By Michael Boulton-Jones MB, B.CHIR, MRCP (auth.)

ISBN-10: 9400980639

ISBN-13: 9789400980631

ISBN-10: 9400980655

ISBN-13: 9789400980655

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However, its simplicity makes it the method of choice in some patients, particularly those presenting with 'medical' causes of ATN in whom catabolism is rarely extreme. Its other great advantage is that it permits more regular fluid removal and thus allows a more liberal fluid regimen. Subsequent Visits to the Patient The nephrologist has to assess repeatedly the effect of therapy on the patient and balance the various risks and benefits of any particular treatment appropriate to the primary condition but potentially damaging to renal recovery.

Similarly if the kidney lost its ability to conserve potassium, the patient would die of hypokalaemia at a stage when the glomerular filtration remained relatively normal. The classical experiments performed by Bricker and his associates led to the 'intact nephron hypothesis'. e. both filtration and tubular functions are lost simultaneously. The remaining nephrons hypertrophy to cope with the increased load, and are capable of adapting their function to do so. The patient remains well until so many nephrons are lost that hypertrophy of the remainder no longer maintains the GFR, which then progressively declines.

The patient is frequently on a ventilator, requiring little sedation, and small areas of petechial haemorrhage can be found. Such patients rarely survive. 2. Drugs or toxins causing ATN and hepatocellular necrosis. There are numerous chemicals that are known to do this, of which paracetamol, ethyleneglycol and carbon tetrachloride are the most common (Plate 3). 3. The increased postoperative incidence of ATN following operations for the relief of biliary obstruction. Dawson (1968) showed that patients undergoing simple surgical procedures for the relief of obstruction were liable to develop renal failure and the severity of the jaundice was proportional to the risk of renal failure.

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Acute and Chronic Renal Failure by Michael Boulton-Jones MB, B.CHIR, MRCP (auth.)

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