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Query: UMLS:C0035078 (renal failure)
 31,970 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Among the diabetic patients we have treated with dialysis blood pressure and blood sugar control have been poor and vascular disease progressive. Intermittent peritoneal dialysis did not improve these problems compared with haemodialysis. Continuous ambulatory peritoneal dialysis was undertaken in three patients as a last resort and electively in another two patients. Insulin was given by the intraperitoneal route and none was used systemically. Self-care was taught from the first using the spouse if visual problems were present. Serum creatinine levels fell and haemoglobin levels rose. Blood pressure was controlled without diet or drugs. Blood sugar levels were controlled without symptomatic hypoglycaemia or rebound hyperglycaemia. The procedure had a demoralising effect on helper spouses, and self-care had to be achieved even with severe visual problems. The advantages of continuous ambulatory peritoneal dialysis to the diabetic with renal failure are greatly improved control of blood pressure and blood sugar.
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PMID:Advantages of continuous ambulatory peritoneal dialysis to the diabetic with renal failure. 54 79

Diabetic patients with chronic renal failure are known to be at risk for exacerbation of renal failure if they undergo intravenous pyelography (IVP). The present report demonstrates that diabetic patients with normal serum creatinine levels can sustain irreversible renal failure following an IVP. The experiences with this case suggest that, if the creatinine clearance is decreased in an insulin-dependent patient irrespective of the serum creatinine value, one must be aware of the possible hazard of acute renal failure and irreversible renal damage following the IVP. This would appear to be especially true if the diabetic patient has proteinuria in combination with the decreased creatinine clearance.
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PMID:Acute renal failure in insulin-dependent diabetics: episodes secondary to intravenous pyelography. 55 65

Between 1972 and 1976 15 patients with chronic renal failure of different aetiology and varying severity were observed who developed 23 hypercalcaemic phases during treatment with calcium-containing drugs. 12 instances of hypercalcaemia occurred during conservative treated during conservative treatment (serum creatinine 177-1061 mumol/l, equivalent to 20-120 mg/l) and 11 during chronic haemodialysis (serum creatinine 707-1061 mumol/l, equivalent to 80-120 mg/l). In 15 cases hypercalcaemia was caused by a hexacalciumhexasodium-heptacitratehydrate complex (Acetolyt), in 6 cases by the combined use of this drug with calcium ion-exchange resins on a calciumpolystyrolsulfonate base, and in two cases by the use of calcium tablets and calciumpolystyrolsulfonate, respectively. The daily doses of these drugs were in the usual therapeutic range in most cases. Deterioration of renal function was observed in two cases and coma in a further two cases. In 5 cases gastric ulcers were demonstrated. Three patients died. In no patient was there evidence of florid hyperparathyroidism. Treatment with calcium-containing drugs in patients with renal failure should only be carried out under regular control of calcium concentrations.
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PMID:[Hypercalcaemic crises in patients with chronic renal failure caused by ion-exchange resins, antacidotics and other calcium-containing drugs (author's transl)]. 59 99

Twenty-two of 29 (76 per cent) diabetic patients with a creatinine level of more than 2 mg/100 ml had exacerbation of renal failure following intravenous pyelography. In nine patients this was irreversible. Particularly at risk seem to be patients with early onset diabetes (less than 40 years), and those patients with severe renal failure (creatine over 5 mg/100 ml). No less that 15 of 16 (93 per cent) such patients had problems after intravenous pyelography; of these, nine (56 per cent) had irreversible deterioration. This report, in context with the increasing number of case reports of similar findin.gs, indicates that intravenous pyelography is dangerous in patients with juvenile onset diabetes who have a creatinine level of more than 5 mg/100 ml.
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PMID:Exacerbation of diabetic renal failure following intravenous pyelography. 60 16

Serial blood samples for determination of drug levels were obtained after intravenous administration of 300 mg of cimetidine. Sixteen patients with varying degrees of renal failure were studied. There was a prolongation of drug half-life in patients with renal insufficiency compared with that in normal controls (P less than 0.001). A significant inverse relationship between the half-life and the creatinine clearance was noted (r= 0.69; P less than 0.01). The effect of hemodialysis was studied in 12 patients. Cimetidine was found to be dialyzable. This was demonstrated both by a shortening of the half-life of the drug during dialysis and by measurement of dialysance. This suggests that the dose schedule should be modified for patients with renal insufficiency and for those on hemodialysis. A single intraveno us dose of cimetidine was well tolerated by the patients. One patient developed an urticarial skin rash, believed to be allergic in nature. There was a transient, mild (but significant) rise in blood urea nitrogen and serum creatinine concentration in 5 patients with moderate renal failure.
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PMID:Effects of renal failure on blood levels of cimetidine. 62 Sep 15

Ten patients have undergone surgical division of the left renal vein (LRV) during operations on the abdominal aorta. Nine were elective procedures performed during the resection of a complicated abdominal aortic aneurysm (six patients) or treatment of complete infrarenal aortic occlusion (three patients). The first patient in this series underwent emergency LRV ligation at the renal hilum for the control of hemorrhage incurred during an elective aneurysmectomy. This patient survived postoperative renal failure and myocardial infarction, but died 21 months later from another myocardial infarction. At the time of death, he had moderate renal insufficiency. None of the remaining nine patients undergoing elective LRV division experienced any apparent renal dysfunction, as measured by urine sediment, serum creatinine, blood urea nitrogen, and intravenous pyelography. Although not recommended as a routine maneuver, division of the LRV is advocated as a safe adjunct for surgical exposure in difficult aortic procedures.
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PMID:Division of the left renal vein: a safe surgical adjunct. 62 89

High dose of intravenous furosemide (2 g/24 hr) was given to six patients with acute renal failure due to leptospirosis. The results, based on urine flow, changes in serum creatinine and creatinine clearance, were compared with a control group of eight patients with the same disease and comparable degree of renal failure. Excellent diuresis was observed following furosemide therapy but renal function and the clinical course of the disease were unaltered. The duration of renal failure was the same in both groups.
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PMID:Furosemide and acute renal failure. 62 55

A rat model was utilized to compare the nephrotoxic potential of gentamicin and tobramycin. Gentamicin, 40 mg/kg per day, predictably produced renal failure and morphological evidence of proximal tubular necrosis over 14 days of treatment. An identical dosage of tobramycin was associated with only minimal morphological changes and normal concentrations of serum creatinine and blood urea nitrogen. Similar results were obtained even after the tobramycin dosage was tripled to 120 mg/kg per day. A decrease in urine osmolality, mechanism unknown, was observed in all aminoglycoside-treated rats, but the lowest osmolalities were found in the gentamicin-treated rats. According to both histological criteria and renal function measurements, gentamicin was more nephrotoxic than tobramycin in this animal model.
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PMID:Comparative nephrotoxicity of gentamicin and tobramycin in rats. 62 89

Proximal tubular reabsorption was studied by the split drop micropuncture technique in HgCl2-induced severe as well as mild acute renal failure. 4 mg/kg of HgCl2 given subcutaneously to normal rats resulted in severe and usually oliguric acute renale failure at 48 h, mean plasma creatinine and urea having risen to 6.9 +/- 0.4 and 420 +/- 30 mg%. On inspection of the kidney surface, usually more than 50% of the convolutions appeared white opaque and collapased. Split drop reabsorption of 0.9% NaCl, 20% mannitol and 20% albumin was markedly accelerated in these necrotic tubular segments, while reabsorptive rates were usually quite reduced in the normal-looking red transparent convolutions. DOCA/saline-pretreated rats developed mild renal failure, with plasma creatinine and urea rising slightly to 1.6 +/-0.3 and 83 +/- 14 mg%, respectively, at 48 h after 4 mg/kh HgCl2. Reabsorptive rates were almost uniformly reduced from 0.55 +/- 0.02 in controls to 0.32 +/- 0.03 nl-mm-2 sec-1 in mild HgCl2-induced acute renale failure. Mild proximal tubular injury features decreased reabsorptive rate while severely damaged tubules appear to be leaky to the extent of allowing rapid disappearance from the tubular lument of the normally barely reabsorbable 20% albumin. Although compatible with unrestricted passive backflow being an additional factor in the pathogenesis of HgCl2-induced acute renal failure, these results do not challenge the importance of primary filtration failure.
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PMID:HgCl2-induced acute renal failure studied by split drop micropuncture technique in the rat. 62 96

Seven patients had acute oliguric renal failure after intravenous urography (2), celiac arteriography (2), or cardiac angiography (3). Diatrizoate meglumine was the contrast media used in all of the cases. These patients had an average age of 63 years and six were 55 years of age or older. Diabetes mellitus, negative fluid balance before the procedure, underlying renal insufficiency, and hypertension were common, being present in three, four, five, and six of the patients respectively . Anuria or oliguria occurred within 24 hours of the procedure and persisted from 36 to 96 hours (72 hours average). The serum creatinine level rose significantly in all of the patients and reached a peak in two to seven days after the procedure. In six patients, recovery was complete by two to three weeks. The seventh patient experienced only partial recovery. These cases taken together with a mounting number of recent reports suggest that contrast media-induced oliguric renal failure is more common than generally believed. Diabetes mellitus, older age, and underlying renal insufficiency seem to be important predisposing factors.
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PMID:Contrast media-induced oliguric renal failure. 62 32


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