American journal of kidney diseases : the official journal of the National Kidney Foundation
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Review Case Reports
Recovery from prolonged metabolic acidosis due to accidental ethylene glycol poisoning.
In this report, we describe a case of accidental ethylene glycol poisoning in a 90-year-old woman. Despite a delay in diagnosis and treatment of over 24 hours, this patient recovered completely from profound and lengthy metabolic acidosis. She is therefore the oldest known survivor of severe ethylene glycol intoxication. We review 79 additional cases of ethylene glycol intoxication reported in the literature since 1976 and comment on diagnostic, therapeutic and prognostic features of this form of poisoning.
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Childbearing is important to women with renal disease, but pregnancy has generally been regarded as very high risk in these women. In this review, an attempt is made to clarify the nature and severity of those risks in the settings of chronic renal insufficiency and end-stage renal disease, including dialysis patients and transplant recipients. Hypertension is the most common life-threatening problem in all three groups. ⋯ All groups have an increased risk for prematurity and intrauterine growth restriction. The percentage of pregnancies resulting in surviving infants in women with renal insufficiency and transplant recipients ranges from 70% to 100%. For women who conceive after starting dialysis, the likelihood of a surviving infant is approximately 50%.
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Case Reports
Expression of aquaporin-1 in a long-term peritoneal dialysis patient with impaired transcellular water transport.
Aquaporin-1 (AQP1) has been claimed to be the molecular counterpart of the transcellular pathway for free-water movement across the peritoneum during peritoneal dialysis. We report the case of a 67-year-old man, on peritoneal dialysis for 11 years, in whom ultrafiltration failure due to an abolition of the transcellular water transfer (documented by a loss of sodium sieving) was associated with an apparently normal expression of AQP1. We suggest that an alteration of AQP1 structure, rather than of its expression, accounts for this observation.