RESUMO
A 68-year-old woman with Guillain-Barré syndrome had profoundly depressed serum creatinine concentration and 24-hour urinary creatinine excretion despite maintenance of her weight by hyperalimentation. Because of hypocreatininemia, the development of aminoglycoside-induced acute renal failure was initially missed. A retrospective study of seven patients with Guillain-Barré syndrome who were treated with hyperalimentation to maintain nutritional status showed a significant decrease in serum creatinine concentration but no significant decline in weight or blood urea nitrogen level. Because the serum creatinine is decreased in patients with Guillain-Barré syndrome, caution must be exercised in using serum creatinine determination as an estimate of glomerular filtration rate.
Assuntos
Injúria Renal Aguda/etiologia , Creatinina/sangue , Polirradiculoneuropatia/complicações , Idoso , Nitrogênio da Ureia Sanguínea , Peso Corporal , Creatinina/urina , Nutrição Enteral , Feminino , Humanos , Exame Neurológico , Polirradiculoneuropatia/diagnóstico , Polirradiculoneuropatia/dietoterapia , Estudos RetrospectivosRESUMO
A 55-year-old white woman had severe hepatocellular damage after taking disopyramide. Simultaneously, disseminated intravascular coagulation developed with thrombocytopenia, prolonged prothrombin time, and elevated fibrin split products. Both problems gradually subsided 14 days after cessation of disopyramide therapy. This case report shows that disopyramide can have the serious side effect of hepatocellular toxicity and provides evidence of the association of hepatocellular damage and disseminated intravascular coagulation.
Assuntos
Doença Hepática Induzida por Substâncias e Drogas , Disopiramida/efeitos adversos , Coagulação Intravascular Disseminada/induzido quimicamente , Piridinas/efeitos adversos , Feminino , Humanos , Fígado/efeitos dos fármacos , Pessoa de Meia-Idade , Trombocitopenia/induzido quimicamenteRESUMO
TWelve patients on chronic intermittent peritoneal dialysis for end-state renal disease were followed a total of eight months on high dialysate flow rate (four liters/hour) and low dialysate flow rate (two liters/hour). Creatine, blood urea nitrogen, serum electrolytes, albumin, calcium and phosphorous were recorded weekly. Interdialytic weight gain and intradialytic weight loss were recorded with each dialysis. No significant differences were noted when the mean values were compared for the two trail periods. The two liter/hour dialytic flow rate is less expensive, more convenient for the patients, and could result in a decreased risk for peritonitis when compared to the four liter/hour flow rate. For chronic intermittent peritoneal dialysis, the two liter/hour flow rate should be the preferred mode of therapy.
Assuntos
Falência Renal Crônica/terapia , Diálise Peritoneal/métodos , Nitrogênio da Ureia Sanguínea , Peso Corporal , Cálcio/sangue , Creatinina/sangue , Eletrólitos/sangue , Humanos , Falência Renal Crônica/sangue , Fósforo/sangue , Albumina Sérica/análiseRESUMO
This report documents a case of hypertension caused by an intrarenal arterial stenosis in a ten-year-old girl. The renovascular origin of her hypertension was suggested by a positive saralasin acetate infusion test, and the lesion was identified by use of the subtraction technique in renal arteriography. Partial nephrectomy resulted in resolution of the patient's hypertension with good function in the remaining portion of the kidney.