RESUMO
A total of 127 patients with end-stage renal disease (ESRD) including 45 from Al-Madinah and 82 from the Gizan regions of Saudi Arabia were studied to determine the etiology of ESRD. The categorization into various diagnoses were according to established criteria. A total of 22 renal biopsies were also obtained to aid in the diagnosis. The mean age of the study patients was 50 years in Al-Madinah region and 37 years in Gizan region. Overall, the etiology could be established in 56 patients (44.1%) including 31 patients (68.9%) in Al-Madinah and 25 patients (30.5%) in Gizan regions. Diabetic nephropathy was the commonest cause of ESRD in Al-Madinah (45.2%) while obstructive nephropathy was the commonest identifiable cause in Gizan (24%). Our study suggests that diabetes and obstruction are the main conditions against which strategies for prevention and treatment should be directed.
Assuntos
Terminais de Computador , Unidades Hospitalares de Hemodiálise/organização & administração , Transplante de Rim , Transplante , Morte Encefálica , Seguimentos , Humanos , Sistema de Registros , Arábia Saudita , Doadores de Tecidos , Obtenção de Tecidos e Órgãos/organização & administração , Listas de EsperaAssuntos
Família , Consentimento Livre e Esclarecido , Doadores de Tecidos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/tendências , Cadáver , Criança , Documentação , Humanos , Pais , Arábia Saudita , Doadores de Tecidos/provisão & distribuição , Obtenção de Tecidos e Órgãos/estatística & dados numéricosAssuntos
Morte Encefálica , Família , Consentimento Livre e Esclarecido , Doadores de Tecidos , Atitude Frente a Morte , Feminino , Humanos , Masculino , Estudos Retrospectivos , Arábia Saudita , Doadores de Tecidos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/tendênciasRESUMO
Anemia is a well recognized complication of chronic renal failure (CRF). Although the use of erythropoietin (EPO) in the treatment of anemia in patients on dialysis is well established, its use in pre-dialysis patients is less well recognized. The preferred route of administration of EPO in pre-dialysis patients is subcutaneous and it is indicated in any patient with CRF who is symptomatic of anemia. Studies have shown that EPO is effective in correcting anemia in these patients with a considerable improvement in quality-of-life scores. There have been no deleterious effects on blood pressure or rate of decline of renal function. However, these two indices should be monitored closely. Common causes of treatment failure include iron deficiency, blood loss and occult sepsis. The available evidence indicates that EPO therapy is safe and effective in the treatment of anemia in pre-dialysis patients.
RESUMO
A 40 year old patient with end-stage renal disease developed features of calciphylaxis and tumoral calcification after four and half years on regular haemodialysis. The patient had hyperphosphatemia, with high calcium-phosphate index and radiological evidence of hyperparathyroidism before the onset of symptoms. Conservative management was without success and the patient developed florid symptoms. Parathyroidectomy was delayed due to unavoidable circumstances. When it was eventually performed there was a prompt regression of the calcific masses, but not of the vascular calcifications. The natural progression of the disease and its regression by parathyroidectomy provides an interesting insight into this phenomenon, the full blown picture of which is rarely seen these days.
