Subject(s)
Adenovirus Infections, Human/complications , Cystitis/microbiology , Cytomegalovirus Infections/complications , Hemorrhage/microbiology , Kidney Transplantation , Adenovirus Infections, Human/drug therapy , Adult , Antiviral Agents/therapeutic use , Cystitis/drug therapy , Cytomegalovirus Infections/drug therapy , Female , Hematuria/microbiology , Hemorrhage/drug therapy , Humans , Immunosuppressive Agents/therapeutic use , Male , Middle Aged , Transplantation, HomologousABSTRACT
Intravesical alum irrigation is the safest and most effective method of treatment for intractable hematuria. Systemic absorption is reported to be minimal and there have been no reported deaths following its use. We describe an elderly man with compromised renal function (serum creatinine 420 mumol./l.) who was treated with 1% alum irrigation for 48 hours for hematuria due to inoperable bladder cancer. He received a total of 9.6 l. during 48 hours, which controlled the bleeding. After cessation of the alum he became lethargic, suffered respiratory depression and died the next day. Laboratory data showed mild metabolic acidosis and increasing daily aluminum levels that peaked at 7,014 nmol./l. (toxic greater than 2,000) beginning on the day after treatment was commenced. The efficacy and safety profile of alum irrigation is discussed.
Subject(s)
Alum Compounds/poisoning , Hematuria/therapy , Aged , Aged, 80 and over , Alum Compounds/administration & dosage , Hematuria/etiology , Humans , Male , Therapeutic Irrigation , Urinary Bladder , Urinary Bladder Neoplasms/complicationsABSTRACT
The effect of glucagon on upper urinary tract peristalsis during extreme diuresis was studied in an unsedated dog preparation. In all experiments glucagon inhibited the peristaltic contraction waves without affecting urine propulsion, suggesting that peristalsis, at least for short periods, is not necessary for effective urine transport during extreme diuresis.
Subject(s)
Diuresis , Glucagon/pharmacology , Muscle Contraction/drug effects , Ureter/physiology , Urodynamics , Animals , Dogs , Female , Pressure , Time Factors , Ureter/drug effectsABSTRACT
Pressures occurring in the upper urinary tract during perfusion and diuresis were compared in an unsedated dog preparation. Perfusion pressures were significantly higher, suggesting that a product of diuresis actively reduces upper tract tone.
Subject(s)
Diuresis , Perfusion , Urinary Tract Physiological Phenomena , Animals , Dogs , Female , Kidney Pelvis/physiology , Pressure , UrodynamicsABSTRACT
A complication of Gianturco coil infarction of a massive renal carcinoma with caval obstruction is presented. The immediate response was excellent but at 4 months the patient became hypertensive and potassium-depleted. A large aneurysm of the renal artery had developed at the site of the coils, necessitating nephrectomy.
Subject(s)
Aneurysm/etiology , Embolization, Therapeutic/adverse effects , Kidney Neoplasms/blood supply , Renal Artery , Aneurysm/surgery , Humans , Kidney Neoplasms/surgery , Kidney Neoplasms/therapy , Male , Middle Aged , Renal Artery/pathologyABSTRACT
The association of ureteric dilatation and urinary infection has been attributed to a direct toxic effect of E. Coli endotoxin on ureteric muscle. A specific causal relationship could not be established in this study in dogs.
Subject(s)
Endotoxins/pharmacology , Escherichia coli , Muscle Contraction/drug effects , Ureter/drug effects , Animals , Dogs , FemaleABSTRACT
An in vivo study of the response of the dog ureter to local anaesthetics administered systemically and by ureteric perfusion, revealed that lidocaine, procaine, and mepivacaine, caused hyperperistalsis. The intravenous use of a near toxic dose produced hyperperistalsis of limited duration, whereas, intraureteric administration produced a prolonged and constant response with low dosage. The mode of action of these drugs is unclear as they are generally regarded as being non specific smooth muscle depressants. Continued peristalsis after prolonged exposure to local anaesthetic favours a myogenic rather than neurogenic conduction of the ureteric contraction wave.
Subject(s)
Lidocaine/pharmacology , Mepivacaine/pharmacology , Muscle Contraction/drug effects , Procaine/pharmacology , Ureter/drug effects , Animals , Dogs , Dose-Response Relationship, Drug , Female , Muscle, Smooth/drug effects , PerfusionSubject(s)
Ureter/drug effects , Animals , Dogs , Female , Histamine/pharmacology , Isoproterenol/pharmacology , Kidney/physiology , Meperidine/pharmacology , Methods , Models, Biological , Morphine/pharmacology , Muscle Contraction/drug effects , Phenylephrine/pharmacology , Pressure , Prostaglandins/pharmacology , Urinary CatheterizationSubject(s)
Kidney Pelvis/physiology , Manometry , Ureter/physiology , Adult , Animals , Anuria/physiopathology , Child , Child, Preschool , Diuresis , Dogs , Humans , Hydronephrosis/physiopathology , Kidney Transplantation , Male , Pressure , Transplantation, Autologous , Ureteral Obstruction/physiopathology , Urinary Bladder , Vesico-Ureteral Reflux/physiopathologyABSTRACT
Nephrectomy has been carried out in 34 patients with hypertension associated with unilateral parenchymal renal disease (28 with unilateral pyelonephritis, 3 tuberculosis, 2 hypoplasia, and 1 adenocarcinoma). In 13 of the patients the blood pressure was corrected, in four it was improved, and in 17 it was unaffected. The intravenous pyelogram (by the infusion technique with nephrotomography if necessary) and renogram give adequate information in most patients with unilateral parenchymal renal disease but may need to be supplemented by aortography, or retrograde pyelography, or divided renal function studies in a few special circumstances. When the function of the damaged kidney is less than 25% of the total (which is well maintained), and the contralateral kidney is intact, nephrectomy is recommended provided the hypertension is significant; success is more likely in younger patients with a short history of hypertension.
