RESUMO
Metabolic alkalosis resulting from nasogastric drainage is a well recognized and potentially serious clinical problem. In the postoperative patient with acute renal failure, the management of the metabolic alkalosis is particularly difficult, and established modalities of therapy are sometimes ineffective and can be hazardous to the patient. In this article, we report on the successful use of cimetidine (an H2-receptor antagonist) as an adjunct in the treatment of severe metabolic alkalosis in a postsurgical renal failure patient. To our knowledge, this is the first reported successful use of cimetidine in the treatment of metabolic alkalosis due to gastric acid loss.
Assuntos
Alcalose/tratamento farmacológico , Cimetidina/uso terapêutico , Guanidinas/uso terapêutico , Sucção/efeitos adversos , Injúria Renal Aguda/complicações , Adulto , Alcalose/etiologia , Sangue , Suco Gástrico , Humanos , Concentração de Íons de Hidrogênio , Intubação Gastrointestinal , Masculino , Período Pós-Operatório , Diálise RenalRESUMO
Seventeen patients without renal failure and 14 patients receiving long-term hemodialysis were studied. Serum and bone marrow ferritin determinations were made at the time of bone marrow aspiration. A good correlation was found between serum ferritin levels and bone marrow iron stores, as well as between bone marrow ferritin levels and iron stores. Serum ferritin determinations appear to give an accurate estimation of bone marrow iron stores, thereby providing a reliable guide for iron replacement therapy and reducing the need for repeated bone marrow aspirations. Serum ferritin levels of less than 105 ng/ml suggest decreased iron stores, and values greater than 120 ng/ml indicate adequate or increased iron stores. Preliminary data also suggest that bone marrow ferritin determinations may be useful in quantitating bone marrow iron stores.
Assuntos
Ferritinas/sangue , Ferro/administração & dosagem , Diálise Renal/efeitos adversos , Anemia Hipocrômica/etiologia , Anemia Hipocrômica/prevenção & controle , Medula Óssea/análise , Exame de Medula Óssea , Feminino , Ferritinas/análise , Humanos , Ferro/análise , Falência Renal Crônica/terapia , MasculinoAssuntos
Derivação Arteriovenosa Cirúrgica , Prótese Vascular , Artérias Carótidas/transplante , Politetrafluoretileno , Diálise Renal , Transplante Heterólogo , Adulto , Idoso , Animais , Derivação Arteriovenosa Cirúrgica/métodos , Prótese Vascular/métodos , Bovinos , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
To reduce the hours and cost of each dialysis and/or to increase adequacy of haemodialysis treatment 14 chronic dialysis patients were dialysed with two Gambro dialysers, 4 hr for 3 days per week. General well-being, anaemia, and nerve conduction velocity improved in some patients during the study period. Increasing dialysis surface area by using two Gambro dialysers enabled reduction of hours of dialysis, which was favourably accepted by all patients and decreased cost of dialysis, mainly by increasing the capacity of a unit to dialyse more patients with the same personnel and equipment.
