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Biomedical subjects

R S Pedersen

Publications and source records attributed to R S Pedersen.

At least 19 recordsLinked to original sources
PubMed1991

Prognosis in septicemia complicated by acute renal failure requiring dialysis.

During a 12-year period 419 patients were admitted because of acute renal failure requiring dialysis. Fifty (12%) had septicemia verified by blood culture. In a retrospective study age, sex, focus of infection, blood culture results, kidney function, mode of dialysis treatment, numbers and durations of complicating organ failures, presence of gastrointestinal bleeding, and secondary complicating events of septicemia were recorded for the purpose of establishing a prognostic index based on clinical criteria. Respiratory failure was present in 34 patients, circulatory failure in 31 patients, failure of coagulation system in 25 patients, and hepatic failure in 10 patients. Overall mortality was 46%. Highest death-rates were found during the first days of dialysis. In patients with multiple organ failures, in elderly and in patients suffering from staphylococcus aureus septicemia, a non-significant trend towards higher mortality was found. The mode of dialysis treatment did not influence patient survival. Our intention of establishing a prognostic index based on bedside clinical criteria has not been fulfilled. Even though mortality-rate increases in patients with acute renal failure complicated by failure of one or more vital organs, survival-rate in patients with four or more organ failures was 30%.

Acute Kidney Injury↗
PubMed1991

Prognosis and risk factors in acute, dialysis-requiring renal failure after open-heart surgery.

Of 1988 patients who underwent open-heart surgery from 1980 through 1988, 68 (3.4%) developed postoperative acute renal failure requiring dialysis (2.5% of adult and 8.3% of pediatric patients). Isolated aortocoronary bypass grafting was the operation with lowest incidence of this complication (0.6%). Acute renal failure usually appeared during the first 3 postoperative days. It carried a mortality rate of 63%, with half of the deaths occurring during the first few postoperative days, due to low cardiac output and progressive multiple organ failure. Logistic regression analysis in cases of aortic valve replacement demonstrated that significant independent preoperative risk factors for acute renal failure were renal insufficiency (serum creatinine greater than 110 mumol/l in greater than or equal to 2 samples) and increased cardiothoracic index/left ventricular end-diastolic dimension. Data from the literature indicated no time-related trend towards reduction of acute renal failure incidence or mortality. Prevention of low cardiac output is of major importance in these respects. Operative intervention before development of advanced disease with left ventricular dilatation and secondary kidney failure is advocated.

Acute Kidney Injury↗
PubMed1990

Hemodialysis does not always protect against recurrence of Wegener's granulomatosis.

Hemodialysis may protect against disease activity in Wegener's granulomatosis. We report here a 41-year-old woman with Wegener's granulomatosis, in whom renal transplantation was performed after a 10-month period of hemodialysis during which no signs of disease activity were detected. Recurrence of disease did, however, take place 2 years after renal allograft transplantation despite immunosuppressive therapy with cyclosporine A and prednisone. Reinstitution of hemodialysis and graftectomy did not improve the patient's condition but plasmapheresis and treatment with cyclophosphamide and prednisone eliminated all signs of disease within a fortnight. A proposal for better maintenance of these patients is made.

Combined Modality Therapy↗
PubMed1990

Prognosis in acute pancreatitis complicated by acute renal failure requiring dialysis.

Acute pancreatitis complicated by acute renal failure (ARF) requiring dialysis is a rare condition with a mortality rate of 80%. During the period 1977-1988 419 patients were admitted to our hospital because of ARF requiring dialysis. Fourteen (3%) had ARF caused by acute pancreatitis. Ten patients developed respiratory failure, eight patients circulatory failure, four hepatic failure, and one disseminated intravascular coagulation. Three patients had complicating septicemia and two gastrointestinal bleeding. Ten patients (71%) died. All patients with four or more organ failures besides the pancreatic failure died. Median time from start of symptoms until death was 28 days. Mortality in this series does not differ from that reported over the last 40 years. The need of multicenter trials for the purpose of improving prognosis is emphasized.

Acute Disease↗
PubMed1989

[18 children with slight glomerular proteinuria demonstrated incidentally].

Out of 61 children with idiopathic chronic glomerulonephritis confirmed by biopsy or minimal lesion diagnosed during the period 1964-1987, 18 were found in whom the first sign of renal disease was slight proteinuria demonstrated at routine examination of the urine. Five of these children were referred directly to a nephrological department with the object of further elucidation of the diagnosis. In six of the remaining 13 children, the first referral to hospital took place after an average of 5.9 years and after signs of renal disease were apparent for the first time. In ten of these 13 patients, an average period of 3.9 years elapsed before renal biopsy was carried out and the nature of the disease elucidated. 29 and 73% of these patients, respectively, had developed terminal uraemia five and ten years after establishing the diagnosis. It is recommended that children in whom persistent proteinuria is demonstrated, regardless of the magnitude, should be referred directly to a nephrological department or a paediatric department with special interests. Renal biopsy may be indicated. Life-long systematic follow-up control is indicated.

Adolescent↗
PubMed1989

[Extracorporeal treatment of poisoning. An analysis of 72 consecutive cases from the period 1977-1988].

During a period of 12 years, extracorporeal treatment of 72 cases of poisoning in the form af dialysis and/or haemoperfusion was undertaken in Medical Department C of Arhus Municipal Hospital. Where 54 patients were concerned, the causes of poisoning were medicinal. Eleven cases were caused by ethyl alcohol, six were caused by technical poisons and one by cantharidine which is employed in veterinary medicine. In 50 cases the primary indication for extracorporeal treatment was elimination of the drug or other poison. In the remaining 22 cases the indication was acute renal failure. The total mortality was 4%.

Denmark↗
PubMed1987

Acute renal failure caused by polymyxin B containing ointment.

A case is presented in which a 67-year-old man suffering from non-insulin-dependent diabetes mellitus, after being treated with polymyxin B containing ointment for leg ulcers, developed acute renal failure. After a period of 13 days during which the patient was treated with peritoneal dialysis 5 times, renal function returned. At discharge creatinine-clearance was 12 ml/min. Treating large ulcers with polymyxin B may be dangerous.

Absorption↗