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Index
acetate in dialysis fluid 265, 266 ACSjNIH Transplant Registry 366 acid-base balance
ammonium excretion 66-8 bicarbonate measurement 70 fixed acid generation 62 measurement 70 normal 62-6 titratable acid excretion 68 in uraemia 66-71 see also buffer systems
acute lupus nephritis 27 acute renal failure 1-27
antibiotic use 21,22 diagnosis 6-13 diuretic phase 22, 23 hypercatabolism 18-21 induced 3 intensive care 1 management 13-24 metabolism 24 nutrition 15-18 obstetric cases 24 pathophysiology, theories 2-5 patients at risk 6 plasma exchange 25-7 prognosis 24 underlying condition 22
air embolism 300 capacitance monitor 260,261 causes 258 monitor types 258
alkaline phosphatase, bone turnover 49 allopurinol and hyperuricaemia 74 allograft nephrectomy 349, 350 amikacin
in acute renal failure 22 in chronic renal failure 133
381
amino acids, essential-keto analogues 107
aminoglycosides 21 in chronic renal failure 132--4 side-effects 132
ammonia and uraemic toxicity 73 ammonium excretion
factors affecting 67 in uraemia 66-8
amphotericin B 21 ampicillin
dose in chronic renal failure 129 side-effects 129
amyloidosis 325 anaemia 189
and androgens 124, 125 in chronic renal failure 78-82 severity and BUN 78 treatment and chronic renal failure
124, 125 in uraemia 75
anaesthesia, side-effects 198, 199 androgens
in anaemia 124 side-effects 124
angiography 8-11,335,346,354, 361 angiotensins 86, 87
and acute renal failure 4 anion gap 70, 71 antibiotics
in acute renal failure 21,22 in chronic renal failure 126--42 in renal transplantation 337
ARF see acute renal failure arginine, danger in chronic renal failure
61 arterial line pressure monitors 261 arteriography II
382 INDEX
arteriosclerotic retinopathy 89 arteriovenous fistulae 14,211-19
antecubital fossa, technique 212, 213
autogenous vein graft procedure 216 blood pressure taking 212 bovine heterografts 216, 217 Brescia-Cimino subcutaneous 290 care in anaesthesia 219 children 222 Cimino-Brescia radiocephalic 222 Dacron 217 disadvantages in leg 211 end-to-end 214 femoral artery-vein 214 Gortex 222 polytetrafluoroethylene (PTFE)
218,219 referral for 237,238 from Scribner shunt 213 Sparks Mandril 214,215 surgical techniques 212,216,219 umbilical vein 218
arteriovenous shunt ankle insertion 204, 205 children, techniques 220-2 clotting prevention 206 disconnection bleeding 206 and fistula creation . 211 home haemodialysis 289 infection 206, 208 insertion difficulties 205 insertion technique 203 postoperative care 205 removal 208
avascular necrosis 357, 358 azathioprine 326, 337, 348, 350
use in chronic renal failure 141 use in immunosuppression 324,
341,369
backflow of filtrate 3 bicarbonate reclamation process 64,
65 in uraemia 68, 69
bicarbonate regeneration process 66 bilateral cortical necrosis 5 bleeding tendency in chronic renal
failure 81, 82 J3-blockers 86
antihypertensive action 112, 360 cardioselective 111-13
uraemic hypertension 111 blood pressure and hypertension
treatment 110 blood transfusion before renal
transplantation 344, 345 blood urea nitrogen (BUN) 95-7
optimum level and diet 105 and protein intake 104
bone disease see orthopaedic complications
brain death 331, 332 British Kidney Patients Association
328 holiday centre 'the Grove' 270, 271
buffer systems 62, 63 biological 63 physiological 63, 64
bumetanide 42 BUN see blood urea nitrogen burning feet 84
calcification calcium phosphate deposition sites
57 and itching 58 metastatic 57-9 renal tissue 58, 59 types 59 vascular 58
calcitonin deficiency in chronic renal failure 49
calcium absorption defects 47 calcium in dialysis fluid 266 calcium metabolism in chronic renal
failure 47-51 malabsorption 47,48 and parathyroid hormone 50,51
calculi in renal allografts 356 calyceal-cutaneous fistulae 355 cancer in renal transplantation
treatment 360 types and incidence 359, 360
Candida spp. infections 20 cannulae 197
infection 200, 289, 290 Silastic-Teflon 289, 290
cannulation direct vessel 199 femoral artery 201 femoral vein 200 insertion 200,201 subclavian vein 199, 200
INDEX 383
carbenicillin dose in chronic renal failure 128,
129 side-effects 129 sodium 129
carbohydrate metabolism 77, 78 intolerance in chronic renal failure
77 cardiovascular system, signs of chronic
renal failure 85-92 catabolic rate, causes of increase
18-21; see also hypercatabolism catheter, acute (stylet) 169-71
complications 171 insertion 170
catheter, permanent peritoneal 171 complications 174, 175 insertion and preparation 172, 173 obstruction 174 types 173
catheters Fogartyembolectomy 208,213 Foley 337 Goldberg 173 in renal transplantation 340 sapheno-femoral in children 220 Tenchkoff 173
cefoxitin 131 active excretion and dose 132
cellulose 263 dialyser re-use 272
central venous pressure 6 cephalexin, dose in chronic renal failure
131 cephaloridine 131 cephalosporins, nephrotoxicity 22,
130 cephalothin, dose in chronic renal
failure 131 cephazolin 131 Ceratonia siliqua, locust bean gum 125 chloramphenicol, use in chronic renal
failure 135 chronic renal failure (CRF) 33--142
acid-base balance 62-71 anaemia 78-82 calcium metabolism 47-51 carbohydrate metabolism 77-9 cardiovascular signs 85-92 causes 34, 35 clinical assessment 92-101 diet 102-10
drug use 126--42 fertility 365, 366 effect on growth in children 370 management 101-26 metastatic calcification 57-9 neurological effects 82-5 phosphate metabolism 42-7 potassium metabolism 59-62 renal osteodystrophy 51-7 sodium metabolism 38--42 uraemic toxicity 71-7 water metabolism 35-8
cimetidine 328,329,361 clofibrate and cholesterol 109 clonidine, antihypertensive 115, 116 colistin 21
dose and toxicity 134 colonic disorders after renal trans
plantation 361,362 constipation, peritoneal dialysis 189 copper
in dialysis fluid 277, 297 intoxication 297
cortical necrosis 12 co-trimoxazole, dose in chronic renal
failure 137 counselling 236 cramps 83 creatinine
clearance rates 330 determination 94, 95 and glomerular filtration rate 93--5 origin 93 serum in acute renal failure 7
CRF see chronic renal failure crush syndrome 2 cuprophan 263 cyclophosphamide
dose in chronic renal failure 140, 141
pretreatment of kidney donor toxicity 141
cytotoxic response, cells involved
Dean's prosthesis 171, 172 deficiencies in acute renal failure dehydration in peritoneal dialysis demyelination 84, 85 dental survey 234 dextrose in dialysis fluid 266 diabetes 229,231
peritoneal dialysis 190
333
318
18 185
384 INDEX
diabetes (continued) and renal transplantation 325
dialysate continuous regeneration 297 preparation and composition for
home 294-7 sterilization 296
dialysers choice 262-5 choice for home 292-4 circuits 265 coils 264 cost 264 disposables 248, 263, 264 fibrin formation 293 formalin sterilization and washout
272,273 hollow fibre 263, 264 Kiil 247,248,263,293,294 manufacturer 264, 265 non-disposable parallel flow 263 preparation, re-use 247, 248 re-use and loss of performance 271-3 size 264
dialysis and HBsAg antigenaemia 326 hepatitis policy 267-9 holiday facilities 269-71 management and acute renal failure
22,23 after renal transplantation 340 stopping in acute renal failure 23 time of starting 236 timing 267 see also haemodialysis, peritoneal
dialysis dialysis fluid
bacterial growth 252, 256, 276 concentrate choice 265-7 plasticizers 278 trace contaminants 276-8
diazoxide 87 diet
calcium 117 children in uraemia 106, 107 fat 103 ketoacids 105, 107 low protein in chronic renal failure
102-6 and metabolic acidosis 122 phosphate 117 potassium 120, 121
salt 109, 110 semisynthetic 105 vitamins 107, 108
digoxin, dose in chronic renal failure 140
dihydrotachysterol in osteomalacia 118 disequilibrium syndrome 185,278 disseminated intravascular coagulation
(DIC) and acute renal failure 5
doxycycline in chronic renal failure 135
drug card 237 drugs
antidepressants 142 antihypertensives 87, 11 0-16 dialysis unit 243, 244 effects in acute renal failure 20 elimination rates 127 treatment of transplant rejection 348 use in chronic renal failure 126-42 use in immunosuppression 341, 342 see also antibiotics, individual drugs
echocardiography 89, 90 uraemic pericarditis 92
economics, comparative of different treatments 367,368
EEC changes in uraemia 82 electrocution during dialysis 274 endotoxinaemia 5 erythrocyte
functions 80 life and uraemia 80 production decreased in chronic renal
failure 80,81 erythromycin, use in chronic renal
failure 136 erythropoietin 81
in anaemia 124 endogenous stimulation 124 extrarenal 81
ethambutol use and toxicity in chronic renal
failure 140 visual effects 140
European Dialysis and Transplant Association Registry 227,365,366
extracellular volume (ECV) expansion in chronic renal failure
36,37,39,41,86 and hypertension 86, 87
INDEX 385
family planning advice 234, 235 fibrin degradation products 5 fluid replacement and renal trans-
plantation 340 fluoride in dialysate 298 fosfomycin, use in chronic renal failure
136,137 furosemide 42, 44
and cephalosporin toxicity 130
gas gangrene 20 gastrointestinal bleeding in acute renal
failure, diagnosis and management 19
gentamicin 21 dose in chronic renal failure 133 plasma levels in acute renal failure
21 glomerular diseases causing chronic
renal failure 34 glomerular filtration rate 37
cephalosporins 131, 132 and creatinine 93, 94 penicillins 128, 130 and plasma urea 96 and protein intake 96, 103-5
glomerular nephritis, rapidly progressive
plasma exchange 26, 27 glomerulonephritis 34, 36, 325, 326 Goodpasture's syndrome
cause 25 plasma exchange 26
graft, cortico-iliac trouser 11 guanethidine, antihypertensive 116 guanidino compounds, uraemic toxicity
72, 73
haemodialysis in acute renal failure 14, 15 complications 274--9 frequency in acute renal failure 15 and peritoneal dialysis success 191 pyrogens 275,276 after renal transplantation . 340 and serum potassium 121 vascular access 14 see also home, hospital dialysis
haemoglobin blood urea correlation in chronic
renal failure 79
and creatinine clearance in chronic renal failure 79
haemolysis 80 haemorrhage 353 Henderson-Hasselbach equation 62 heparin
thrombosed shunt 207 use in renal transplantation 337,348
heparinization 273, 274 batch variability 273 home haemodialysis 293,301
hepatitis antigen detection 235 antiglobulin use 268, 269 carriers 268 cross-infection 242 epidemics 269 peritoneal dialysis 189 policy in dialysis 267-9 predialysis clinic 231 Rosenheim report 241,267,268 and renal transplantation 326 separation facilities 250, 251
HLA antigen detection 314 B8 and hepatitis carriers 268 and blood transfusion 344 D-Iocus antigens 315-17 D and DR antigen matching 320,
321 DR antigen 316 DR and Ia homology in mice 314 matching and graft survival 319-21 PL T cloning 317 primed LD typing (PL T) 316, 317 recognized loci 315 scheme in man 314,315
home haemodialysis 287-311 alarms 300 development 287,288 dialyser choice 292-4 dialysate preparation 294--7 disposable, re-use and cost 294 electrical safety 292 equipment needed 291-302 future prospects 310,311 heparin 301 home adaptations 301,302 monitoring 298-300 motivation 304, 309 needle type 290, 291 objectives 288, 289
386 INDEX
home haemodialysis (continued) organization 305-7 patient restrictions 307 patient selection 232, 302, 303 proportioning systems 295 psychological factors 303 pump and line types 300,301 rehabilitation 308 results 308-10 return to hospital 309 sterilization 296 training programme and personnel
304-7 water preparation 297,298
hormones in uraemic toxicity 76 hospital dialysis unit
air embolism monitor 258-61 area per patient 243 bed weighers 252 Bellco pump 262 blood pumps 259, 261 catering 249 design 238-51 desirable features 239, 240 dialysing area 242, 243 drug cupboard 243, 244 equipment 251-65 essential components 239,240 heparin pumps 258 hepatitis policy and quarantine
267-9 nurse: station ratio 242 operating and laboratory space 250 patient changing room 241,242 proportionating systems 252-8 reclining chairs and beds 251 scheme 240 seminar rooms 249, 250 staff facilities 242 technician's workshop 248, 249 toilet segregation 241 visitor preparation 241 waiting areas 242
hospital haemodialysis 227-79 expense 227 oversubscribed 233, 234 patient referral 228 preparation 234-8 rationing 228 reasons for 233 survival 227 water treatment 244-7
hydralazine in uraemic hypertension 112, 113
hydronephrosis 10, 11,99, 100 hypercalcaemia 182
contributing factors 356, 357 treatment 357
hypercatabolism, causes in acute renal failure 19-21
hyperkalaemia 61 treatment 120, 121
hypematraemia during dialysis 274, 275
hyperparathyroidism, secondary 356, 357
bone features 53--5, 75 in chronic renal failure 46, 50, 51,
53,83 and pancreatitis 362 skull appearance 54 tertiary 51
hyperphosphataemia treatment 117 hypertension
drugs 87,110-16 incidence in uraemia 85 indication for nephrectomy 329 and ocular disorders 363 rebound 115 after renal transplantation 354, 360 salt -dependent 42, 43
hypertension, uraemic 85-8 kidney damage 86 mechanism and drug action 86 salt dependent 88 salt and water retention 87, 88 treatment 11 0-16
hypertensive retinopathy 88, 89 hypertriglyceridaemia 189
in chronic renal failure 78 management 108,109 in uraemia and diet 108, 109
hyperuricaemia 73, 182 kidney function 74 treatment 74
hypoaldosteronism 61 hypokalaemia in peritoneal dialysis 185 hyponatraemia, acute in dialysis 274,
275 hypophosphataemia 117 hyporeninaemia 61 hypotension
in dialysis 279 postural 114
INDEX 387
hypothermia 182 hypothyroidism in uraemia 83
immune complex detection 26 immunosuppression
and cancer development 359 common scheme of therapy 341 dangers of 344 in paediatric renal transplantation
369 and pregnancy 365
infection in acute renal failure 17 arteriovenous shunt 206, 207 bovine heterografts 217 cannula 289 diagnosis and management in ARF
19,20 home haemodialysis 289 mortality 350, 352 permanent peritoneal catheter 174 after renal transplantation 350--2,
356 injured tissue removal in acute renal
failure 20 injury, metabolic response 21 insulin in acute renal failure 18 interstitial oedema and acute renal
failure 3 intravenous urography 98 isoniazid use and toxicity in chronic
renal failure 139 itching
in chronic renal failure 57, 58, 75 and parathyroidectomy 120 treatment 120
kanamycin in chronic renal failure 133 toxicity 133
ketoacids, nitrogen load 105 kidney function 72
vasodepression 88 kidney rupture 353 Kussmaul breathing 71
labetalol, a,- and f3-blocking effects 112,113
laboratory tests, predialysis clinic 235, 236
left ventricular hypertrophy 89, 90
Legionnaire's disease 351 lincomycin, use in chronic renal failure
135,136 lipoprotein 78 Listeria monocytogenes 351 Looser's zone 52 lymphocoele, after renal transplantation
353,354 lymphocyte
response to MHC antigens 319 T cytotoxic 319 T helper 319
magnesium in dialysis fluid 266, 267 major histocompatability complex
(MHC) cell response to antigens 313 coded antigens 313 see also HLA
metabolic acidosis clinical signs 71 and decalcification 69 diet 122 evaluation 69, 70 sodium bicarbonate infusion 122 sodium lactate 122, 123 treatment 121-3 in uraemia 69
methicillin 128, 129 dose in chronic renal failure 129
methyldopa antihypertensive effects 115 sedation 116
methylprednisolone 12,333,337,341, 348
metoprolol 112 middle molecules
peptide hormones 77 and uraemic toxicity 76, 77
minoxidil 112 side-effects 113 use in hypertension 113
mixed lymphocyte culture (MLC) 313, 314
mortality acute renal failure 17, 24 and post renal transplantation
disorders 350, 352, 360, 361, 370 hepatitis 268
muzolimine sodium and urine output 42, 44
myoglobin casts 2
388 INDEX
nalidixic acid, use in chronic renal failure 138
nerve conduction block 84 neurological disorders
cerebral signs 82, 83 in chronic renal failure 82-5 peripheral neuropathy 83--5
nickel in dialysis fluid 277,278 nitrofurantoin dose in chronic renal
failure 138 nocturia 35 nutrition
in acute renal failure amino acid solutions energy source 17 intravenous 17 parenteral 16
15-18,24 17, 18
ocular disorders after renal transplantation
causative factors 363 types and incidence 363
oligourea, acute renal failure 4 oral hypoglycaemics 142 oral sorbents 125 orthopaedic complications after renal
transplantation 357-9 osteitis fibrosa
bone features cystic lesions skull features
53--6 54,56 54
see also secondary hyperparathyroidIsm
osteomalacia 51-3 causes 52 definition 51 and diet 52, 118 25-0HD3 119 pseudofracture (Looser's zone) 52 treatment 118, 119 in untreated uraemia 49
osteoporosis 56, 57 senile 56
osteosclerosis 55, 56 bone thickening 55 rugger jersey sign 55
overheating, dialysis fluid 274 oxolinic acid, dose in chronic renal
failure 138, 139 oxygen, factors affecting transport
124, 125
paediatric renal transplantation 368-71 assessment criteria 368 choice of donor 369 and growth 370 immunosuppression 369 mortality 370 results, factors affecting 370,371
pain in peritoneal dialysis 185 pancreatitis after renal transplantation
362,363 parathyroidectomy 188
incidence 120 in uraemia 119,120
parathyroid gland and impotence 83 suppressIOn 76
parathyroid hormone 35 action on bone 55 and calcium metabolism 50, 51 effects 50 immunoreactive 46 and pathogenesis in uraemia 75 and phosphate reabsorption 45 uraemic toxin 75, 76
parenteral feeding 16 penicillins
G, dose and effects 127, 128 hazards 22 salts 128 side-effects 128, 129
pericarditis 189 peripheral neuropathy 83--5
asymptomatic 84 demyelinating 84 dying back 84
peritoneal clearance 179-81 factors affecting 180
peritoneal dialysate, Baxter-Dianeal 178,179
peritoneal dialysis 169--93 acute, indications 182, 183 in acute renal failure 14 advantages 14 and age 184 chronic, indications 184 chronic national usage 183 complications 184--90 contraindications 183 in diabetes 184 diabetes, prognosis 190 drug removal 181, 182 heparin use 181
INDEX 3S9
peritoneal dialysis (continued) in hepatitis 189 history 169 home 183, 191 peritonitis 186-8 after renal transplantation 340 reverse osmosIs 169--77
peritoneal dialysis, continuous ambulatory (CAPD) 170, 191-3, 238, 310, 311
complications 192, 193 disadvantages 191 patient selection 232,233 technique 192, 193 Toronto General Hospital Technique
191 peritoneal dialysis machines 175-8
cyclers 175 Lasker 175, 176 physio-control reverse osmosis 177,
178 peritoneal membrane area and
clearance 179 peritonitis
antibiotic lavage 186 aseptic and bacterial 186 management 186-8 in peritoneal dialysis 186-8 type of infection and protocol 187
pharmacokinetics in chronic renal failure 126, 127
phenacetin in chronic renal failure 142 phosphate
absorption 44 fractional excretion in uraemia 46 reabsorption inhibition 47 regulation of dietary 117
phosphate metabolism in chronic renal failure 42, 44-7 and glomerular filtration rate 45 normal serum levels 42, 44 reduced nephrons 45
pipemidic acid use in chronic renal failure 139
plasma exchange in acute renal failure 25 factors removed 25
plasticizers in dialysis fluid 278 polycystic kidney 99--101, 329, 330,
336 potassium
deficiency 60
depletion 60 in dialysis fluid 265 dietary control 120, 121 distribution changes 61 exchange resins 121 pseudodepletion 60 serum level significance 60 sources and loads 61, 62
potassium excretion 59 in chronic renal failure 59, 60 faecal and glomerular filtration rate
60 potassium metabolism in chronic renal
failure 59--62 and acid-base balance 61
prazosin mechanism in hypertension 114, 115 side-effect 114
predialysis clinic patient selection 229-34 problem card 230 procedure checklist 229 transplantation suitability 231 yellow units 231
prednisolone 341, 348 pregnancy 365, 367 proportionating units 252-8
alarms 255, 256 bubble trap 256 choice 253 concentrate tank 253 conductivity monitor 255 effluent pump wear 257 electrical safety 253 flow monitor 254 fluid temperature monitor 254, 255 Lucas Mark 2 253-7 Nycotran ADPAC 256,257 output return connection 255 pasteurization 255, 256 pressure control 254 single patient 252 types 257,258 venous pressure monitor 254, 255
propranolol 112 prostacyclin, heparin substitution 273 prostaglandins 4
in acute renal failure 4, 5 protein
requirements in childhood 106, 107 restriction in chronic renal failure
102-6
390 INDEX
pyrexia and bacterial counts 276 in dialysis unit 275, 276
receptors, J3-types 111 Registry of the European Dialysis
Transplant Association 34, 365, 366
rejection therapy 87 renal artery stenosis 354 renal biopsy
in acute renal failure 11-13 in transplant rejection
renal cyst 99, 100 renal failure, incidence renal function
347
324
clinical assessment 92-101 recovery in acute renal failure 23
renal haemodynamics and acute renal failure 3,4
renal osteodystrophy in peritoneal dialysis 188 treatment 116-20 see also individual conditions
renal preservation techniques 334 renal stone 100, 101, 189 renal transplant donors 330--6
cadaver 330-4 live 232,324,334-6 pretreatment 332, 333 protection of kidneys 331 removal of kidneys 333, 334, 336 tumour-bearing 359
renal transplant recipients 324-30 actuarial graft and patient survival
related to donor source 367 age factor 333, 334 assessment 328, 329 economic factors 367,368 paediatric 368 removal of kidney 329,330 results, factors affecting 366, 367
renal transplantation 311,313,323--71 age factor 324, 325 alimentary tract complications 360,
363 allograft nephrectomy 349 blood transfusion 344, 345 bone disease 357-9 and cancer development 359, 360 cadaver donor 330-4 constraining factors 331
contraindications 326 follow-up care 340, 341 history 323 HBsAg antigenaemia 326 HLAmatching 319--21 hypercalcaemia 356, 357 hypertension 87, 360 ileal urinary diversion 327, 328 incidence 324,331 live donor 232, 324, 334-6 and multisystem diseases 325 and neuropathy 85 ocular complications 363 orthopaedic complications, type/
incidence table 358 paediatric 368-71 patient selection 229,231,232,323,
324 peritoneal dialysis 190, 191 postoperative infection 350-2 postoperative management 339,340 preservation of kidneys 334 pregnancy 365,367 public attitudes and cooperation 332 rehabilitation 364-6 rejection 324, 345-9 sexual function 365, 366 technique 336-9 urological complications 354-6 vascular complications 352--4
renal tubular acidosis, type II 123 renal vessels, anastomosing methods
338,339 renin
in acute renal failure 3, 4 in uraemic toxicity 76
renography 346 isotope 10
restless legs syndrome 83 retinopathy, classification 88, 89; see
also hypertensive rickets 51,52 rifampicin, use in chronic renal failure
137 salt-losing nephritis 42 Schwartzmann reaction, catecholamine
release 5 sexual function 75,365,366
in chronic renal failure 75, 82, 83 peritoneal dialysis J 89
shock lung 20 shunt 197
INDEX 391
shunt (continued) Allen Brown 197,209,210 Buselmeier 197,201,203,210,211 care in anaesthesia 219 checking; look, touch and listen 206 children 220-2 femoral saphenous 209 ideal, properties 210 infections 206, 208 insertion 203--5, 209 Quinton-Scribner 197,201,202,
211 Ramirez 15, 197,201,202 Scribner conversion to fistula 213,
214 Silastic wrist 14, 15 S-T 202 Thomas 197, 201, 208, 209 thrombosed, management 207,208 see also arterio-venous shunt
single needle apparatus 261,262 sisomicin 133 skull, ground glass/salt and pepper 54 single nephron glomerular filtration
rate 3 Slow-Sodium tablets 22 sodium
basal excretion 11 0 in dialysis fluid 265 dietary in chronic renal failure 109,
110 fractional excretion in chronic renal
failure 39 fractional excretion and intake 40,
41 urinary in acute renal failure 7
sodium metabolism in chronic renal failure 38-42 limits to excretion 41 nephrotic syndrome 42
soil bacteria, enzymes in uraemia 125, 126
SONAR 98 spironolactone
side-effects III in uraemic hypertension III
streptomycin dose and toxicity 134
T cell growth factor 317,318; see also lymphocytes
tetracyclines danger in renal failure 20, 135
use in chronic renal failure 134, 135 thrombosis 352, 353
management in shunt 207, 208 ticrynafen, uricosuric III tissue grafting 313--21; see also renal
transplantation tobramycin 133 trace elements in dialysis fluid, effects
27fr8,297,298 transmembrane pressure monitoring
299,300 transplant rejection 345-9
in children 369, 370 diagnosis 345-7 treatment 348, 349, 350 types and indications 345, 346
triglyceride metabolism in acute renal failure 17
tuberculosis 351, 352 tubular obstruction and acute renal
failure 2 tubulo-interstitial disease and chronic
renal failure 34
ultrafiltration, need for understanding 293,299
ultrasonic renography 98 hydronephrosis 99, 100 normal kidney 99 polycystic kidney 99-101 renal cyst 99, 100 renal stone 10 1
ultrasound 7, 346 and urinary tract obstruction 10, 11
ultraviolet photometry 120 upper gastrointestinal tract disorders
after renal transplantation 360, 361
uraemia diluting capacity 38 EEG changes 75 emotional effects 75, 76 experimental and calcium deposits
76 obligatory sodium excretion 41 phosphate excretion 46 symptoms 92, 93
uraemic neuropathy 83--5, 188 mechanisms 84, 85
uraemic pericarditis 90,91 and dialysis 90, 91 electrocardiogram 92
392 INDEX
uraemic toxicity 71-7 urea
in acute renal failure 6, 7 excretion 95 glomerular filtration rate and dietary
protein 96 plasma (PUN) 95 production and diet 103 tubular and reabsorption 97 in uraemic toxicity 72 see also BUN
ureteric obstruction 355, 356 ureterocutaneousfistula 355 ureteroneocystostomy 339,355 uric acid
excretion 73 in uraemic toxicity 73, 74
urinary sediment in acute renal failure 7
urinary tract obstruction 7 infection 356 obstruction 7, 355
urine concentrating 23 in chronic renal failure 35 countercurrent multiplication 36
urine culture, count and infection 97 urine output, normal diurnal rhythm
35 urine/plasma osmolality in acute renal
failure 7 urine volume
acute renal failure 6 chronic renal failure 35
urochromogens and skin pigmentation 76
urography, intravenous high~dose 7-9 safety 8
urokinase 207
Vamin 17,18 vascular access
adult 199-219 anaesthesia 198, 199 children 219-22 home haemodialysis 289-91 see also cannulae, shunts, arterio
venous fistulae and shunts 197-223
vascular diseases and chronic renal failure 34
very low density lipoprotein (VLDL) 78
vesicocutaneous fistula 354, 355 vesicoureteric reflux 356 vitamin
diet supplement 107, 108 in uraemia 119
vitamin D calcium transport 47 metabolism 48-50 resistance in chronic renal failure
48,49 sources in man 48 uraemia treatment 118, 119
vitamin D2 resistance 118 25-0H vitamin D3 46,48,49, 116
in osteomalacia 119
Warfarin 337 wasting syndrome 102 water metabolism
in chronic renal disease 35-8 in uraemia 35
water softeners 267,297 bacterial growth 298
water treatment cost 245 dialysis 244-7, 297, 298 home haemodialysis 297, 298 materials used 247 reverse osmosis 244-6, 272 softening 267, 297 system at RVI, Newcastle 246
weight and salt retention 43 WHO Expert Committee on Energy
and Protein Requirements 107
X-ray uraemic lung 89 uraemic pericarditis 90, 91
zinc in dialysis fluid and chronic renal failure 277