Urinary diagnostic indices in the management of leptospirosis: selection of patients for dialysis therapy
West Indian med. j
; 38(1): 33-8, Mar. 1989.
Article
in English
| MedCarib
| ID: med-11029
Responsible library:
JM3.1
Localization: JM3.1; R18.W4
ABSTRACT
Cases of leptospirosis admitted to the Queen Elizabeth Hospital (QEH), Barbados, were assessed for the presence of "pre-renal azotaemia" (NON-ARF) as opposed to "acute renal failure" (ARF). Distiction between the two diagnoses was made on the basis of clinical course. Peritoneal dialysis was inappropriately utilised in 26 percent of patients receiving such therapy. This study evaluates diagnostic tests for pre-renal azotaemia, and acute renal failure in leptospirosis, and indicates guidelines for the management of azotaemia in such patients. U/P urea and osmolar ratios show high sensitivity and specificity in diagnosing pre-renal azotaemia. While "early" dialysis is essential for patients with acute leptospiral renal failure, in those with plasma creatinines less than 600 umol/litre on entry and indices indicating NON-ARF, decisions regarding dialysis can safely be delayed for 48-72 hours while the effect of rehydration is assessed (AU)
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Collection:
International databases
Database:
MedCarib
Main subject:
Uremia
/
Acute Kidney Injury
/
Leptospirosis
Type of study:
Diagnostic study
/
Etiology study
/
Practice guideline
/
Prognostic study
Limits:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Male
Country/Region as subject:
Barbados
/
English Caribbean
Language:
English
Journal:
West Indian med. j
Year:
1989
Document type:
Article