (27%) had oliguria, 10 (22%) had hypotension, 7 (16%) experienced hypoglycaemia, 4 (9%) had disseminated intravascular coagulopathy (DIC) and 1 (2%) had persistent pulmonary hypertension of the newborn (PPHN). Fourteen infants (31%) died in the neonatal period and four (9%) died during infancy. Risks of death and adverse neurodevelopment were significantly increased in infants with stage 2 or 3 HIE (P < 0.005). Follow-up assessment of 24 of the 27 surviving infants revealed a normal outcome in 15 (63%), severe disability in six (25%), moderate disability in two (8%) and mild disability in one (4%) infant. The positive predictive value of stage 2 or 3 HIE was 70% for mortality and 80% for morbidity. One-third (15/45) of successfully resuscitated apparently stillborn infants were normal at follow-up assessment and the outcome for these infants was predicted with complete accuracy by the stage of HIE present during the neonatal period.
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PMID:Outcome of resuscitated apparently stillborn infants: a ten year review. 819 46

The pathogenetic agents which cause encephalopathy due to fulminant hepatic failure are still under debate. Ammonia and benzodiazepine-like compounds are two of the most important agents considered, so far. Herein, we report the levels of benzodiazepine-like compounds in serum and in urine and of venous ammonia measured during the course of the disease (30 days). The patient rapidly developed stage IV encephalopathy with high levels of ammonia and with only a slight increase of benzodiazepine-like compounds. At that moment, the levels of these compounds were similar to those recorded in the blood when the patient regained full consciousness 28 days later. During the course of the disease, there was a 10-fold increase of benzodiazepine-like compounds in serum which was recorded in parallel with an impaired excretion due to oliguria. This observation seems to indicate that encephalopathy may develop in the absence of significantly increased levels of these compounds and that their episodic increase during fulminant hepatic failure may be an epiphenomenon linked with several factors such as impaired renal function.
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PMID:Changes in endogenous benzodiazepine-like compound levels during the course of fulminant hepatic failure: potential effects of decreased renal function. 949 56


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