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 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The material for this report is based on the examination data produced from 105 patients with a single kidney who were operated on for contralateral kidney tuberculosis. The conducted clinical trial confirms the approach that the correct solution of the problems in medical labor examination depends on the nature of a pathologic process in the single kidney, clinical course of the disease and period of a pathologic process, degree of a chronic renal failure, arterial hypertension and severity of the pain syndrome. The role of social factors and the rehabilitation aspects of this type of the patients are considered.
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PMID:[Work capacity of patients with tuberculosis of a solitary kidney]. 223 43

We present three cases of benign prostatic hypertrophy associated with chronic renal failure for three years from 1982 to 1984. Endogenous 24-hour creatinine clearance (Ccr) on admission ranged from 8.7 to 29.4 ml/min. Temporary hemodialysis treatment was required in one patient at the beginning of hospitalization. Indwelling intraurethral catheterization for 3 months or more improved the renal function in one patient, but brought troublesome complications of gross hematuria, intractable urethral pain or recurrent pyelonephritis in the other patients. These complications might arise from strong uninhibited detrusor contractions triggered or accelerated by stimuli and/or urinary tract infection induced by urethra-indwelt catheters. Intermittent self catheterization reduced these complications in one patient. In two patients, Ccr increased beyond 30 ml/min as a desirable standard level for safe operations. Suprapubic prostatectomy was successfully performed in all the patients. However, severe gastric ulcer or fatal duodenal ulcer occurred in two patients. Hypoproteinemia and/or urinary tract infection was thought to be highly related to ulceration. In conclusion, we would like to emphasize that a Ccr of more than 30 ml/min is needed for safe operations concerning renal function in patients with benign prostatic hypertrophy associated with chronic renal failure.
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PMID:[A pre- and post-operative clinical study in three patients with benign prostatic hypertrophy and implicated chronic renal failure]. 243 7

The ureteropelvic junction (UPJ) is the most common site of upper urinary tract obstruction. We report on 46 adult patients (50 renal units) that had been treated for a UPJ anomaly at our department over a 10-year period. The most common clinical manifestations observed were lumbar pain and/or colic (82.6%) and infection (34.8%). Genitourinary malformations were observed in 21.8% of the patients. The following treatment modalities were performed: 8 nephrectomies, 39 repair surgery procedures, 3 renal units with mild dilatation and no obstruction did not undergo surgery and were closely followed. The Anderson-Hynes pyeloplasty procedure was performed in 37 (95%) renal units and the Foley Y-V plasty in 2 (5%). The most important complications were anastomotic stricture (4) and urinary fistula (2). Overall, the results of repair surgery were good in 69.2%, fair in 20.5% and poor in 10.3% of the cases. Better results were achieved in those cases with moderate (86% good results) than in those with severe (47% good results) dilatation. Following pyeloplasty, 95% of the patients were pain-free, 1 (2.3%) patient had episodes of symptomatic infection and deterioration of renal function was observed in only 1 patient with a single kidney and severe chronic renal failure prior to surgery. At 2 years, dilatation had improved in 64%, remained unchanged in 31%, and became worse in 5%. In the management of pyelocaliceal dilatation, we believe it is fundamental to clearly establish the presence of obstruction and predict the functional recovery of the obstructed kidney. Our diagnostic and therapeutic approach is described. For upper urinary tract dilatation, the following is performed: simple or diuresis IVP, diuresis renography, ultrasonography and CUMS (if reflux is suspected). When doubts exist or when the results are unclear, pressure flow urodynamic studies are performed. Thus, we perform repair surgery in dilatations with functional obstruction to avoid progressive renal deterioration. The literature on the diagnostic techniques for the assessment of obstruction and functional recovery is reviewed.
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PMID:[Obstruction of the pyelo-ureteral junction in adults. Diagnostic and therapeutic management]. 249 Mar 47

Autosomal dominant polycystic kidney disease is the third cause of end-stage chronic renal failure (CRF) requiring dialysis and transplantation. Over a 5-year period we collected 21 cases of that disease. The patients' mean age at the time of diagnosis was 48 years and the sex ratio 1.1. Pain was the most frequent signal symptom, being present in 43 p. 100 of the patients. Varying degrees of renal impairment were found in 61 p. 100 of the cases, and arterial hypertension in 38 p. 100. The diagnosis, suspected on clinical grounds, was confirmed by ultrasonography in 95 p. 100 of the patients. Beside CRF and hypertension, the main complications were microscopic haematuria (38 p. 100) and urinary tract infection (24 p. 100). In two patients the disease was associated with hepatic polycystosis. Treatment was symptomatic for CRF (4 patients were put on periodical haemodialysis) and for the other complications. On the basis of this series, we discuss the profile and prognosis of polycystic kidney disease in our environment, and notably its effects on renal function, and we underline the usefulness of familial investigations and the need for genetic counselling.
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PMID:[Dominant renal polycystic disease]. 252 23

Three haemodialyzed chronic renal failure patients with histologically proven osteomalacia due to aluminium toxicity were treated with repeated injections of desferrioxamine, a potent chelator of aluminium. The drug, in doses of 3 or 6 g, was administered intravenously once a week for 5 to 11 months, at the end of a dialysis session. Treatment was well tolerated. Dramatic clinical improvement was observed, with rapid regression of pain and functional impairment. There was a 65% increase in alkaline phosphatase and a rise of immunoreactive parathyroid hormone (terminal C fragment). Healing of fractures was confirmed by radiology, and a second bone biopsy in the 3 patients after double tetracycline labelling showed regression of morphological and dynamic signs of osteomalacia, considerable reduction in stainable aluminium deposits and strong increase in bone remodelling compatible with the development of hyperparathyroidism. It is concluded that a moderate dose of desferrioxamine administered once a week is effective against osteomalacia due to aluminium toxicity.
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PMID:[Desferrioxamine treatment of osteomalacia caused by aluminum poisoning]. 293 57

A 36-year-old woman was admitted for initiation of hemodialysis for chronic renal failure. Two days after catheter placement the patient developed a fever that persisted and resulted in subsequent removal of the catheter. Although blood cultures were negative, cultures of the catheter tip were positive for Staphylococcus epidermidis. An initial vancomycin dose was well tolerated, but the patient later experienced numbness and tingling of her lower back accompanied by pain ten minutes after initiation of the second dose. Symptoms abated when the vancomycin infusion was discontinued, and the drug was subsequently well tolerated when reinstituted at a slower infusion rate. Similar symptoms were observed five minutes into a vancomycin infusion a week later that also resolved after decreasing the infusion rate. Patients on hemodialysis receiving vancomycin should be carefully monitored during drug administration for the development of paresthesia and spasmodic lower back pain.
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PMID:Paresthesia and back pain in a patient receiving vancomycin during hemodialysis. 297 72

We recently treated three patients with chronic renal failure who required subclavian vein cannulation with Uldall catheters following thrombosis of their arteriovenous fistulae. New arteriovenous fistulae were created in each patient following removal of the Uldall catheters. The patients were seen subsequently with massive, painful edema in the ipsilateral upper extremities from one to 10 weeks following creation of the arteriovenous fistulae. Radiographic studies documented stenosis or occlusion of the ipsilateral proximal subclavian vein. The arteriovenous fistula was ultimately ligated in each patient, which promptly resolved the pain and edema. Because subclavian vein thrombosis following temporary hemodialysis through an indwelling catheter is frequently asymptomatic until an arteriovenous fistula is constructed, venography should be considered in patients requiring upper extremity vascular access procedures. Demonstration of subclavian vein stenosis or occlusion would either preclude use of the upper extremity for an arteriovenous fistula or would require a concomitant procedure to relieve the venous obstruction.
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PMID:Massive upper extremity edema following vascular access surgery. 322 42

Familial Mediterranean fever (FMF) has been observed in a Swiss child without ethnic predisposition. The case is analyzed and the current literature briefly reviewed. Recurrent attacks of fever, accompanied by abdominal pain, colic and arthritic symptoms, and often by pleuritic pain and a transitory skin rash, are the hallmarks of FMF, which is predominantly seen in ethnic groups of the Mediterranean area, notably Sephardic Jews, Turks and Armenians. However, it rarely occurs among individuals without an ethnic predisposition. Its most ominous manifestation is amyloidosis, which leads to chronic renal failure within a matter of years. Thanks to colchicine treatment, which is now widely accepted, patients often lead normal lives, and it appears that amyloidosis can be prevented.
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PMID:[Familial Mediterranean fever. Study of a Swiss child]. 356 45

A 79-year-old Armenian-born woman with stable, long-term familial Mediterranean fever had progression of chronic renal failure concurrently with two types of skin lesions. One lesion resembled erysipelas, which is quite common in familial Mediterranean fever, whereas the other was panniculitis, only occasionally described in familial Mediterranean fever. The unique histopathologic features of the latter are presented. The onset of acute cutaneous disease in this patient coincided with worsening renal disease and preceded a flare of disease activity in other sites after a 14-year period of quiescence. The severe and unremitting pain from the skin lesions and their tendency to form nonhealing ulcers were substantial causes of morbidity in this patient with familial Mediterranean fever.
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PMID:Panniculitis in familial Mediterranean fever. Case report with histopathologic findings. 356 36

The joint disorders associated with osteodystrophy of 124 regularly haemodialysed patients are reviewed. The most common signs and symptoms of uraemic osteoarthropathy are summed up. It is pointed out that in osteoarthropathy accompanying chronic renal failure or haemodialysis the bones are generally affected first, arthropathy being secondary to this process. In addition to the classic signs and symptoms of arthropathy (calcification, pain, stiffness) capsulitis, carpal tunnel syndrome and in 3 cases avascular necrosis were observed. The laboratory findings included hypocalcaemia, hyperphosphataemia and hypersecretion of parathormone. The current preventive and therapeutic measures are reviewed and in this context the benefits of combined local lidocaine, and steroid iontophoresis are emphasized in the light of personal observations.
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PMID:Arthropathy in haemodialysed patients. 360 87


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