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Biomedical subjects

K M Butt

Publications and source records attributed to K M Butt.

At least 91 records · Page 5Linked to original sources
PubMed1978

Pragmatic realities in uremia therapy.

The present status and future prospects of uremia therapy in the United States are reviewed. Approximately 3500 renal transplants were done in 1976 as compared to 3700 in 1975. Functional two-year survival of grafts has not changed recently (40 to 45 per cent for cadaver donors; 70 to 75 per cent for siblings), but patient survival with cadaver grafts continues to improve (now 65 per cent at two years). Patients on hemodialysis in facilities are increasing rapidly. Only 13 per cent are on home dialysis, as compared with nearly 40 per cent five years ago. Home patients do at least as well as those in centers (80 per cent two-year survival) and cost 40 per cent less. Physician bias probably explains the trend to center dialysis, but pending legislation may provide new incentives for home treatment. Prospects for technical advances are good, but a greater federal investment in research and development is needed. Dollars saved on the center dialysis could be used for this purpose.

Attitude of Health Personnel↗
PubMed1978

Relationship of renal transplantation to hypertension in end-stage renal failure.

The relationship of renal transplantation to new onset or persistence of previously established hypertension was analyzed in 164 transplant recipients in whom the renal allograft functioned for six months or longer. Of the 164, thirty-seven (23%) had normal blood pressure and 127 (77%) were hypertensive prior to transplantation. Following transplantation 83 patients (51%) were normotensive; high blood pressure was found in 81 (49%). Posttransplant hypertension could not be correlated with the recipient's original renal disease, age, sex, renal donor source, donor age, or maintenance dose of prednisone. More normotensive paients had undergone prior binephrectomy when compared with the hypertensive group (P less than .05). Mean serum creatinine levels was higher (2.0 mg/dl) in hypertensives than in normotensives (1.54 mg/dl) (P greater than .05). Selective renal veins' renin measurements in patients with severe hypertension were not helpful in predicting the beneficial effects of either bilateral nephrectomy or surgical correction of transplant renal artery stenosis.

Adult↗
PubMed1978

Blood access.

Blood access is the most important determinant for the continued well-being of an end-stage renal failure patient, maintained on hemodialysis. From the variety of angioaccess techniques available today, the choice of one most suitable for a patient, applied at the appropriate time with an exacting technique may liberate the patient from incessant fear of loss of his "life line". Quinton-Schribner shunt as a prototype of external prosthetic angioaccess devices made life on the artificial kidney possible, but repeated thrombosis, inevitable infection, limitations of activity and threat of accidental dislodgement have severly restricted its usefulness. The internal arteriovenous fistula and its several modifications have almost completely supplanted the use of external prosthetic devices. When the procedure of choice, a direct arterio-venous fistula, is not applicable, an interposed graft of biologic prosthetic origin may be employed. Percutaneous femoral vein catheterization and veno-venous dialysis is an acceptable, indeed a valuable "stop gap" measure.

Arteriovenous Shunt, Surgical↗
PubMed1977

Successful renal transplantation in infancy.

This infant's post renal transplantation course, representing apparently the smallest long term survivor, illustrates that neither age nor size are contraindications to successful renal transplantation in infants with end stage renal failure. Additional experience with the transplantation of a single kidney into a 1-yr-old baby weighing 4650 gm with congenital bilateral renal hypoplasia has also been successful with a 3-mo follow-up. Both cases demonstrate that single or double renal transplantation in infants is feasible and should be considered when indicated.

Acute Kidney Injury↗
PubMed1977

Patient self-referral for kidney transplantation.

A total of 634 patients referred for transplantation was followed for up to 5 yrs, 149 being self-referred and 485 being referred by their physicians. The survival rates of those transplanted in both groups were compared to those not transplanted. The self-referred group increased their chances of receiving a transplant by 20% and did not increase their risk of mortality. These findings suggest that transplantation should be recommended to all patients with end-stage renal failure as the procedure of choice.

Adolescent↗
PubMed1976

Angioaccess.

Explore the source record for details and available documents.

Adult↗
PubMed1976

Renal transplantation in patients with posterior urethral valves.

Abnormalities of the lower urinary tract are relative contraindications for kidney transplantation that have been overcome by corrective operations or construction of conduits. In our 2 patients with posterior urethral valves and defunctionalized lower urinary tracts kidney transplantation with ureteroneocystostomy and later resection of the valves resulted in satisfactory bladder function and normal voiding patterns. Therefore, urinary diversion was completely avoided.

Adolescent↗
PubMed1976

Nephrolithiasis and nephrocalcinosis after renal transplantation: a case report and review of the literature.

Stone formation in renal allografts is rare. Although infection or renal tubular acidosis can predispose to calcium deposition in a renal allograft, hyperparathyroidism is usually an accompanying factor. Parathyroidectomy is recommended as the treatment of choice when stone deposition or nephrocalcinosis occurs after transplantation. The reported case demonstrates that aggressive therapy is also necessary to eliminate calculi from the urinary system to avoid mechanical obstruction, continued infection or renal paraenchymal damage.

Adult↗
PubMed1976

Elective and emergency surgery in renal transplant patients.

Additional operations were necessary in 67 (41%) of 162 renal allograft patients. General anesthesia was employed in all but 5 patients with no morbidity or mortality. All patients were immunosuppressed and no additional steroids were used before, during, or after the procedure. The source of the donor kidney made no difference in predicting if a recipient would require post-transplantation surgery or if an emergency or elective operation was required. Oerations were necessary to correct complications either directly related to the transplant procedure (71%), or medical problems of immunosuppression or uremia (21%). Nine patients (6%) required operations unrelated to transplantation. The data indicate that transplant patients frequently need additional procedures which are directly related to the transplant operation, immunosuppression, or metabolic alterations of their past uremic condition. Mortality is related to the degree of toxicity from the immunosuppressive therapy.

Adolescent↗
PubMed1976

Vascular complications in human renal transplantation.

There were 13 arterial complications in 202 transplants done in 162 patients, an incidence of 6.5 percent. Renal arterial stenosis was demonstrated by angiogram in six kidneys; four were reconstructed successfully. Four renal arterial occlusions were found in delayed rejected kidneys. Of three arterial dehiscences secondary to infection, all led to graftectomy. One of these patients died 56 days later due to infectious hepatitis, and one underwent a successful retransplant. One patient had an occluded iliac artery which was repaired successfully. A single venous complication occurred in one patient.

Humans↗