Search PubMed⌕ Search

Biomedical subjects

E Quellhorst

Publications and source records attributed to E Quellhorst.

At least 37 records · Page 2Linked to original sources
PubMed1985

Optimum dialysis treatment for patients over 60 years with primary renal disease. Survival data and clinical results from 242 patients treated either by haemodialysis or haemofiltration.

An analysis of the data of 180 haemodialysis patients and 62 haemofiltration patients over 60 years of age when commencing treatment, clearly shows that this age group of patients (when suffering from primary renal disease) has a very good chance of surviving many years when treated with either haemodialysis or haemofiltration. This refers also to patients being older than 75 or 80 years, who have survival rates of 50 per cent after five years and three years respectively. The presented data further indicate that chronic haemofiltration seems to be the superior treatment when compared with acetate haemodialysis for the treatment of elderly renal patients, as the survival rates are at any chosen time interval higher with haemofiltration than with haemodialysis.

Age Factors↗
PubMed1983

Long-term follow up in chronic hemofiltration.

The course of treatment is demonstrated in 72 patients with chronic renal insufficiency who were undergoing regular hemofiltration for more than 6 months. 29 patients were treated for more than 5 years and 8 for more than 6 years with hemofiltration exclusively, total experience comprising 2,985 patient months. Thus, 16% of all patients accepted for artificial kidney treatment were selected for this form of therapy. Main reasons for transfer from hemodialysis to hemofiltration were hypotension, hypertension and/or repeated episodes of overhydration. In 12 patients with severe drug- and dialysis-resistant hypertension, blood pressure was normalized within 6 weeks after transfer to hemofiltration. Whereas some parameters of lipid and bone metabolism showed a tendency towards normalization, a favourable effect of hemofiltration on neuropathy was not observed. Main causes of death were encephalomalacia and cardiac infarction. Contraindications for post-dilution hemofiltration are vascular access problems resulting in a reduced blood flow and severe catabolism with accumulation of low molecular protein metabolites or potassium.

Adolescent↗
PubMed1981

How to prevent vascular instability: haemofiltration.

Most investigators agree that the remarkable tolerance of the vascular system to fluid withdrawal by haemofiltration is one of the most important advantages of this method. On the other hand it has been shown that blood pressure can be normalised in patients with dialysis-resistant hypertension by applying haemofiltration. The preservation of extracellular osmotic pressure during haemofiltration, obviously caused by the maintenance of a relatively high extracellular Na+ concentration, may induce a rapid and effective refilling of this compartment thus preventing vascular instability. A concept which may explain the apparently contradictory effect of haemofiltration on hypo- and hypertension, is proposed.

Blood↗
PubMed1980

Response of the vascular system to different modifications of haemofiltration and haemodialysis.

In order to evaluate the reasons for the better tolerance of the cardiovascular system to body fluid removal in HF, different modifications of single-pass and recirculation HD as well as post-dilution HF were applied in 6 patients with stable chronic renal insufficiency under identical conditions of fluid removal, Curea and use of dialysers. A remarkable tolerance of the vascular system could be observed in HF as in HD when the Na+ concentration in the dialysis or diluting fluid was raised from 130 to 150mEq/L or when plasma osmotic pressure was stabilised by i.v. infusion of mannitol. The different buffers acetate and lactate did not influence the results specifically. Total peripheral resistance and plasma noradrenaline levels increased in HF but showed no changes in HD. Important factors causing the greater tolerance of the cardiovascular system in HF may be a more stable extracellular osmotic pressure, inducing a rapid refilling of the extracellular space, combined with an increasing total peripheral resistance.

Blood↗
PubMed1979

[Meproscillarin in patients with renal failure and concomitant heart failure (author's transl)].

Meproscillarin is a glycoside with a high bioavailability (about 70%) and an elimination independent of the renal function. It was to be investigated whether a good cardiac effectiveness can be demonstrated during oral long-term application of meproscillarin to patients with renal failure. 29 patients with renal failure of varying degree and concomitant heart failure were daily given an oral dose of 0.75 mg of meproscillarin over 14 days. The effectiveness of the glycoside was measured as change of the electromechanical systole (QS2c) and the quotient of the diameter of heart and thorax (C/T) from the 1st--15th day. The plasma levels of the glycoside were determined on the 1st, 8th, and 15th day. There was a significant shortening of QS2c (by mean = 27 ms, P less than 0.005) and a marked decrease in the size of the heart (P less than 0.0025); heart rate and PQ-interval were only insignificantly influenced. Plasma levels of 0.95 ng/ml were found after 8 days of treatment compared to 1.25 ng/ml after 15 days. As the pharmacokinetics of the glycoside is practically not influenced by the renal function, meproscillarin represents an alternative in the treatment of patients with heart failure and impaired renal function.

Adult↗
PubMed1979

[Diuretic resistant ascites in hepatic cirrhosis and renal insufficiency (author's transl)].

In decompensated hepatic cirrhosis the glomerular filtration rate is reduced. Use of diuretics frequently leads to hyponatraemia, hypotension, hypovolaemia and oliguria. The ensuing renal insufficiency is reversible when the peritoneal fluid is redirected into the vascular system. For this purpose a subcutaneously implantable pump developed by Agishi was used in a 37-year-old patient permitting drainage of the ascites from the peritoneal cavity into the superior vena cava using an actively operated pumping mechanism. Use of the pump in the patient abolished the ascites, considerably improved renal function, equilibrated electrolyte metabolism and improved renal response to diuretics.

Adult↗