RESUMO
Of five patients with hypernephroma who were maintained on hemodialysis after nephrectomy, four died with metastic disease after having been on hemodialysis for an average of 13.7 months (range 8 to 19). The fifth patient had no evidence of malignancy after 21 months of dialysis; he then received a renal allograft from his sister, and did well for 24 months before he developed liver metastasis. We believe hemodialysis is an appropriate mode of treating the renal failure of patients with hypernephroma after therapeutic nephrectomy. These patients may be considered for renal transplantation after a period of hemodialysis, and we suggest the currently recommended 12-month waiting period before transplantation be extended to 18 to 24 months. Use of living related donor renal allograft in these patients is questionable.
Assuntos
Adenocarcinoma/cirurgia , Nefropatias/terapia , Neoplasias Renais/cirurgia , Transplante de Rim , Nefrectomia , Complicações Pós-Operatórias , Diálise Renal , Adulto , Feminino , Humanos , Nefropatias/etiologia , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Fatores de Tempo , Transplante HomólogoRESUMO
A striking reduction in serum arsenic level was achieved after four hours of hemodialysis in a patient with acute arsenic intoxication and transient renal failure. Quantitative dialysance of arsenic and a comparison of daily urinary excretion of arsenic with amount removed by dialysis suggested that hemodialysis is indicated in the treatment of acute arsenic intoxication if there is concomitant renal failure. In the presence of normal renal function, supportive measures, including dimercaprol (BAL in Oil) therapy, constitute the best available treatment.
