RESUMO
A noninvasive technique, color Doppler flow imaging, was used to study the predictive value for future episodes of thrombosis in vascular access (polytetrafluoroethylene [PTFE] grafts and radial-cephalic fistulae) in a series of chronic hemodialysis patients. Patients with grafts were classified into three groups based on maximum constriction of the vascular access diameter: narrowing of greater than 50% (group I), narrowing of 30% to 50% (group II), and no narrowing or narrowing less than 30% (group III). More than half of the patients in group I suffered vascular access thrombosis within 6 months, while only 9% to 13% of patients in groups II and III had episodes of thrombosis during the same time interval. Decreased access volume flow (AVF) also correlated with episodes of thrombosis in these patients. No correlation could be demonstrated between recirculation and future thrombosis. No patient with a fistula had narrowing greater than 30% and none had vascular access thrombosis during the 6-month follow-up.
Assuntos
Derivação Arteriovenosa Cirúrgica , Prótese Vascular , Oclusão de Enxerto Vascular/diagnóstico por imagem , Diálise Renal , Trombose/diagnóstico por imagem , Ultrassonografia/métodos , Velocidade do Fluxo Sanguíneo/fisiologia , Oclusão de Enxerto Vascular/epidemiologia , Humanos , Politetrafluoretileno , Valor Preditivo dos Testes , Trombose/epidemiologia , UltrassomAssuntos
Rejeição de Enxerto , Transplante de Rim , Rim/fisiopatologia , Injúria Renal Aguda/fisiopatologia , Injúria Renal Aguda/terapia , Adulto , Humanos , Glomérulos Renais/patologia , Masculino , Síndrome Nefrótica/fisiopatologia , Síndrome Nefrótica/terapia , Prednisona/uso terapêutico , Remissão Espontânea , Diálise RenalRESUMO
Six hundred thirty-two percutaneous renal biopsies were performed in 479 patients between 1965 and 1978. Complications occurred with 86 biopsies, an incidence of 8.5 per cent. Most complications (seventy-six of eighty-six) were minor, and either resolved spontaneously or did not require intervention. There were ten major complications, including 6 patients with gross hematuria requiring blood transfusions, 3 with hemorrhage treated with arterial embolization, and 1 with a symptomatic arteriovenous fistula that was treated with partial nephrectomy. Major complications of percutaneous renal biopsy and the modes of therapy are discussed.
Assuntos
Biópsia por Agulha/efeitos adversos , Rim/patologia , Adolescente , Adulto , Idoso , Fístula Arteriovenosa/etiologia , Fístula Arteriovenosa/terapia , Criança , Pré-Escolar , Embolização Terapêutica , Feminino , Glomerulonefrite/patologia , Hematúria/etiologia , Hematúria/terapia , Humanos , Nefropatias/patologia , Masculino , Pessoa de Meia-Idade , Artéria Renal , Veias RenaisRESUMO
3 patients with chronic renal failure due to lupus nephritis received kidney allografts from cadaver donors. Serological activity was present in 2 patients at the time of transplantation, and continued unabated despite intensive immunosuppressive therapy. Their allograft failed at 5 and 7 months after transplantation. Anti-DNA antibody in the allograft was found in 1 patient. The 3rd patient, with no serological activity at the time of transplantation, remained serologically negative, and her allograft functioned for 18 months. The persistence of serological activity in 1 patient, and the recovery of anti-DNA antibody from her allograft provide proof for the recurrence of lupus nephritis in the allograft.
