ABSTRACT
We studied prospectively 18 patients with sodium-losing nephropathy. In 12 patients (66.7 per cent) the sodium-losing nephropathy was owing to obstructions, challenging the hitherto existing concept that the most common cause of the condition is pyelonephritis. The diagnosis of sodium-losing nephropathy is important in urological practice since sodium repletion in these cases shortens significantly the hospitalization and preoperative waiting time.
Subject(s)
Hyponatremia/etiology , Kidney Diseases/metabolism , Sodium/metabolism , Adult , Aged , Bicarbonates/therapeutic use , Blood Pressure , Female , Humans , Hyponatremia/physiopathology , Kidney Diseases/drug therapy , Kidney Diseases/physiopathology , Male , Middle Aged , Prospective Studies , Sodium/therapeutic use , Syndrome , UrodynamicsABSTRACT
This is a prospective study on 24 patients with chronic renal failure. Thirteen of them had evidence of acute uraemic encephalopathy. Of those 9 patients were found to have dilutional hyponatraemia, two patients severe salt and water depletion and one patient septicaemia. Hyponatraemia was associated with pulmonary oedema in 3 patients. Correction of salt and water disturbances and treatment of heart failure improved cerebral functions in 10 (77%) patients. It is therefore concluded that dilutional hyponatraemia probably leading to cerebral oedema is a reversibe major factor in the development of acute uraemic encephalopathy. This, if left uncorrected, may prove fatal especially in tropical countries.
Subject(s)
Brain Diseases/etiology , Kidney Failure, Chronic/complications , Acute Disease , Adolescent , Adult , Brain Diseases/therapy , Child , Female , Humans , Male , Middle Aged , Sodium/blood , Unconsciousness/etiology , Uremia/complications , Water-Electrolyte BalanceABSTRACT
Urine produced by obstructed kidneys was analysed in 35 cases. In the absence of infection by urea splitting organisms, estimation of urinary pH of hydroephrotic kidneys was found to be a reliable method for determination of recovery potential. After removal of obstruction, radiological recovery was almost complete when the pH was lower than 6. Obstructed kidneys producing urine with a pH between 6-7.1 showed only partial radiological recovery after surgical correction. All kidneys that showed no function on IV urography and those found at operation to possess only a very thin shell of cortex to justify nephrectomy were found to have urinary pH near 7.3 or more, implying inability of those kidneys to acidify urine. Urinary specific gravity and sodium concentration of obstructed kidneys were not reliable in prediction of renal recovery.
