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Biomedical subjects

R S Pedersen

Publications and source records attributed to R S Pedersen.

At least 19 recordsLinked to original sources
PubMed1991

Prognosis in septicemia complicated by acute renal failure requiring dialysis.

During a 12-year period 419 patients were admitted because of acute renal failure requiring dialysis. Fifty (12%) had septicemia verified by blood culture. In a retrospective study age, sex, focus of infection, blood culture results, kidney function, mode of dialysis treatment, numbers and durations of complicating organ failures, presence of gastrointestinal bleeding, and secondary complicating events of septicemia were recorded for the purpose of establishing a prognostic index based on clinical criteria. Respiratory failure was present in 34 patients, circulatory failure in 31 patients, failure of coagulation system in 25 patients, and hepatic failure in 10 patients. Overall mortality was 46%. Highest death-rates were found during the first days of dialysis. In patients with multiple organ failures, in elderly and in patients suffering from staphylococcus aureus septicemia, a non-significant trend towards higher mortality was found. The mode of dialysis treatment did not influence patient survival. Our intention of establishing a prognostic index based on bedside clinical criteria has not been fulfilled. Even though mortality-rate increases in patients with acute renal failure complicated by failure of one or more vital organs, survival-rate in patients with four or more organ failures was 30%.

Acute Kidney Injury↗
PubMed1991

Prognosis and risk factors in acute, dialysis-requiring renal failure after open-heart surgery.

Of 1988 patients who underwent open-heart surgery from 1980 through 1988, 68 (3.4%) developed postoperative acute renal failure requiring dialysis (2.5% of adult and 8.3% of pediatric patients). Isolated aortocoronary bypass grafting was the operation with lowest incidence of this complication (0.6%). Acute renal failure usually appeared during the first 3 postoperative days. It carried a mortality rate of 63%, with half of the deaths occurring during the first few postoperative days, due to low cardiac output and progressive multiple organ failure. Logistic regression analysis in cases of aortic valve replacement demonstrated that significant independent preoperative risk factors for acute renal failure were renal insufficiency (serum creatinine greater than 110 mumol/l in greater than or equal to 2 samples) and increased cardiothoracic index/left ventricular end-diastolic dimension. Data from the literature indicated no time-related trend towards reduction of acute renal failure incidence or mortality. Prevention of low cardiac output is of major importance in these respects. Operative intervention before development of advanced disease with left ventricular dilatation and secondary kidney failure is advocated.

Acute Kidney Injury↗
PubMed1990

Hemodialysis does not always protect against recurrence of Wegener's granulomatosis.

Hemodialysis may protect against disease activity in Wegener's granulomatosis. We report here a 41-year-old woman with Wegener's granulomatosis, in whom renal transplantation was performed after a 10-month period of hemodialysis during which no signs of disease activity were detected. Recurrence of disease did, however, take place 2 years after renal allograft transplantation despite immunosuppressive therapy with cyclosporine A and prednisone. Reinstitution of hemodialysis and graftectomy did not improve the patient's condition but plasmapheresis and treatment with cyclophosphamide and prednisone eliminated all signs of disease within a fortnight. A proposal for better maintenance of these patients is made.

Combined Modality Therapy↗
PubMed1990

Prognosis in acute pancreatitis complicated by acute renal failure requiring dialysis.

Acute pancreatitis complicated by acute renal failure (ARF) requiring dialysis is a rare condition with a mortality rate of 80%. During the period 1977-1988 419 patients were admitted to our hospital because of ARF requiring dialysis. Fourteen (3%) had ARF caused by acute pancreatitis. Ten patients developed respiratory failure, eight patients circulatory failure, four hepatic failure, and one disseminated intravascular coagulation. Three patients had complicating septicemia and two gastrointestinal bleeding. Ten patients (71%) died. All patients with four or more organ failures besides the pancreatic failure died. Median time from start of symptoms until death was 28 days. Mortality in this series does not differ from that reported over the last 40 years. The need of multicenter trials for the purpose of improving prognosis is emphasized.

Acute Disease↗
PubMed1978

Thallium intoxication treated with long-term hemodialysis, forced diuresis and Prussian blue.

A 56-year-old woman, who ingested 2 g of thallium sulfate, was successfully treated with long-term hemodialysis for 200 hours during ten days, combined with forced diuresis and Prussian blue. The effect of the artificial kidney dialysis was determined by repeated analysis of the thallium concentration in the dialysis bath and in blood samples. During the first 120 hours of hemodialysis, 143 mg of thallium was eliminated via the artificial kidney and 110 mg via the urinary tract. The present case of acute thallium intoxication is the first in which long-term hemodialysis has been used in the acute phase together with forced diuresis and Prussian blue. The data obtained are compared to those obtained from cases treated with hemodialysis in the past. It is concluded that treatment with hemodialysis should be considered as an important supplement to treatment with forced diuresis and Prussian blue in cases of thallium intoxication.

Antidotes↗
PubMed1978

Chromic acid poisoning treated with acute hemodialysis.

Poisoning with chromium compounds is rare, but often serious. The symptoms are quite characteristic, the most dramatic of these being circulatory collapse, hepatic and renal failure. A case is reported where an 18-year-old woman ingested 5 g of chromic acid. She was treated with acute hemodialysis and forced diuresis, and survived with surprisingly few symptoms of poisoning.

Adolescent↗
PubMed1978

A longitudinal study of arterial blood pressure in chronic haemodialysis patients with different levels of plasma renin concentration.

The purpose of the study was to examine the value of regular measurements of plasma renin concentration (PRC) in selecting those chronic haemodialysis patients suitable for bilateral nephrectomy to prevent development of uncontrollable hypertension. Regular measurements of arterial blood pressure (BP) and PRC were performed during one year in 31 patients undergoing regular haemodialysis because of end-stage renal disease. Among 18 patients with PRC greater than or equal to 100 micro Goldblatt units per ml plasma (microGU/ml) systolic and/or diastolic hypertension persisted or developed in 12. In contrast, among 13 patients with PRC greater than 100microGU/ml, BP became normal in all but one, who had a slightly increased systolic BP. However, hypertension was mild and easily controlled by conventional therapy in all except one, who probably had an overlying volume-dependent hypertension. Therefore, bilateral nephrectomy was not necessary in any case. The results indicate that hypertension in the majority of chronic haemodialysis patients with high PRC can be adequately controlled without surgical intervention and that regular measurements of PRC have no practical value in forecasting the development of uncontrollable hypertension in chronic haemodialysis patients.

Adult↗
PubMed1978

Lead poisoning treated with haemodialysis.

A 27-year-old woman ingested as an abortifacient 40 grams of litharge (PbO). She was treated with EDTA infusion and haemodialysis. The half-life of lead in the blood was 9 hours during combined haemodialysis and EDTA infusion and 96 hours when EDTA was given alone. Signs and symptoms attributable to acute lead intoxication were mild.

Adult↗