PROTOTYPE MAINTENANCE HAEMODIALYSIS UNIT.
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Biomedical subjects
Publications and source records attributed to S SHALDON.
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Twelve patients with active ;juvenile' cirrhosis (active chronic hepatitis, ;lupoid' hepatitis) and six subjects with other types of portal or postnecrotic cirrhosis were submitted to percutaneous renal biopsy. In addition, renal function was assessed in all patients by measurement of the 24-hour endogenous creatinine clearance, maximal urinary osmolality after deprivation of water, 24-hour urinary protein excretion, and routine urine analysis. Renal function was not significantly abnormal in either group of patients, but seven of the 12 patients with active ;juvenile' cirrhosis showed mild histological changes on renal biopsy. These changes are very similar to the lesions described in early ;lupus nephritis'.The significance of these findings in relation to the aetiology of active ;juvenile' cirrhosis is discussed.
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In eight patients with cirrhosis and stable ascites controlled on chlorothiazide and spironolactone, a small particle preparation of spironolactone (Aldactone A) was as effective, at one quarter the dosage, as conventional spironolactone (Aldactone). Plasma spironolactone metabolite levels and urinary excretion of spironolactone metabolite were equivalent with both preparations. The variable dosage requirement of spironolactone in patients with cirrhosis and ascites is discussed in relation to these observations.
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