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M H Sheriff

Publications and source records attributed to M H Sheriff.

14 recordsLinked to original sources

Medullary sponge kidney presenting with hypokalaemic paralysis.

Medullary sponge kidney associated with a defect in urine acidification is rare and usually of no clinical significance. We report a case presenting as hypokalaemic paralysis due to associated congenital distal renal tubular acidosis.

Acidosis, Renal Tubular

Alkaptonuria.

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Alkaptonuria

Is azathioprine necessary in renal transplantation?

In renal-transplant patients in whom azathioprine therapy was withdrawn early because of bone-marrow suppression no rebound graft rejection was noted. Any subsequent rejection episodes were satisfactorily treated with methylprednisolone pulse therapy. Of 15 patients in whom azathioprine was stopped electively after at least 2 years, only 1 had a subsequent cellular rejection. It is concluded that azathioprine may not have a major role in the immunosuppressive management of renal-transplant patients. If azathioprine has to be stopped there seems to be no good indication for restarting it.

Adult

Successful pregnancy in a 44-year-old haemodialysis patient.

A 44-year-old patient had been treated by intermittent haemodialysis for almost three years when she presented with a 28-week pregnancy. Successful delivery of a healthy but small infant was achieved by Caesarean section at 36 weeks. The successful outcome of this pregnancy was attributed to close control of the haemoglobin concentration and blood chemistry, and to increased frequency of dialysis. The relative value of various chemical tests of fetal maturity in the presence of maternal renal failure are discussed.

Adult

Nutritional blood flow to the limbs after access procedures.

We have measured the blood flow to skin and muscle in normal subjects, asymptomatic dialysis patients, and dialysis patients, and dialysis patients who complained of cold hands (symptomatic patients) in whom a radiocephalic fistula had been constructed. Mean skin blood flow in asymptomatic dialysis patients was identical to that in normal subjects. Skin blood flow in the fistula hand of symptomatic dialysis patients was greatly reduced but it was normal in the contralateral hand. Muscle blood flow at rest was lower in dialysis patients than in normal subjects, but was reduced still further in the fistula hand of symptomatic patients. Muscle hyperaemia in response to exercise was greatly impaired in the fistula hands of all patients, irrespective of symptoms. The haemodynamic consequences of arteriovenous fistulae may be a cause of pain, paraesthesiae, muscle wasting or claudication in dialysis patients.

Arteriovenous Shunt, Surgical