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1998| July-September | Volume 9 | Issue 3
Online since
February 26, 2008
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ARTICLES
Slow Continuous Ultrafiltration with Dialysis in Patients with Acute Renal Failure in the Intensive Care Unit
Faissal A.M Shaheen, Iftikhar A Sheikh
July-September 1998, 9(3):294-297
PMID
:18408303
[FULL TEXT]
[PDF]
[PubMed]
20,975
642
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Rhabdomyolysis and Myoglobin-induced Acute Renal Failure
Ghulam Hassan Malik
July-September 1998, 9(3):273-284
PMID
:18408300
[FULL TEXT]
[PDF]
[PubMed]
13,601
1,170
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Acute Renal Failure in the Tropics
V Sakhuja, K Sud
July-September 1998, 9(3):247-260
PMID
:18408297
[FULL TEXT]
[PDF]
[PubMed]
12,152
1,093
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Pathogenesis of Acute Renal Failure: Shock-Kidneys
E Nigel Wardle
July-September 1998, 9(3):231-236
PMID
:18408295
Causes of acute renal failure (ARF) are summarized. The article focuses on "shock kidneys" as they occur following traumatic or septic shock. There may be low-grade intermittent but persisting endotoxemia in the former together with other factors like rhabdomyolysis, and marked endotoxemia at least for a few hours in the latter. Endotoxin is a prime cause of release of noxious cytokines like tumor necrosis factor-alpha (TNFa). At present, many studies support the evidence for its role in multi-organ failure (MOF). One can account for endotoxemia along with bacterial translocation through the gastrointestinal mucosa if there is transient mesenteric ischemia during shock. Hence, monocytemacrophages can be stimulated to release their cytokines that predispose to MOF. The cell biology of renal tubular changes in ARF is then briefly discussed in order to mention new therapeutic approaches.
[ABSTRACT]
[FULL TEXT]
[PDF]
[PubMed]
11,849
662
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Acute Renal Failure Due to Snake-Bite: Clinical Aspects
Mohammed A Al-Homrany
July-September 1998, 9(3):285-289
PMID
:18408301
[FULL TEXT]
[PDF]
[PubMed]
5,714
478
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Acute Renal Failure in Pregnancy
Susan Hou, Claudia Peano
July-September 1998, 9(3):261-266
PMID
:18408298
[FULL TEXT]
[PDF]
[PubMed]
4,292
767
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Acute Renal Failure and HELLP Syndrome: A Single Center's Experience
Iftikhar A Sheikh, Faissal A.M Shaheen
July-September 1998, 9(3):290-293
PMID
:18408302
A total of 52 patients were referred to our center from gynecology and obstetric units in our area with acute renal failure during the last two years. Seven patients were found to have so called syndrome of hemolysis (H), elevated liver enzymes (EL) and low platelets (LP) associated with acute renal failure. The syndrome can easily be confused with other diagnoses like hemolytic uremic syndrome, idiopathic thrombotic thrombocytopenic purpura and disseminated intravascular hemolysis. Six patients had renal biopsies to confirm the diagnosis, while one did not consent for biopsy. Four patients were found to have acute tubular necrosis, one had acute cortical necrosis and one was not enough for interpretation. We conclude that the patients can easily be misdiagnosed if we are not familiar with the diagnosis and that the overall prognosis is good if the patient survives the acute stage.
[ABSTRACT]
[FULL TEXT]
[PDF]
[PubMed]
4,081
486
-
Prevention of Acute Renal Failure
Magdi M Hussein, Jacob M.V Mooij
July-September 1998, 9(3):237-246
PMID
:18408296
[FULL TEXT]
[PDF]
[PubMed]
3,177
494
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Acute Renal Failure in Sudan
Salma Mohamed Sulieman
July-September 1998, 9(3):316-318
PMID
:18408307
[FULL TEXT]
[PDF]
[PubMed]
2,838
376
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Acute Renal Failure in Jordan
Riyad Said
July-September 1998, 9(3):301-305
PMID
:18408305
We evaluated 215 patients with acute renal failure (ARF) in three centers in Jordan over an 18 months period. Their ages ranged between 12-90 years, and 120 of them were males. Parenchymal renal insult was the commonest cause of ARF as it was seen in 125 patients (58%). Pre-renal azotemia was seen in 60 patients (28%) and acute obstructive uropathy in 30 patients (14%). At presentation, 152 patients (70.7%) were oligo-anuric, while 63 (29.3%) were non-oliguric. Forty patients (18.6%) required dialysis support; 30 of them were in the renal failure group (75%). Thirty-two of the 40 patients were oliguricaruric. Complete recovery of renal function was achieved in 80% for the whole group, and in 64% of those with parenchymal renal insult. Forty-seven patients (21.9%) died; 35 of them (63.9%) were in the renal group, and 37 patients (78%) were oligo-anuric. Sepsis and cardiac complications were together responsible for almost 75% of the deaths.
[ABSTRACT]
[FULL TEXT]
[PDF]
[PubMed]
2,807
319
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Acute Renal Failure: Six Months Pilot Study in Qatar
Awad Rashed, Omar Abboud, Awad Addasi, Mustafa Taha, Mohammed El Sayed, Adel Ashour
July-September 1998, 9(3):298-300
PMID
:18408304
Over a period of six months, 55 patients out of 11,216 (0.49%) admitted to the hospital developed acute renal failure (ARF). The diagnosis of ARF was based on the usual criteria, a sudden rise in blood urea nitrogen and creatinine with or without oliguria. Patients age ranged between 15 and 81 years with a mean of 51.9 years. Renal ischemia (69%) and nephrotoxic drugs (16.3%) were the two main etiologic factors. Among the causes of ischemia, septic shock was the commonest (29%), followed by severe hypotension due to several causes such as hemorrhage, burns, severe diarrhea and cardiogenic shock (25.4%), and ACE inhibitors (10.9%). ARF was associated with an average of 15.8 days stay in hospital versus 5.1 days for the overall hospital admissions. Immediate management of hypotension by intravenous fluid replacement, vasopressor agents and the necessary surgical intervention was appropriately considered. Intravenous frusemide was used for oliguric patients. Intermittent hemodialysis was used in 18 patients and continuous venovenous hemofiltration in six patients. Twelve patients with ARF due to ischemia died, while there were no deaths in the nephrotoxic group (p < 0.05). The overall mortality was (21.8%), which had no correlation with patient age. All non-oliguric patients survived with the mortality being exclusively in the oliguric group.
[ABSTRACT]
[FULL TEXT]
[PDF]
[PubMed]
2,748
323
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Acute Renal Failure in the Intensive Care Unit
KH Mujtaba Quadri, Sameer O Huraib
July-September 1998, 9(3):267-272
PMID
:18408299
[FULL TEXT]
[PDF]
[PubMed]
2,445
409
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Opinion Survey about the Evaluation and Management of Acute Renal Failure in Saudi Arabia
Muhammad Ziad Souqiyyeh, Faissal A.M Shaheen, Abdullah A Al-Khader
July-September 1998, 9(3):306-315
PMID
:18408306
To evaluate the approach of physicians to the diagnosis and management of acute renal failure (ARF) in the Kingdom of Saudi Arabia, a questionnaire was mailed to nephrologists, physicians attending to renal failure patients, specialists working in intensive care unit (ICU) and the general physicians in 110 hospitals, which have either an ICU or a dialysis unit. The questions were related to the areas of evaluation, conservative management, dialysis therapy, and prognosis of ARF. There were 135 responses from 76 hospitals (69%); 37 of small size (<150 beds), 21 of medium size (151-400 beds), and 18 of large size (401-1200 beds). There were 69 respondents from the small hospitals, 34 from the medium-sized, and 32 from the large hospitals. According to the respondents, the most encountered ARF patients were in the intensive care units and were most likely due to sepsis and nephrotoxic drugs. There were no differences among the respondents in the areas of initial evaluation, conservative and/or emergency treatment. However, the nephrologists were significantly more willing to follow-up their ARF patients and to carry more specific diagnostic procedures (i.e., renal biopsy) and specific advanced therapeutic procedures (i.e., dialysis), More ARF patients are being treated by continuous renal replacement therapy (CRRT) than intermittent hemodialysis or peritoneal dialysis. The minority of the respondents believed that the prognosis of ARF had not improved much, despite the improvement in diagnosis and therapy. They attributed this to the change in the demographics of ARF, since more ICU and elderly patients are seen in practice. We conclude that nephrologists are indispensable for the management of acute renal failure. More efforts may be needed to recruit nephrologists to hospitals in Saudi Arabia. A local fellowship program may help in this regard. Furthermore, CRRT facilities, at least in the large hospitals, are required.
[ABSTRACT]
[FULL TEXT]
[PDF]
[PubMed]
2,428
317
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LETTERS TO THE EDITOR
Acute Renal Failure in the Neonate
PT Subramanian
July-September 1998, 9(3):320-320
PMID
:18408309
[FULL TEXT]
[PDF]
[PubMed]
1,086
228
-
Bilingual Medical Journal
PT Subramanian
July-September 1998, 9(3):319-319
PMID
:18408308
[FULL TEXT]
[PDF]
[PubMed]
1,048
231
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© 2007 - Saudi Journal of Kidney Diseases and Transplantation | Published by Wolters Kluwer -
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