Nefrología : publicación oficial de la Sociedad Española Nefrologia
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Review Case Reports
[Heparin-induced thrombocytopenia in hemodialysis. Case report and review of the literature].
Thrombocytopenia is a potential complication of heparin therapy. There are two forms of heparin-induced thrombocytopenia (HIT). Type-I HIT is characterized by a mild decrease in platelet count that occurs within the first 2-4 days after heparin initiation. ⋯ The mechanism of thrombocytopenia appears to be due to a direct effect of heparin on platelet activation. The second form (type-II) is an immune-mediated disorder characterized by severe thrombocytopenia, which may include both arterial and venous thrombosis. We present a case of type-II HIT occurred in a hemodialysis patient resulting in acute pulmonary embolism and peripheral venous thrombosis, and review the literature.
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Multicenter Study
[A burden questionnaire for caregivers of peritoneal dialysis patients].
Despite the interest generated by the increasing number of studies that measure Quality of Life among patients and caregivers, few of these studies measure the caregivers burden in Peritoneal Dialysis (PD). ⋯ A questionnaire has been created to measure burden and repercussions on caregivers of peritoneal dialysis patients. It can already be applied, as requirements of both reliability and validity are fulfilled. This questionnaire can be a useful tool to prevent caregivers' burnout.
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Review a large experience in the placement of tunnelled catheters to assess the outcomes with twin catheter system as hemodialysis access. ⋯ Placement of tunnelled twin catheters system using real-time sonography technique can be performed with excellent technical success, safety and acceptable catheter performance and outcomes for effective hemodialysis.
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SUMMARY Sixty seven hypertensive children age 2-18 with at least one possible clinical sign of renovascular hypertension (RVH) were enrollment into a screening program for diagnose and treatment of RVH over a 19 year period. Patients underwent a variety of biochemical and imaging studies, but in all cases, renal arteriography was used to determine the precise diagnosis and treatment strategy. Of the 67 patients 21 (31.3%) were identified with renal artery stenosis Group 1, 14 (66.6%) unilateral, 5 (23.8%) bilateral and 2 (9.6%) branches. ⋯ On december 2004, 19/21 (90%) RVH adolescents blood pressure was normalized with normal serum creatinina, 10 (48%) of these completed cured, 9/21 (43%) improved (normotensión with decrease in medication requirements) and 2 (9%) other cases ware lost of follow-up. The 46 non-RVH adolescents (68.7%) were treated with long term antihypertensive medications; all of these have adequate BP control and normal renal function. We conclude that our work-up used in order to make a proper and timely diagnosis and treatment of renovascular hypertension in adolescent was successful in our population.