PubMed · 14273003
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P P FIGDOR. 1965. [REMARKS ON MANNITOL THERAPY].. https://pubmed.ncbi.nlm.nih.gov/14273003/
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A case is reported of anuria and urinary ascites secondary to bilateral ureteropelvic obstruction by fungal balls. Management consisted of bilateral nephrostomy drainage with local irrigation with amphotericin B, and systemic antifungal treatment without surgery. Aspiration by paracentesis was performed for the urinary ascites and continuous drainage through an 8 Fr pig tail catheter for the urinoma. The literature on renal fungus balls in neonates and infants is reviewed.
BACKGROUND: It remains unknown whether results of survival studies in anuric patients can be extrapolated to those who still have significant urine output. It is possible that after a prolonged period on dialysis, anuric patients are qualitatively different from patients with residual renal function. METHODS: We performed a retrospective review to study the cause of death of 296 peritoneal dialysis patients of our centre over a 7 year period, and compared the mortality and distribution of cause of death between patients with and without residual renal function. RESULTS: One hundred and forty-two cases (48.0%) died of vascular diseases, 82 cases (27.7%) died of infections and 72 cases (24.3%) died of other causes. Anuric patients had a higher overall mortality rate than non-anuric patients (14.9 vs 9.9%, P=0.0005), and the difference was almost completely attributed to the difference in mortality from vascular diseases (8.0 vs 4.1%, P<0.0001). Vascular disease was a more common cause of death in anuric patients than those with residual renal function (55.3 vs 40.8%, P=0.011). The difference was largely explained by the higher prevalence of sudden cardiac death in anuric patients (39 in 149 vs 19 in 147 cases). Patients without pre-existing cardiovascular disease more commonly died of vascular disease after they became anuric (47.4 vs 34.0%, P=0.017). The difference could not be explained by the longer duration of dialysis in anuric patients because there was no significant change in the distribution of cause of death with time on dialysis (chi-square test, P=0.341). CONCLUSIONS: Our observation suggests that peritoneal dialysis patients with and without residual renal function are qualitatively different. Studies on peritoneal dialysis adequacy and survival in anuric patients should only be extrapolated to the general dialysis population with caution.
INTRODUCTION: The dialysis parameters are used for prescribing the dose of dialysis therapy. Delivered dialysis dose could be calculated from predialysis and postdialysis blood urea concentrations. Seasonal variations in some clinical and laboratory variables occur among chronic hemodialysis patients. Seasonal variations in chronic hemodialysis dose have not been investigated. We prospectively compared hemodialysis adequacy parameters in order to demonstrate its seasonal differences. SUBJECTS AND METHODS: Data were processed on 201 single dialysis treatments involving a group of 51 anuric chronic hemodialysis patients. The study period was 12 months. Four measurements per subject were obtained (in January, April, July, and October). RESULTS: We could not demonstrate seasonal variability in prescribed and delivered hemodialysis dose, in "delta" values (absolute differences between prescribed and delivered dialysis doses for the same hemodialysis treatment), or in ultrafiltration per hemodialysis. Seasonal differences were found in blood urea concentrations before and after hemodialysis (p = 0.001, p = 0.010). When the data were grouped into two groups: cold (January and October) and mild (April and July) months; we could not demonstrate significant differences in dialysis adequacy parameters, but there were differences in blood urea concentration before hemodialysis (26.06 +/- 14.73 vs. 24.35 +/- 4.50, p = 0.004), blood urea concentration alter hemodialysis (10.24 +/- 2.96 vs. 9.43 +/- 2.60, p = 0.019), and ultrafiltration per hemodialysis (3.36 +/- 1.13 vs. 3.10 +/- 1.11, p = 0.046). CONCLUSION: Based of the results of this investigation conducted on chronically hemodialyzed patients in the mild Mediterranean climate in South Croatia, Europe; we have concluded that clinicians should not pay attention to season when they prescribe hemodialysis dose or analyze delivered hemodialysis dose.