PubMed · 7362176
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J A Lorch, S Garella. 1980. Hemoperfusion for intoxication.. https://doi.org/10.7326/0003-4819-92-4-573_2
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The authors describe the development of clinical nephrology from 1948 to 2002 at the Medical Faculty of the P. J. Safarík University and L. Pasteur Faculty Hospital from the aspect of therapeutic and preventive care, teaching and research activities. The dialysis centre which was established in 1966 at the Medical Clinic of the Faculty Hospital in Kosice continued in the activities as the Nephrological laboratory which was founded in 1954. This laboratory still operates under the conditions of the Nephrological Clinic. In 1964 at the Medical Clinic the first percutaneous renal biopsy was implemented. In 1966 the first peritoneal dialysis was implemented and the first haemodialysis in a patient with chronic renal failure, later gradually all so far known therapeutic methods were introduced which replace renal function and are used in acute and chronic renal failure and in acute intoxication. On March 18, 1977 in the authors' department the first haemoperfusion over active charcoal was made successfully in a patient intoxicated with parquat. It was the first haemoperfusion in the former Czechoslovak Republic. From 1991 at the Clinic a Sub-chair of nephrology and dialysis was established attached to the Institute for Postgraduate Training, later SPAM. Within the framework of the latter several nephrological courses were organized as well as courses in extracorporeal elimination treatment and in acute toxicology. The department acted also as a training place for future nephrologists before the specialization examination in nephrology. Since 1981 successfully several research grants concerned with the use of haemoperfusion over active charcoal and other sorbents in acute intoxications were completed as well as grants focused on metabolic vitamin disorders in chronic renal failure. On October 24 1997 in our department within the framework of the P. J. Safarík University Medical Faculty and L. Pasteur Faculty Hospital the Nephrological Clinic was established, the first one in the Slovak Republic. This stimulated further qualitative development of nephrology not only in Kosice but in the whole of Slovakia.
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The treatment of serious drug or chemical poisoning relies mostly on the use of standard intensive care measures. Supplementation of intensive care with dialysis and hemoperfusion may be necessary at times to remove the intoxicant in seriously ill patients. Factors governing drug and chemical removal by dialysis and hemoperfusion are discussed, and guidelines given when to employ these techniques. Tables of drugs removed by both techniques are given for guidance. These tables will be updated regularly on the Advances in Renal Replacement Therapy website.