[Chronic hemodialysis: experience of the 1st 15 years at university hospital].
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Biomedical subjects
Publications and source records attributed to S Vial.
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Acute renal insufficiency due to ureteral obstruction is relatively uncommon and gives rise to difficulties of diagnosis and treatment. The series presented here analyzes these aspects in 24 patients who had 27 episodes of proven anuria due to ureteral obstruction. Their average age was 62. Six patients had only one kidney (25%). The most common etiology was cancer (two thirds of the cases), mainly of genitourinary origin (10/16). Calcium or uric acid urethral lithiasis was the main cause of obstruction in the benign group. Treatment corresponded to a wide range of obstruction removal procedures depending on the etiology, but in the secondary to cancer it was very aggressive and the most used was nephrostomy. The decision to perform any treatment of obstructive anuria in patients with cancer should take into account a variety of important aspects amongst which prevail the prognosis of the basal illness, the handling of cancerous pain, the complications and mortality associated with the procedure and the patient's prospects.
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The effects of vasopressin administered by continuous infusion (0.75 and 0.5 mU/m2/minutes) was studied in two groups of three normal and two groups of 5 and 8 malnourished children given 0.5 and 0.3 mU/m2/minute. The following parameters were analyzed: urine volume, osmolality, water reabsorption, PAH, urea and inulin clearances, Na and K urinary excretion. Malnourished children had a urine volume 3 to 5 times higher than the normal groups. Vasopressin increased urine volume initially, but a mild antidiuretic effect followed in the normal groups. In malnourished children with a high CH2O, antidiuresis showed quite important figures with vasopressin. A transient fall in PAH and inulin clearances was observed with vasopressin in both malnourished groups with a mild drop in the normal group. Natriuresis with a higher % of the filtered sodium excretion was observed in the malnourished groups and in normal children with 0.5 mU of vasopressin. These results show that vasopressin had similar effects, but at a different level in the normal and malnourished children that we studied.