Biomedical subjects

M Radović

Publications and source records attributed to M Radović.

At least 19 recordsLinked to original sources

PubMed2002

Epidemiology of end-stage renal disease and current status of hemodialysis in Yugoslavia.

Maintenance hemodialysis (HD) in Yugoslavia started in the sixties and followed the dialysis trends in the Western Europe. However, in the last decade the development of renal replacement therapy (RRT) slowed down. In this report the epidemiology of ESRD from 1997-1999 and the survey of the status of HD treatment in Yugoslavia in 1999 are presented. Epidemiological data are obtained by the annual center questionnaires (response rate: 92.6 -94.2%). The survey of HD status is based on a specific questionnaire and covered 2108 patients (65%). At the end of 1999 there were 56 RRT centers in Yugoslavia treating 3939 patients: 3232 (82%) patients by HD, 248 (6.3%) by peritoneal dialysis, and 459 (11.7%) living with transplanted kidney. In a three year period, incidence of ESRD ranged from 108-128 pmp, point prevalence from 435-463 pmp and mortality rate from 20.7-17.9. Numerous refugee patients were treated over the last 10 years. Main causes of ESRD were glomerulonephritis (30%); Balkan nephropathy represented 11% and diabetic nephropathy 7% of all primary renal diseases. Cardiovascular and cerebrovascular diseases were the most common causes of death of RRT patients. Most centers are overcrowded and HD machines are worn out. Mean Kt/V was 1.19+/-0.08, mean URR% 58.8+/-7.4. The shortage of drugs prevented adequate management: 83% of HD patients had hemoglobin level less than 100 g/L but only 10.3 -17.8% were treated with rHuEpo; 64.5% of patients had phosphate levels higher than 1.7 mmol/L but only 33.5% used phosphate binders; 47% of patients had hypertension despite the antihypertensive therapy. The prevalence of hepatitis B remained unchanged (about 14%) in HD population during the last three years, but the prevalence of anti-HCV positive patients decreased (31-23%). In conclusion, there is a well developed dialysis service in Yugoslavia but insufficient conditions for adequate treatment.

Balkan Nephropathy↗

PubMed1996

Malignant tumors in hemodialysis patients.

We reviewed the incidence of malignant tumors among 923 patients with chronic renal failure, treated with hemodialysis (HD) in seven dialysis centers in Serbia between January 1983 and July 1993. Neoplasms were diagnosed in 45 cases (4.9%). The mean age of the cancer patients was 58.7 years. Eighteen cases (40.0%) were diagnosed in the first year after starting HD treatment and 21 (46.7%) cases were detected less than 5 years after induction of HD treatment. Most of the cancer patients (60.0%), especially the patients with Balkan endemic nephropathy (31.1%), developed cancer of the urinary tract. We concluded that HD patients have a several times greater risk of developing malignant tumors than the general population.

Adult↗

PubMed1996

Acute renal failure in polytraumatized patients: prediction of outcome.

Prediction of outcome of acute renal failure (ARF), particularly in patients with multisystem organ failure (MSOF), is a very important issue and a very difficult task. In patients with ARF as a consequence of severe polytrauma, frequent complications (e.g., sepsis, respiratory insufficiency, DIC, hepatic insufficiency, etc.) contribute to a hyperbolic state, and in the case of synergistic action, they start the mechanism of MSOF. In 33 patients (1 female, 32 male, 38.61 +/- 8.79 years) with severe polytrauma acquired in war combat, ARF developed requiring hemodialysis (HD) treatment. Seventeen out of 33 (51.4%) recovered renal function. In 12 out of 33 patients, MSOF occurred with less successful recovery results. The analysis of pathophysiologic mechanisms of MSOF appearance and ARF outcome has shown the importance of blast injuries, bowel injury, respiratory insufficiency requiring assisted ventilation, and sepsis. Although severe hemorrhage and shock are the common mechanism of ARF appearance in these patients, it seems that wounds by themselves can be of great importance, as abdominal wounds are more frequently associated with ARF and MSOF than in other types.

Acute Kidney Injury↗

PubMed1996

Validity of prediction scores in acute renal failure due to polytrauma.

During a 36-month period from 1992 to 1994, 33 patients with severe polytrauma acquired in war combat (1 female, 32 male, 38.61 +/- 8.79 years) developed acute renal failure (ARF) which required hemodialysis (HD) treatment. In 12 patients, multiple system organ failure (MSOF) occurred as a complication of either general conditions or septic complications. In 17 patients (51.4%), and in 3 patients with MSOF, recovery of renal function occurred. We compared the outcome of ARF and several predictive scores (APACHE II and ATNISS). The APACHE II score did not correlate with the outcome of ARF, and ATNISS significantly correlated with the outcome of ARF. The maximum value of ATNISS in the patients with lethal outcome was 1.004, and the minimal value with the same outcome was 0.182. Although ATNISS is a very good score of severity, it seems to underestimate very influential factors in patients with severe polytrauma with ARF (MSOF, mechanism of trauma).

APACHE↗

PubMed1996

[Incidence and clinical manifestations of hepatitis C virus infection in patients on hemodialysis].

Hepatitis C virus infection is a very important problem among patients on maintenance hemodialysis. To determine incidence and clinical manifestations of hepatitis C virus infection, we tested blood samples of patients on hemodialysis in 1992 and 1994 using ELISA a HCV test of second generation. In 1992 46 out of 119 patients (38%), and in 1994 36 out of 122 (29%) patients on hemodialysis were aHCV positive. Duration of dialysis program and level of serum aminotransferases were significantly higher in the group of aHCV positive patients had received more blood transfusions per year, but not significantly higher than HCV negative patients. These results with knowledge about common routes of HCV transmission, demand strict preventive measures in dialysis units, routine and regular HCV testing of patients' blood samples and serum aminotransferases level, and isolation of HCV positive patients and machines.

Adult↗

PubMed1996

[The effect of septic complications on recovery in acute renal insufficiency in patients with multiple injuries].

Septic complication in patients (pts) with ARF are among the most important causes of mortality, especially in pts with polytrauma and multiple-organ failure. Prevention procedures, early and accurate diagnosis and persistent treatment in time are necessary to avoid septic shock. During the period od 27 months (1992-1994), 25 pts with wounds inflicted in war and AFT were treated by haemodialysis. Eighteen (72%) pts had septic complication. Eleven (71%) of them recovered from ARF, while 7 (39%) pts died despite the undertaken procedures. Nine pts (81%) with septic complication and ARF who improved their renal function were treated by one or more nephrotoxic antibiotics. Haemodialysis was initiated when average BUN concentration was 35.7 mmol/l and plasma creatinine level about 0.8 mmol/l. Simultaneously with symptomatic and substituting therapy, and surgical correction of polytrauma, approximately 9 haemodialysis in the period of 21 day were necessary for ARF recovery. In the group of pts who had no improvement of renal function, 6 (85%) received 1 or more nephrotoxic drugs. Approximately 5 haemodialysis were done in these pts, in a shorter period of time. In polytraumatized pts with ARF with septic complication, factors which potentiate hypercatabolism aggravate the prognosis of ARF, increase mortality, require a greater number of haemodialysis and significantly prolong the recovery time of ARF.

Acute Kidney Injury↗

PubMed1996

[Kidney transplantation in Bombay].

The paper presents results of renal transplantation from a living unrelated donor in Bombay. Within the past three years 15 patients reported themselves at our Clinic immediately upon renal transplantation from a living unrelated donor, 7 of whom were women and 8 men, 17 to 52 years of age. There were no data on previous pretransplantation processing for the majority of patients, and treatment by repeated hemodialyses in 46.7% of patients lasted less than a year, which increased the risk of transplantation. On admission at our clinic, nine patients had satisfactory renal function, four patients moderate insufficiency and two advanced insufficiency. The most frequent complications occurring in these patients were various forms of infections. A three-year follow-up of these patients showed at the results of renal transplantation in Bombay were unsatisfactory, and the survival rate of the patients and the graft was far too worse that the one in Europe, that is at our Centre.

Adolescent↗

PubMed1995

The use of therapeutic plasma exchange for treatment of acute polyradiculoneuropathy.

The rationale for therapeutic plasma exchange (TPE) in acute polyradiculoneuropathy (APRN) is based on the presence of circulating antibodies which cause demyelination of the peripheral nerves. This study included 24 patients, most having a neurological defect of grade 4, classified into groups A and B. Group A was treated with immunosuppressive drugs only, while group B was treated by a combination of immunosuppressive drugs and TPE. The average volume of plasma removed during a single TPE procedure was 2.95 L, and totalled 21 L overall. The efficacy of the TPE treatment was assessed on the basis of changes in the neurological deficit grade, and in electrophysiological parameters. It was shown that improvements were significantly better and faster in patients treated by a combination of immunosuppressive drugs and TPE, and when TPE was started within the first 7 days after the onset of the disease.

Acute Disease↗

PubMed1994

Application of therapeutic plasma exchange in hematology.

Therapeutic plasma exchange (TPE) was used in 146 patients with hematologic disorders: hyperviscosity syndrome, 74; cryoglobulinemia, 53; porphyria, 9; immune complex disease, 3; cold agglutinin disease, 1; hemolytic uremic syndrome, 1; autoimmune hemolytic anemia, 1; autoimmune thrombocytopenia, 1; autoimmune neutropenia, 1; Clq deficiency, 1; and secondary immunodeficiency, 1. It was shown that TPE applied in patients with hyperviscosity syndrome resulted in rapid reduction of paraprotein concentrations, and normalization or significant decrease of serum viscosity associated with marked clinical improvement (regression of neurologic, renal, hematologic, visual and other disturbances). Application of TPE in patients with cryoglobulinemia resulted in plasma cryoglobulin reduction and clear clinical effects (blood flow improvement, skin ulcer healing, reversal of impaired renal function and disappearance of purpura and other abnormalities). Very good results were obtained in patients with porphyria (decreased sensitivity to sunlight) and also in patients with Clq deficiency. Satisfactory clinical improvement and better laboratory findings were also seen in patients with immune complex disease, autoimmune hemolytic anemia, autoimmune thrombocytopenia and hemolytic uremic syndrome.

Evaluation Studies as Topic↗

PubMed1994

[Acute normovolemic hemodilution].

Performing acute normovolemic hemodilution reduces needs for transfusion of stored homologous blood, exposure of patients to homologous blood and incidence of diseases transmitted by transfusion. Apart from that it provides significant quantities of immunologically best, completely fresh blood and/or some blood components necessary for transfusion. Apart from the latest literature data, in this paper represent the first experiences considering acute normovolemic hemodilution performed in 20 patients operated for having low localized colon's neoplasm in whom amputation of rectum was performed. 780 ml of blood was exfunded from each patient with simultaneous infusion of three times larger volume of lactated Ringer's solution (In 10 patients) one volume of Haemacell (in 5 patients) and one volume of Soludex 70 (in 5 patients). Considering these patients 15600 ml autologous and 2500 ml of homologous blood was used up for transfusion.

Adult↗

PubMed1990