Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0035078 (renal failure)
 31,970 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sixteen patients underwent a modification of the Sugiura procedure for bleeding esophageal varices, involving (a) esophageal transection, (b) splenectomy, (c) selective vagotomy, and (d) pyloroplasty. Five patients died, and the remaining 11 had barium studies of the esophagus and stomach which were compared with the preoperative appearance. Esophageal varices disappeared in 7 patients and persisted in 1. No recurrent bleeding or encephalopathy was seen: however, there were a large number of complications, including pleural effusion, ascites, ileus, pneumonia, and renal failure. Hepatic failure, respiratory failure, and sepsis secondary to gastrointestinal leakage also occurred and were fatal in all cases. As the Sugiura procedure is increasingly being employed in the United States, radiologists should be familiar with the spectrum of postoperative radiographic findings in the esophagus and stomach.
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PMID:Radiographic findings in the esophagus following the Sugiura procedure. 697 61

Twenty-eight patients entered a double-blind controlled trial to evaluate the efficacy of prednisolone treatment in severe acute alcoholic hepatitis accompanied by encephalopathy. Fifty-three percent (8 of 15) given prednisolone and 54% (7 of 13) given placebo died during the study. The mean duration of hospitalization was 66 days for the prednisolone-treated group and 56 days for those treated with placebo. Prednisolone treatment produced no important beneficial effect on any of the hepatic biochemical tests. The outcome in any particular case was directly related to the development of specific lethal complications (renal failure, injection, and gastrointestinal bleeding) rather than to the treatment employed. We were unable to show any beneficial effect of prednisolone treatment on morbidity or mortality in patients with severe acute alcoholic hepatitis and encephalopathy.
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PMID:Double-blind controlled trial of prednisolone therapy in patients with severe acute alcoholic hepatitis and spontaneous encephalopathy. 698 81

Among the patients considered for hepatic transplantation, cirrhosis should be theoretically the best indication. Results so far are disappointing because the patients who have undergone a transplantation had end stage liver disease. When gastrointestinal bleeding, renal failure, coagulopathy and encephalopathy are used as criteria, one can accurately select patients who will die from cirrhosis within one month. Our results for those who had a liver graft in this group are poor. Criteria were then selected to identify a less dramatically ill group of patients with cirrhosis. These patients have residual poor liver function after surviving acute severe complications and have a spontaneous survival of less than one year. The results of liver transplantation in two patients in this group are encouraging.
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PMID:Criteria for hepatic transplantation in cirrhosis. 699 11

Administered the Halstead-Reitan Battery (HRB) of neuropsychological tests to 24 patients with advanced renal failure, 24 patients with neurological disorders, and 24 patients with medical and/or non-psychotic psychiatric conditions in order to assess the effects of uremic encephalopathy on human neuropsychological functioning. The groups did not differ significantly in age, education, verbal intelligence, or level of affective disturbance. Results indicated that the uremic and neurological groups were equal in overall level of neuropsychological impairment and that both were significantly more impaired than the medical-psychiatric group. However, the uremic group showed a pattern of deficits that was qualitatively different from both the neurological and medical-psychiatric groups. Results were discussed with reference to selective cortical dysfunctions in uremia and contrasted with earlier studies that did not consider differential sparing of abilities in renal patients.
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PMID:Neuropsychological patterns in uremia. 705 Jan 78

Kupffer cell and hepatocyte function were studied in 36 patients with fulminant hepatic failure by measurement of clearance of 125I microaggregated albumin (125IMAA) and galactose, respectively. Both were impaired but there was no correlation with final outcome, although on sequential testing 48 hours later, those patients who survived had a significantly greater improvement in Kupffer cell and hepatocyte function. In six other patients with similar hepatocyte dysfunction but no encephalopathy, Kupffer cell function was not significantly different from that of controls. This is additional support for a possible relation between encephalopathy and damage to Kupffer cell function. The latter was also shown to correlate with renal failure; this is consistent with the suggestion that endotoxaemia is important in the pathogenesis of this complication.
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PMID:Reticuloendothelial system and hepatocytic function in fulminant hepatic failure. 707 3

A retrospective analysis of children with renal failure during the first year of life revealed that 20 of 23 patients developed profound neurologic abnormalities. The encephalopathy was characterized by developmental delay, microcephaly, hypotonia, seizures, dyskinesia, and EEG abnormalities. No patient had been dialyzed, and four had not received aluminum salts prior to the development of neurologic symptoms. Inadequate statural growth and poor nutrition were present in all patients. It is probable that infants with chronic renal insufficiency are more susceptible to the development of this syndrome than are older children or adults because of the significant growth and maturation of the brain that occurs during the first years of life.
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PMID:Progressive encephalopathy in children with chronic renal insufficiency in infancy. 708 84

The pathogenesis of neuropathy and encephalopathy in patients with renal failure remains unknown. Possible factors include particularly aluminium intoxication, accumulation of certain middle molecular substances (MMS) and disturbances of tryptophan metabolism. Serum and CSF taken post-mortem from 8 uremic subjects who had been treated conservatively and from 4 patients on a chronic intermittent hemodialysis program who had dialysis dementia were subjected to MMS fractionation. Although MMS could not be detected in the CSF of normal controls, these substances were found in the CSF of uremic subjects in a pattern similar to that found in serum, although their concentrations were clearly lower than in serum. Their appearance could be due to impairment of the blood-CSF barrier. Uremic patients who had been treated conservatively had significantly increased CSF tryptophan concentrations when compared to the control subjects, but the CSF tryptophan concentrations of patients with dialysis dementia were in the normal range. Thus the pathogenesis of dialysis dementia cannot be related to the accumulation of MMS or to disturbances of tryptophan metabolism in the CSF.
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PMID:Middle molecular weight substances in the cerebrospinal fluid of uremic patients. 710 4

This study is part of a five-year project to investigate the long term effect of chronic hemodialysis on patients with end-stage renal failure. Previous research has associated hemodialysis with progressive dialysis encephalopathy (PDE), which is characterized by speech disturbances, cognitive impairment, myoclonus and behavioral changes. Little is known about the cause or the course of this syndrome except that it begins 14-36 months after treatment onset and usually culminates in death. The purpose of this study was to investigate neuropsychological (cognitive and behavioral) functioning in dialysis patients over a period of years. To date, 34 patients have been studied for 22 months utilizing a cross-sectional method comparing patients at different stages of treatment combined with a longitudinal method of repeated evaluations over time. Current findings show improved cognitive functioning during at least the first year of treatment and no evidence of cognitive deterioration in patients on dialysis for more than one year (M = 4.3). These findings offer strong evidence that PDE is not necessarily a general phenomenon among patients on chronic hemodialysis.
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PMID:Longitudinal study of neuropsychological functioning in patients on chronic hemodialysis: a preliminary report. 715 43

Among 103 patients with fulminant hepatic failure due to viral hepatitis, paracetamol overdose, or halothane anaesthesia, treated over a 2-year period, 23 had bacteraemia. Gram-positive organisms, mainly streptococci and Staphylococcus aureus, were isolated from 61% of patients. Escherichia coli, the main type of gram-negative organism isolated, was found in 26% of patients and was associated with a fatal outcome more often than gram-positive bacteria. The type of organism isolated was not related to the aetiology of the hepatic necrosis, the presence of renal failure, or the clinical outcome. In the 23 patients with bacteraemia the same organism was isolated from other sites of infection, including sputum in four, urine in two, and the central venous catheter and arteriovenous shunt in one. Bacteraemia usually occurred 3 days after admission or on average 2 days after clinical deterioration to grade IV encephalopathy had begun. In 11 patients, the infection had an adverse effect on their clinical course, in three patients being implicated as a cause of the encephalopathy. Although in four patients the development of infection after all signs of encephalopathy had cleared may have been a major factor in their death, two of these patients had evidence of severe sepsis, pneumococcal peritonitis, and renal abscesses from which Candida albicans was cultured. An awareness of infection as a complication both of the acute stage of the illness and during recovery is essential if early detection and treatment are to be effective.
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PMID:Bacteraemia in patients with fulminant hepatic failure. 717 37

Brain aluminium concentration has been found significantly higher in patients dying with dialysis encephalopathy than in uraemic patients without this syndrome, and it has previously been reported only in haemodialysed patients. We report a case of high brain aluminium concentration in a uraemic boy showing symptoms of severe encephalopathy. He was never dialysed but only treated with aluminium hydroxide orally. Baluarte reported corresponding symptoms in nondialysed uraemic children, but brain aluminium concentrations were not reported. His patients as well as our had very high levels of parathormone which may play a role in the resorption and distribution of aluminium. Aluminium preparations should be avoided in children with renal failure.
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PMID:Dialysis encephalopathy in a non-dialysed uraemic boy treated with aluminium hydroxide orally. 721 65


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