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Klinische Probleme des Hämodialysepatienten

  • W. Huber
  • A. Kettner
  • U. Muth

Zusammenfassung

Mit der Vermeidung des fortgeschrittenen Urämiestadiums durch den rechtzeitigen Beginn der Dialysebehandlung haben die Lebenserwartung der Dialysepatienten zu- und somatische Komplikationen abgenommen. Nach dem Einleiten der Hämodialysetherapie bestimmen die Besserung der urämischen Intoxikation einerseits und neu hinzutretende Komplikationen im Zusammenhang mit dem Behandlungsverfahren der Hämodialyse andererseits die klinische Problematik des Hämodialysepatienten. Herz-Kreislauf-Komplikationen, Knochenstoffwechselstörung, Neuropathien und Myopathien, gastroenterologische und hämatologische Probleme, metabolische und endokrinologische Störungen sowie erhöhte Infektanfälligkeit bei reduzierter Immunabwehr stehen im Vordergrund.

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Literatur

  1. Ahearn DA, Mäher JF (1972) Heart failure as a complication of a hemodialysis arterio venous fistula. Ann Intern Med 77:201–204.PubMedGoogle Scholar
  2. Andriulli A, Bergia R, Masoero G, Baiardi P, Pellegrino S, Tondolo M (1979) Amylase to cre-atinine clearance ratio in renal disease. Gastroenterology 77:86–90.PubMedGoogle Scholar
  3. Arora KK, Lacay JP, Schacht RA, Martin DG, Gurch CF (1975) Calcific cardiomyopathy in advanced renal failure. Arch Intern Med 135:603–605.PubMedCrossRefGoogle Scholar
  4. Bagdade JB (1975) Disorders of carbohydrate and lipid metabolism in uremia. Nephron 14:153–162.PubMedCrossRefGoogle Scholar
  5. Baggenstoss H (1948) The pancreas in uremia, a histopathologic study. Am J Pathol 24:1003–1011.PubMedGoogle Scholar
  6. Ball JH, Lowrie EG, Hampers CL, Merill JP (1975) Testosterone therapy in hemodialysis patients. Clin Nephrol 4:91–98.PubMedGoogle Scholar
  7. Barbour GL, Sevier BR (1974) Adrenal responsiveness in chronic hemodialysis (Letter). N Engl J Med 290:1258.PubMedGoogle Scholar
  8. Barret LJ, Robinson MA, Whitford JA, Lawrence JR (1976) The diastolic murmur of renal failure. N Engl J Med 295:121–124.CrossRefGoogle Scholar
  9. Bennett WM (1981) Approach to drug use in the azotemic patient. In: Schrier RW (ed) Manual of nephrology, 1st edn. Diagnosis and therapy. Little Brown, Boston p 184.Google Scholar
  10. Bergquist KR, Maynard JE, Murphy BL (1976) Infectivity of serum containing HBS-AG and antibody to E-antigen. Lancet II:1026–1027.CrossRefGoogle Scholar
  11. Birge SJ, Haddad JG (1975) 25.-Hydroxycholecalciferol stimulation of muscle metabolism. J Clin Invest 56:1100–1107.PubMedCrossRefGoogle Scholar
  12. Bloch R, Menge H, Lange H, Dombrowski H, Rieken EO (1973) Funktionelle und morphologische Befunde am Dünndarm bei chronischer terminaler Niereneinsuffizienz. Z Gastroenterol 11:535–546.PubMedGoogle Scholar
  13. Brunner FP, Brynger H, Chantier C et al. (1979) Combined report on regular dialysis and transplantation in Europe, IX, 1978. Proc Eur Dial Transplant Assoc 16:74–103.Google Scholar
  14. Bundschu D, Pfeilsticker C, Matthews C, Ritz E (1975) Myopathy in experimental uremia. Res Exp Med (Berl) 165:205–211.CrossRefGoogle Scholar
  15. Burck HC (1980) Hepatitisprophylaxe bei Dialysepatienten und Pflegepersonal durch passive Immunisierung. Mitteilung der Arbeitsgemeinschaft für Klinische Nephrologie 9:94–99.Google Scholar
  16. Burke JF Jr, Francos GC, Moore LL, Cho SY, Lasker N (1978) Accelerated atherosklerosis in chronic — dialysis patients another look. Nephron 21:181–185.PubMedCrossRefGoogle Scholar
  17. Burnell JM, Teubner E (1976) Effects of decreasing magnesium in patients with chronic renal failure. Proc Clin Dial Transplant Forum 5:191–198.Google Scholar
  18. Caciani CU, De Simone C, Bonini S et al., (1978) Immunological aspects of chronic uremia. Kidney Int [Suppl 8] 13:49–54.Google Scholar
  19. Chester AL, Schreiner GE (1978) Hypertension and hemodialysis. Trans Am Soc Artif Intern Organs 24:36–42.PubMedGoogle Scholar
  20. Coburn JW, Llach F (1979) Renal osteodysdtrophy and maintenance dialysis. In: Drukker W, Parsons FM, Mäher JF (eds) Replacement of renal function by dialysis. Nijhoff, The Hague Boston London, p 571.Google Scholar
  21. Comty CM, Wathen R (1975) Incidence, mortality and effects of treatment on uremic pericarditis (Abstract). Am Soc Nephrol 8:28.Google Scholar
  22. Comty CM, Cohen SL, Shapiro FL (1971) Pericarditis in chronic uremia and its sequels. Ann Intern Med 75:173–183.PubMedGoogle Scholar
  23. Davison AM, Williams R, Mawdsleg C, Robson JS (1972) Neuropathy associated with hepatitis in patients maintained on hemodialysis. Br Med J I:409–411.CrossRefGoogle Scholar
  24. Deutsch E, Fischer M (1968) Hämostase und Urämie. In: Verh. Dtsch. Arbeitsgem. Blutgerinnungsforsch. 1-2. 4. 1966, Würzburg. Schattauer, Stuttgart, S 155–182.Google Scholar
  25. Dobbins WO (1963) Mallory-Weiss-Syndrome: A commonly overlooked cause of upper gastrointestinal bleeding. Report of three cases and review of the literature. Case Reports 44:689–695.Google Scholar
  26. Dyan AD, Thorpe CG, Down PF, Cleadle R (1970) Peripheral neuropathy in uremia. Neurology (Minneap) 20:649.Google Scholar
  27. Dyck P, Johnson WJ, Lambert EH, O’Brien PC (1971) Segmental demyelination secondary to axonal degeneration in uremic neuropathy. Mayo Clin Proc 46:400–431.PubMedGoogle Scholar
  28. Eschbach JW, Adamson JW, Cook JD (1970) Disorders of red blood cell production in uremia. Arch Intern Med 126:812.PubMedCrossRefGoogle Scholar
  29. Gibson DG (1966) Haemodynamic factors in the developement of acute pulmonary oedema in renal failure. Lancet II:1217.CrossRefGoogle Scholar
  30. Goldstein DA, Massry SG (1978) Effect of parathyroid hormone and its withdrawl on brain calcium and electroencephalogram. Min Elec Metabol 1:84.Google Scholar
  31. Haire H, Sherrard D, Scardapare D (1976) Cardiovascular risk factors in dialysis patients (Abstracts). Am Soc Artif Intern Organs 5:33.Google Scholar
  32. Heuck CC, Ritz E (1980) Hyperlipoproteinemia in renal insufficiency. Nephron 25:1.PubMedCrossRefGoogle Scholar
  33. Hung J, Harris PJ, Uren RF, Tiller DJ, Kelly DT (1980) Uremic cardiomyopathie — effect of hemodialysis on left ventricular function in end-stage renal failure. N Engl J Med 302:547.PubMedCrossRefGoogle Scholar
  34. Hurst JW, Logue RB (1970) The heart, 2nd edn. McGraw-Hill, New York.Google Scholar
  35. Ianhez LE, Lowen J, Sabbaga E (1975) Uremic myocardiopathy. Nephron 15:17.PubMedCrossRefGoogle Scholar
  36. Kersh ES, Kronfield SJ, Unger A, Popper RW, Cantor S, Cohn K (1974) Autonomic insufficiency in uremia as a cause of hemodialysis. Included hypotension. N Eng J Med 3:21.Google Scholar
  37. Klütsch K (1971) Herz und Kreislauf bei regelmäßiger Haemodialyse. VIII. Symp. d. Ges. f. Neph. Aachen Heintz & Holzhüter, Aachen, S 241.Google Scholar
  38. Knodell R, Conrad M, Ishak K (1976) Development of chronic liver disease following acute non-A, non-B-posttransfusion hepatitis. Role of gammaglobulin prophylaxis in its prevention (Abstract). Gastroenterology 71:916.Google Scholar
  39. Knoll O, Graefe U (1980) Neurologische Untersuchungen als Kontrollparameter einer adäquaten Dialysetherapie. Nieren Hochdruckkrankh 1:36–43.Google Scholar
  40. Koch KM, Radtke HW (1978) Absolute und relative erythropoetin deficiency in renal anemia. Contrib Nephrol 13:60–68.PubMedGoogle Scholar
  41. Koch KM, Patyna WD, Shaldon S, Werner E (1974) Anemia of the regular hemodialysis and its treatment. Nephron 12:405–419.PubMedCrossRefGoogle Scholar
  42. Kopple JP, Swendseid ME, Shinaberger JH, Umezawa CY (1973) The free and bound amino-acids removece by hemodialysis. Trans Am Soc Artif Intern Organs 19:309–313.PubMedGoogle Scholar
  43. Lazarus JM, Lowrie EG, Hampers CL, Merrill JP (1975) Cardiavascular disease in uremic patients on hemodialysis. Kidney Int [Suppl] 2:167–175.Google Scholar
  44. Leonard A, Raij L, Shapiro FL (1973) Bacterial endocarditis in regulary dialyzed patients. Kidney Int 4:407–422.PubMedCrossRefGoogle Scholar
  45. Lim VS, Fang VS (1975) Gonadal dysfunction in uremic men: A study of the hypothalamopi-tuitary testicular axis before and after renal transplantation. Am J Med 58:655–662.PubMedCrossRefGoogle Scholar
  46. Lim VS, Auletta F, Kathpalia S, Frohmann LA (1977) Gonadal function in women with chronic renal failure: A study of the hypthalamo-pituitary-ovarian axis. Proc Clin Dial Transplant Form 7:39–47.Google Scholar
  47. Lindner A, Charra B, Sherrard DJ, Scribner BH (1974) Accelerated atherosclerosis in prolonged maintenance hemodialysis. N Eng J Med 290:697–701.CrossRefGoogle Scholar
  48. Lindsay RM, Moorthy AV, Koens F, Linton AL, Oreopoulus D, de Veber G (1976) Platelet function in patients on long term peritoneal dialysis. Clin nephrol 6:335–339.PubMedGoogle Scholar
  49. Mako M, Bloch M, Starr J, Nielson K, Friedman E, Rubenstein A (1973) Proinsulin in chronic renal and hepatic failure; a reflection of the relativ contribution of the liver and kidney to its metabolism (Abstract). Clin Res 21:631.Google Scholar
  50. Malluche HH, Ritz E (1976) Bone histology in incipient and advanced renal failure. Kidney Int 9:355–362.PubMedCrossRefGoogle Scholar
  51. Maupas P, Gaudean A, Coursaget P, Drucker J (1976) Immunisation against hepatitis B in man. Lancet I:1367–1370.CrossRefGoogle Scholar
  52. McConnell JB, Stewart WK, Tjodleifsson B, Wormsley KG (1975) Gastrics funktion in chronic renal failure. Effects of maintenance hemodialysis. Lancet II:1121–1123.CrossRefGoogle Scholar
  53. Pierides AM (1978) Dialysis dementia, osteomalacic fractures and myopathie. A syndrome due to chronic aluminum intoxication. Int J Artif Organs 1:206–208.PubMedGoogle Scholar
  54. Pippig L (1968) Herz-und Kreislauffunktion bei Urämie. Arch Klin Med 214:244–272.PubMedGoogle Scholar
  55. Poll M, Werner J, Huber W, Kempmann G, Willig F (1979) Exokrine Pankreasfunktion bei chronischer Niereninsuffizienz. Z Gastroenterol 7:177–186.Google Scholar
  56. Posen GA, Marier JR, Jaworski ZF (1971) Renal osteodystrophy in patients on long-term hemodialysis with fluoridated water. Fluoride 4:114–128.Google Scholar
  57. Ramirez G, Jabiz W, Gutch CF, Blomer HA, Siegler R, Kolff WJ (1973) Thyroid abnormalities in renal failure. Ann Intern Med 79:500–504.PubMedGoogle Scholar
  58. Rao TKS, Friedman EA (1975) Fluoride and bone disease in uremia. Kidney Int 7:125–129.PubMedCrossRefGoogle Scholar
  59. Reis DJ, Duba N (1974) The central nervous system and neurogenic hypertension. Prog Car-diovasc Dis 17, 51–71.CrossRefGoogle Scholar
  60. Remuzzi G, Livio M, Cavenoghi AE, Marchesi D, Mecca G, Donati MB, de Gaetano G (1978) Unbalanced prostaglandin synthesis an d plasma factors in uraemic bleeding. Thromb Res 13:531–536.PubMedCrossRefGoogle Scholar
  61. Richardson RQ, Guyton AC (1959) Effects of polycythemia and anemia on cardiac output and other circulatory factors. Am J Physiol 197:1167–1170.Google Scholar
  62. Richet G, Lopes de Novals E, Verraist E (1970) Drug intoxication and neurological episodes in chronic renal failure. Br Med J 11:394–395.CrossRefGoogle Scholar
  63. Ritz E, Prager P, Krempin B et al. (1978) Skeletal x-rayfindings and bone histology in patients on hemodialysis. Kidney Int 13:316–323.PubMedCrossRefGoogle Scholar
  64. Rodrigo F, Shideman R, Huch Mc, Buselmeier T, Kjellstrand C (1977) Osmolality changes during hemodialysis. Ann Intern Med 86:554–561.PubMedGoogle Scholar
  65. Samaan NA, Freeman RM (1970) Growth hormone levels in severe renal failure. Metabolism 19:102–113.PubMedCrossRefGoogle Scholar
  66. Schultz W (1978) Diagnostik der renalen Osteopathie. Therapie der renalen Osteopathie. Dtsch Med Wochenschr 51:2023–2025.CrossRefGoogle Scholar
  67. Seybold P, Pilgrim R (1977) Herz und Kreislauf. In: Gessler U (Hrsg) Urämie. Aesopus, München, S 171–200.Google Scholar
  68. Sheperd AMM, Stewart WK, Wormsley KG (1973) Peptic ulceration in chronic renal failure. Lancet I:1357–1359.CrossRefGoogle Scholar
  69. Sherrard DJ, Goldberg AB, Haas LB, Brunzell JD (1980) Chronic clofibrate therapy in maintenance hemodialysis patients. Nephron 25:219–221.PubMedCrossRefGoogle Scholar
  70. Spodick BH (1967) Acute cardiac temponade: Pathologic physiology, diagnosis and management. Prog Cardiovasc Dis 10:64–96.PubMedCrossRefGoogle Scholar
  71. Suchenwirth R, D’Avis, Bundschu HD (1972) Enzymhistologische Untersuchungen an der Skelettmuskulatur des Menschen. IV. Inaktivitätsatrophie. Klin Wochenschr 50:199–204.PubMedCrossRefGoogle Scholar
  72. Teschan PE (1975) Elektroencephalographic and other neurophysiological abnormalities in uremia. Kidney Int [Suppl] 210-216.Google Scholar
  73. Teschan PE, Glinn H, Bourne JR, Ward JW (1977) Neurobehavioral probes for adequacy of dialysis. Trans Am Soc Artif Intern Organs 23:556–559.PubMedGoogle Scholar
  74. Trznadel K, Luciak M, Wyszogrodzka M (1980) The left ventricular systolic function after digoxin administration in patients with chronic renal failure. Clin Nephrol 13:231–234.PubMedGoogle Scholar
  75. Tyler HR (1975) Neurological aspects of uremia: An overview. Kidney Int 2:188–193.Google Scholar
  76. Weidmann P, Maxwell MH, Lupu AN (1973) Plasma aldosterone in terminal renal failure. Ann Intern Med 78:13–18.PubMedGoogle Scholar
  77. Westervelt FM Jr (1973) Insulin effect in uremia. J Lab Clin Med 74:79.Google Scholar
  78. Wing AJ, Brunner FP, Brygner H, Chantier C, Donckerwolcke RA, Gurland HJ, Hathway RA, Jacobs C, Seiwood NA (1979) Combined report on regular dialysis and transplantation in Europe X, Prov Eur Dial Transpl Ass.Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1985

Authors and Affiliations

  • W. Huber
  • A. Kettner
  • U. Muth

There are no affiliations available

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