Search PubMed⌕ Search

Biomedical subjects

R J Winney

Publications and source records attributed to R J Winney.

62 records · Page 4Linked to original sources
PubMed1977

The effect of dialysate calcium concentration on 1alpha-hydroxyvitamin D3 on skeletal calcium loss and hyperparathyroidism in haemodialysis patients.

The response of hyperparathyroidism and skeletal calcium loss in haemodialysis patients to treatment with 1alpha-hydroxyvitamin D3 and a dialysate calcium concentration of 1.375 mmol/l was compared with the response to treatment with a dialysate calcium concentration of 1.375 or 1.75 mmol/l alone over a 6 month period. In patients treated with 1alpha-hydroxyvitamin D3 there was a significant rise in plasma calcium associated with a significant fall in plasma alkaline phosphatase and plasma parathyroid hormone as well as resolution of sub-periosteal erosions. In these patients there was a significant rise in the calcium content of the forearm assessed by neutron activation analysis in comparison to patients treated with a dialysate calcium concentration of 1.75 or 1.375 mmol/l alone. In patients treated with a dialysate calcium concentration of 1.375 or 1.75 mmol/l alone there was no significant change in the plasma calcium, alkaline phosphatase or parathyroid hormone after 6 months and in these patients subperiosteal erosions either did not change or became worse. No significant difference in the response in these two groups was observed. This study indicates that treatment of haemodialysis patients with 1alpha-hydroxyvitamin D3 is significantly more effective than treatment with a dialysate calcium concentration of 1.375 or 1.75 mmol/l alone in preventing progression of hyperparathyroidism and skeletal calcium loss.

Adult↗
PubMed1977

Echocardiography in uraemic pericarditis with effusion.

Serial chest radiology and echocardiography were performed in seven patients undergoing chronic haemodialysis who developed pericarditis. Echocardiography was helpful in making an early diagnosis of a pericardial effusion in the absence of specific clinical or radiological signs of an effusion. It also enabled changes in the thickness of a pericardial effusion to be detected, which was of value when clinical features suggestive of cardiac tamponade occurred during dialysis, and showed that the effusion could increase in size despite the use of regional heparinisation for dialysis. Resolution of a pericardial effusion could be defined accurately using echocardiography, whereas this was not possible clinically or radiologically. It is concluded that serial echocardiography is a good method of monitoring a pericardial effusion in dialysis patients.

Adult↗
PubMed1977

Oral or parenteral iron therapy in haemodialysis patients?

In 28 haemodialysis patients, in whom there was a high incidence of depleted marrow iron stores, a significant rise in Hb, and Hct, occasionally to a normal level, was achieved as effectively with oral as with i.v. iron supplements. There was a variable response to iron in individuals which could not be predicted from the initial iron status. No patient in whom marrow iron stores were reassessed after iron therapy developed increased marrow iron stores. Routine iron supplements are recommended in haemodialysis patients with regular monitoring of body iron stores.

Administration, Oral↗
PubMed1975

Periosteal new bone formation developing during haemodialysis for chronic renal failure.

Periosteal new bone formation in the pelvis is reported in five patients on maintenance haemodialysis for chronic renal failure. In two of the cases the shafts of long bones were also involved. The associated radiological and biochemical findings suggest that this unusual radiological feature may be a manifestation of secondary hyperparathyroidism. In one patient in whom the plasma phosphate and calcium X phosphate [Ca X P1] product were reduced there was partial incorporation of the periosteal new bone into the underlying cortex.

Adolescent↗
PubMed1974

Oligaemia, renal failure, and jaundice associated with acute pustular psoriasis.

An episode of acute pustular psoriasis in a middle-aged man was associated with cholestatic jaundice and followed by acute tubular necrosis. It is suggested that renal failure was due to oligaemia after the loss of albumin into and from the skin. Fluid balance, central venous pressure, and arterial blood pressure should be monitored in patients with acute pustular psoriasis.

Acute Disease↗