• Title/Summary/Keyword: peritoneal dialysis

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Radionuclide Peritoneal Scintigraphy in Patients with Ascites and Pleural Effusion (방사성핵종 복막촬영술을 이용한 복수에 동반된 수흉의 감별 진단)

  • Lee, Jae-Tae;Lee, Kyu-Bo;Whang, Kee-Suk;Kim, Gwang-Weon;Chung, Byung-Cheon;Cho, Dong-Kyu;Chung, Joon-Mo
    • The Korean Journal of Nuclear Medicine
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    • v.24 no.2
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    • pp.279-285
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    • 1990
  • Simultaneous presence of ascites and pleural effusion has been documented in patients with cirrhosis of the liver, renal disease, Meigs' syndrome and in patients undergoing peritoneal dialysis. Mechanisms proposed in the formation of pleural effusion in most of the above diseases are lymphatic drainage and diaphragmatic defect. But sometimes, hepatic hydrothoraxes in the absence of clinical ascites and pleural effusion secondary to pulmonary or cardiac disease are noted. It is not always possible to differentiate between pleural effusion caused by transdiaphragmatic migration of ascites and by other causes based soly on biochemical analysis. Authors performed radionuclide scintigraphy after intraperitoneal administration of $^{99m}Tc-labeled$ colloid in 23 patients with both ascites and pleural effusion in order to discriminate causative mechanisms responsible for pleural effusion. Scintigraphy demonstrated the transdiaphragmatic flow of fluid from the peritoneum to pleural cavities in 13 patients correctly. In contrast, in 5 patients with pleural effusion secondary to pulmonary, pleural and cardiac diseases, radiotracers fail to traverse the diaphragm and localize in the pleural space. Ascites draining to mediastinal lymph nodes and blocked passage of lymphatic drainage were also clarified, additionaly. Conclusively, radionuclide peritoneal scintigraphy is an accurate, rapid and easy diagnostic tool in patients with both ascites and pleural effusion. It enables the causes of pleural effusion to be elucidated, as well as providing valuable information required when determining the appropriate therapy.

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Differences in Illness Intrusivenss between Rheumatoid Arthritis and Osteoarthritis (골관절염 환자와 류마티스 관절염 환자의 지각된 질병 영향 비교)

  • Kim, In-Ja;Kim, Jong-Im;Lee, Eun-Ok
    • Journal of muscle and joint health
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    • v.10 no.2
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    • pp.119-130
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    • 2003
  • Illness intrusiveness(illness induced lifestyle disruption) was investigated in 902 patients with arthritis and compared between rheumatoid arthritis(N=439) and osteoarthritis(N=463) patients. Arthritis patients were reported to perceive illness intrusiveness similar to patients with ESRD(end stage renal disease), bipolar disorder and peritoneal dialysis. Especially they were intrusive into health, work, and active recreation domains. And patients with rheumatoid arthritis were significantly more intrusive into activities, especially in diet, financial situation, family relations, other social relations, self-expression/self improvement, religious expression, and community and civic involvement. Differences in treatment regimens and age were hypothesized to account for these differences in illness intrusiveness.

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Treatment of Acute Renal Failure in Neonate (신생아 급성 신부전의 치료)

  • Lee, Jin-A
    • Neonatal Medicine
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    • v.17 no.2
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    • pp.168-180
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    • 2010
  • Acute renal failure (ARF) is common in the neonatal period, however, there are no uniform treatment strategies of ARF. The main treatment strategies are conservative management including medical treatment and the renal replacement therapy. Because ARF in the newborn is commonly acquired by hypoxic ischemic injury and toxic insults, removal of all the offending causes is important. Aminoglycoside, indomethacin, and amphotericin-B are the most common nephrotoxic drugs of ARF. To relieve the possible prerenal ARF, initial fluid challenge can be followed by diuretics. If there is no response, fluid restriction and correction of electrolyte imbalance should begin. Adequate nutritional support and drug dosing according to the pharmacokinetics of such drugs will be difficult problems. Renal replacement therapies may be provided by peritoneal dialysis, intermittent hemodialysis, or hemofiltration. New promising agents, bioartificial kidney, and stem cell will enable us to extend our therapeutic repertoire.

Illness Intrusiveness by Symptoms in Patients with Rheumatoid Arthritis (류마티스 관절염 환자의 증상에 따른 지각된 질병 영향)

  • Kim, Inja;Lee, Eun-Ok
    • Korean Journal of Adult Nursing
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    • v.16 no.2
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    • pp.288-296
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    • 2004
  • Purpose: Illness intrusiveness (illness induced lifestyle disruption) by symptoms was investigated in 439 patients with rheumatoid arthritis. Method: The cross-sectional and retrospective survey design was used. Fatigue, disability, pain, and depression were considered as symptoms of rheumatoid arthritis. Result: Patients were reported to perceive more illness intrusiveness than other chronic disease patients such as end stage renal disease, bipolar disorder, and peritoneal dialysis patients. They were especially intrusive into work, health, and active recreation domains. Stepwise regression analysis identified four variables counting for 26% of illness intrusiveness variances: fatigue, disability, marital status, and depression. All of the symptoms except pain were found to significantly predict illness intrusiveness. Fatigue explained 16% of illness intrusiveness variances. Conclusion: Fatigue and depression usually overlooked by health professionals must be carefully assessed and managed to reduce perceived illness for rheumatoid arthritis patients.

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A Case of Rapidly Progressive Glomerulonephritis in $Henoch-Sch\"{o}nlein$ Purpura (급속 진행성 사구체신염형의 $Henoch-Sch\"{o}nlein$ 신염 1 례)

  • Chang Soo-Hee;Jo Dae-Sun;Lee Dae-Yeol
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.82-85
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    • 1997
  • The incidence of nephritis associated with Henoch-Sch nlein purpura varies, but glomerulonephritis consistently accounts for most of the associated morbidity and mortality. A very small number of Henoch-Sch nlein purpura develop rapidly progressive glomerulonephritis. A three-year old male patient who showed acute nephritic nephrotic syndrome developed abdominal pain, arthralgia and multiple purpurae on lower extremities later. Peritoneal dialysis was done at the 6th hospital day and continued for 7 months. Renal biopsy disclosed crescentic glomerulonephritis (with 81% crescent formation) and methylprednisolone pulse therapy was done. These days, his general condition is good, but serum creatinine levels are 1.2-1.3 mg/dL. This case was reviewed briefly with the literatures.

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Treatment of Dead Space with Prolonged Air-leak after Lobectomy by Artificial Pneumoperitoneum -A case report- (인공기복으로 치료한 폐엽절제후 발생된 사강과 공기누출 -1례 보고-)

  • 이응석;윤용한;백완기;손국희;김광호;안승익
    • Journal of Chest Surgery
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    • v.34 no.7
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    • pp.578-581
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    • 2001
  • We successfully treated a 59-year-old male with adenocarcinoma in the right lower lobe who had developed a dead space with prolonged air-leak, which continued for 21 days after lower and middle lobectomy, by creating artificial pneumoperitoneum. He had a history of subtotal gastrectomy due to stomach cancer 5 years ago. Artificial pneumoperitoneum was made after introducing a peritoneal dialysis catheter into the right upper quardrant. The chest tube was removed 14 days after creating pneumoperitoneum.

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Familial renal amyloidosis in a Shar Pei dog

  • Lee, Seung-Gon;Moon, Hyeong-Sun;Han, Jeong-Hee;Yoon, Byung-Il;Hyun, Changbaig
    • Korean Journal of Veterinary Research
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    • v.47 no.2
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    • pp.255-257
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    • 2007
  • Familial renal amyloidosis was found in a four-year-old male Shar Pei dog. The dog had intermittent fever with signs of renal failure. Another sibling of this dog also showed subclinical signs of renal amyloidosis. Despite aggressive therapy with peritoneal dialysis, the dog died after 10 days of the first presentation. With special staining for amyloid, the renal amylodosis was confirmed.

Renal replacement therapy in neonates with an inborn error of metabolism

  • Cho, Heeyeon
    • Clinical and Experimental Pediatrics
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    • v.62 no.2
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    • pp.43-47
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    • 2019
  • Hyperammonemia can be caused by several genetic inborn errors of metabolism including urea cycle defects, organic acidemias, fatty acid oxidation defects, and certain disorders of amino acid metabolism. High levels of ammonia are extremely neurotoxic, leading to astrocyte swelling, brain edema, coma, severe disability, and even death. Thus, emergency treatment for hyperammonemia must be initiated before a precise diagnosis is established. In neonates with hyperammonemia caused by an inborn error of metabolism, a few studies have suggested that peritoneal dialysis, intermittent hemodialysis, and continuous renal replacement therapy (RRT) are effective modalities for decreasing the plasma level of ammonia. In this review, we discuss the current literature related to the use of RRT for treating neonates with hyperammonemia caused by an inborn error of metabolism, including optimal prescriptions, prognosis, and outcomes. We also review the literature on new technologies and instrumentation for RRT in neonates.

Peritonitis in Children Undergoing Peritoneal Dialysis: 10 Years' Experience in a Single Center (소아 복막 투석 환자에서 발생한 복막염: 단일기관에서 10년간의 경험)

  • Lee, Se-Eun;Han, Kyoung-Hee;Jung, Yun-Hye;Lee, Hyun-Kyung;Kang, Hee-Gyung;Cheong, Hae-Il;Ha, Il-Soo
    • Childhood Kidney Diseases
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    • v.14 no.2
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    • pp.174-183
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    • 2010
  • Purpose : The organisms causing peritonitis and their antibiotic sensitivities vary in different regions and centers, and these data are necessary to establish regional treatment guidelines. The aim of this study was to investigate the changes in incidence and characteristics of the organisms that cause peritonitis in children undergoing peritoneal dialysis (PD) during recent 10 years. Methods : We retrospectively collected and analyzed the data from medical records of 110 children on PD during the period from 2000 to 2010. Results : One hundred and forty episodes of peritonitis have occurred in 57 patients. The overall incidence of peritonitis was 0.43 episodes/patient year, and similar incidence have been maintained since 2003. Sixty percent of the patients experienced peritonitis within 1 year of PD, and all patients commencing PD in infancy experienced peritonitis. Gram positive (G (+)), gram negative (G (-)) organisms and fungi were cultured in 58%, 38%, and 4.1% respectively and cultures were negative in 13.6%. Staphylococcus was the most common G (+) organism, and Pseudomonas and Acinetobacter were 2 most frequent G (-) organisms isolated. Fifty-six percent of the G (+) organisms were sensitive to first generation cephalosporin and 91% of G (-) pathogens were sensitive to ceftazidime. Methicillin-resistance rate was not higher in children less than 2 years of age than in those more than 2 years. Conclusion : An additional breakthrough has to be made to further reduce the incidence of peritonitis. Treatment guideline customized for peritonitis in Korean children on PD need to be established through a nationwide co-work.