Microsoft Word - NEF459BF

نویسنده

  • K. Kazuyoshi Okada
چکیده

Dr. K. Okada, Second Department of Internal Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo 173 (Japan) appeared (fig. lb). We therefore reached a diagnosis of uremic pericarditis. CAPD schedule was Dianeal PD-2 UV-flash twin-bag 1.5%, 1,500 ml (Baxter Co.) 3 exchanges/day, because his urine volume was maintained by the administration of diuretics. His renal Ccr was improved to 5.1 ml/ min/1.73 m2. Since the patient became stable 2 weeks after the introduction of CAPD, we discontinued CAPD during 72 h with the administration of diuretics, vitamin D metabolite and uric acid synthesis inhibitor (table 1). The levels of UN, Cr, UA, K and Pi Dear Sir, Continuous ambulatory peritoneal dialysis (CAPD) has been established as a treatment of end-stage renal failure [1]. To achieve adequacy of dialysis in CAPD, patients have usually been dialyzed every day with four 2-liter volume exchanges per day. However, there are no prospective studies of methodology for prescription of CAPD. In addition, individual variation in peritoneal dialysis prescription exists. It has been indicated that one of the tools for prescribing minimum adequacy of peritoneal dialysis is overall (peritoneal and renal) creatinine clearance (Ccr) of 50 l/week/1.73 m2 (4.96 ml/min/1.73 m2) [2], We therefore attempted intermittent ambulatory peritoneal dialysis (IAPD), which is modified CAPD, in a patient with renal CCΓ near 5 ml/min/ 1.73 m2, and the results have been reported here. A 68-year-old male was started on hemo-dialysis (HD) because of chronic renal failure due to diabetes mellitus and tamponade due to massive pericardial effusion (fig. la) on May 11, 1995. His blood pressure was 120/80 mm Hg, pulse 108/min, temperature 36.0 °C, height 160 cm, and body weight (BW) 53.8 kg. Examination of the blood and urine yielded the following data: hemoglobin concentration, 7.1 g/dl; hematocrit, 21.3%; serum urea nitrogen concentration (UN), 83.7 mg/dl; serum creatinine concentration (Cr), 10.9 mg/dl; serum uric acid concentration, 10.5 mg/dl; 24-hour Ccr, 9.2 ml/min/ 1.73 m2; serum total protein concentration, 6.6 g/dl; serum sodium concentration (Na), 141 mEq/1; serum potassium concentration Fig. 1. Chest radiograph (a) at admission and (b) on CAPD. (K), 4.4 mEq/1; serum total calcium concentration (Ca), 6.9 mg/dl; serum phosphate concentration (Pi), 7.2 mg/dl; blood glucose concentration, 194 mg/dl, and HCC1⁄8 17.6 mmol/l. The genesis of pericardial effusion could not be clarified. Although his BW was

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تاریخ انتشار 2008