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ACUTE PERITONEAL DIALYSIS

ACUTE PERITONEAL DIALYSIS

Indications in acute renal failure
Absolute:
1) Severe fluid overload with CCF
2) Severe hyperkalemia unresponsive to medical Rx or with ECG changes
3) Severe hyponeatrmia
4) Server metabloic acidosis requiring > 2 doses of NaHCO3 (2mEq/kg/dose)
5) Uraemia
6) Fluid restriction curtailling ample nutrition
Relative:
1) Anuria
2) High urea and creatinine values alone are not indications

METHOD
Materials:
1) Pertioneal dialysis tubing, trocar and cannula
2) Yellow intracath #14 gauge needle – …

Management of Rapidly Progressive Glomerulonephritis or RPGN

Management of Rapidly Progressive Glomerulonephritis or RPGN

Rapidly progressive is characterized by the histopathologic finding of crescents in the majority of glomeruli. The natural history in most forms is rapid progression to end-stage renal failure.
It is characterized by rapid deterioration of renal functions over days to weeks.
MANAGEMENT of RPGN-
We have elaborated “The regimen used by the Glomerular Disease Collaborative Network at the University of North Carolina at …

Auscultatory gap in hypertension

Auscultatory gap in hypertension

Sometimes during manual blood pressure measurement by auscultatory method, after a few initial tapping sounds, no sound is heard for a variable duration and then the sounds are heard again. This period when no sound is heard is called as auscultatory gap.
Korotkoff sounds:
When the cuff pressure is great enough to close the artery during part of the arterial pressure cycle, …

Pathogenesis of Glomerular Injury

Pathogenesis of Glomerular Injury

Primary Immunopathogenic mechanism:
Initiator of the disease process by:

Antibody mediated injury: immune complex deposition or cytotoxic antibodies
T-cell mediated immune injury: non-immune complex deposition mechanism

Secondary immunopathogenic mechanism:
Role of mediators of the disease:
A) Cells:

Neutrophils and monocytes
Macrophages, T lymphocytes and NK cells
Platelets
Resident glomerular cells (Mesagnial cells)

B) Soluble mediators:

Complement components
Eicosanoids, NO, angiotensin and endothelin
Cytokines: IL-1 and TNF
Chemokines: MCP-1, RANTES, TGF-B
Coagulation system

Antibody Mediated Injury
Include:

Membranous glomerulonephritis
IgA nephropathy
Membranoproliferative …

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