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Biomedical subjects

D J Rainford

Publications and source records attributed to D J Rainford.

At least 19 recordsLinked to original sources
PubMed1991

Flexible urethrocystoscopy in nephrological investigation.

Flexible urethrocystoscopy under local anaesthetic was performed on 100 patients as part of their nephrological investigations. This was carried out by a nephrologist, obviating the previous practice of referral to a surgical colleague for rigid instrumentation under general anaesthetic. A pathological diagnosis was made in 69 patients with flexible urethrocystoscopy alone; 17 patients required subsequent rigid cystoscopy to obtain or confirm a diagnosis. Thirty-four patients had normal examinations and of these 13 underwent renal biopsy for diagnosis. Considerable savings in theatre time, man-hours and anaesthetic risk to the patients were made without compromising diagnostic accuracy or patient wellbeing.

Adolescent↗
PubMed1990

Isovolemic hemodialysis combined with hemofiltration in acute renal failure.

One hundred cases of servere acute renal failure managed in the intensive care unit were analyzed to assess the value of isovolemic hemodialysis combined with interdialysis hemofiltration to control fluid balance. Forty-five patients were treated prior to the availability of this technique and 55 subsequently. There was a significant reduction in the oliguric period of survivors in the second group compared with the group treated by intermittent hemodialysis alone (p = 0.0459). The significant difference in age between survivors and deaths observed in the first group (p = 0.0027) was not demonstrated in the second group due to a reduction in the incidence of primarily cardiovascular deaths with an improvement in survival of the elderly.

Acute Kidney Injury↗
PubMed1989

C-reactive protein in acute renal failure.

This paper demonstrates the utility of C-reactive protein (CRP) in the diagnosis of infection in patients with acute renal failure. C-reactive protein can be assayed using plasma as effectively as using serum, thus avoiding the problems of microclots in serum, which can occur in samples from a heparinised patient. Plasma concentrations of C-reactive protein are unaffected by the process of haemodialysis. In the complicated setting of the severely ill patient with acute renal failure, infection remains the most common cause of death and its detection is often difficult. The use of C-reactive protein assay in this setting is illustrated by data from 20 patients, and two representative cases are described in detail. It is recommended that C-reactive protein be assayed daily to aid in the detection of infection in patients with acute renal failure.

Acute Kidney Injury↗
PubMed1989

Proteinuria--what value is the dipstick?

The value of the urinary dipstick in the assessment of proteinuria was investigated in a study correlating laboratory measurements of protein and albumin against the dipstick protein in the same samples of urine; 94 patients (100 admissions) were studied at the Royal Air Force Renal Unit, each patient collecting two 24-h urine samples. Along with each 24-h sample, 10-ml aliquots of urine were obtained at 3 designated times during the day for both ward dipstick testing and laboratory assay; + or more on the dipstick correlated with abnormal proteinuria (greater than or equal to 150 mg/24 h) in 88% of cases, whilst trace values straddled the level of significant proteinuria. Further differentiation of trace was possible by repeat testing during the day. The subsequent presence of a dipstick negative during that day correlated with normality in all but 5% of cases. In order to ensure detection of renal disease presenting as isolated orthostatic proteinuria, assay of the mid-morning sample is recommended.

Adolescent↗
PubMed1986

High altitude haemofiltration.

Evacuating people in acute renal failure by air is difficult because the hazards of fluid overload and anaemia are potentiated by altitude. In two such patients continuous arteriovenous haemofiltration was used to control their fluid problems during aeromedical evacuation. In the first case, a patient with renal failure and blast lung, haemofiltration was performed at 500 ml/h over a four hour journey; in the second, a woman with severe pre-eclamptic toxaemia who developed acute renal failure after caesarean section, haemofiltration was performed at 200 ml/h over a 14 hour flight. Both patients recovered fully. In these two cases haemofiltration permitted control of the intravascular volume during aeromedical evacuation. The technique represents a major advance in the safe transfer of casualties.

Acute Kidney Injury↗
PubMed1979

Leptospirosis and acute renal failure--clinical experiences and a review of the literature.

About 50 cases of leptospirosis are diagnosed each year in the United Kingdom, with an overall mortality of 5%. Renal failure, in association with jaundice, is commonly held responsible for this figure. Over a period of 18 years, 6 cases of leptospirosis complicated by renal failure were treated at the Royal Air Force Renal Unit; there were 4 survivors. The 2 deaths occurred before the unit policy of daily haemodialysis and total parenteral nutrition, and were both from haemorrhagic complications. The authors believe that patients with leptospirosis and progressive renal impairment should be managed in renal units experienced in the management of the hypercatabolic patient, and that this should improve their prognosis.

Acute Kidney Injury↗
PubMed1979

Acute renal failure in burns.

We present the combined experience of a burns unit and a renal dialysis unit in treating acute renal failure in burn injury patients. A total of 28 cases have been treated of whom 4 regained normal renal function. We would like to emphasize the following points which may improve the usually very poor prognosis: early diagnosis, early daily haemodialysis, adequate feeding and the early amputation of non viable limbs. A search of the literature reveals that only 11 previously reported cases of burns injury patients being successfully dialysed for acute renal failure.

Acute Kidney Injury↗