[Peritoneal dialysis in the treatment of acute renal insufficiency]. / Primena peritoneumske dijalize u lecenju akutne insuficijencije bubrega.

106 patients with acute renal failure (ARF) treated with peritoneal dialysis (PD) for the last 15 years (except for postrenal ARF treated only with HD, or ARF with conservative treatment) were analyzed. The commonest causes were sepsis (3), hemorrhagic fever (17) and complications of some internal or surgical disease (28). ARF appeared more frequently in older ages (> 50 y). Some causal diseases had closer relationship with sex like sepsis (22 women vs 8 men) and hemorrhagic fever (16 men vs 1 woman). The treatment was started on time (2-3 day after onset of ARF). In most of the patients stabilization of uremic symptoms was achieved in five days (average). The duration of oliguric phase, polyuric phase and treatment with PD where closely related to the causal disease. Mortality of ARF was 60% in patients with causal disease. Mortality of ARF was 60% in patients with surgical or internal complications, in patients with sepsis and 20-30% in others (complications during ARF were most frequently observed in patients with sepsis). Hemodialysis was used in severe cases and we were unable to determine its role in survival of patients with ARF.

[The effect of subtotal parathyroidectomy in patients on haemodialysis]. / Rezultati suptotalne paratireoidectomije kod bolesnika na hemodijalizi.

Secondary hyperparathyroidism is one of the main and most consistent clinical manifestations of chronic renal failure. It develops in the early stage of chronic renal failure, and its severity increases with further deterioration of renal function. Renal osteodystrophy is the most frequent form of secondary hyperparathyroidism. The management of secondary hyperparathyroidism leads to improvement of calcium and phosphorus homeostasis and suppression of parathyroid secretion. Such treatment with medicament may be unsuccessful, and certain features of secondary hyperparathyroidism may necessitate parathyroid surgery. The aim of this article is to present our experience in the treatment of secondary hyperparathyroidism with subtotal parathyroidectomy. Twenty two patients on haemodialysis after subtotal parathyroidectomy were followed for about 2 years (x +/- SD: 2.0 +/- 1.5) after the operation. During this time the effect of operation on biochemical and clinical signs, and radiographical features of secondary hyperparathyroidism was evaluated. According to our results the subtotal parathyroidectomy stopped in most cases, the progression of secondary hyperparathyroidism. In two patients the reappearance of overt secondary hyperparathyroidism was observed 2.5 and 3.5 years after the operation.