PMID: 2484192Dec 1, 1989Paper

Comparison of five modes of dialysis in neurosurgical patients with renal failure

Neurologia Medico-chirurgica
G GondoI Kim

Abstract

In neurosurgical patients with renal failure, dialysis entails specific problems, chief of which is increased intracranial pressure and progressive brain edema as a result of rapid lowering of the serum osmolality. Another major problem is a tendency to hemorrhage, in response to either systemic heparinization or insufficient dialysis. The authors describe the results obtained with hemodialysis (HD), continuous arteriovenous hemofiltration (CAVH), continuous ambulatory peritoneal dialysis (CAPD), continuous peritoneal dialysis (CPD), and intermittent peritoneal dialysis (IPD). Nine patients were treated with HD, one with CAVH, five with CAPD or CPD, and two with IPD. Three of the six patients treated with continuous dialysis (CAVH, CAPD, and CPD) died, whereas intermittent dialysis (HD and IPD) carried an 82% mortality rate (nine of 11 patients). The causes of death were progressive brain edema in three cases, intracranial hemorrhage in three, gastrointestinal bleeding in three, overhydration due to insufficient dialysis in one, septicemia in one, and rupture of a cerebral aneurysm in one. Continuous dialysis appeared to be superior to intermittent dialysis in these neurosurgical patients in that it produced less brain edema an...Continue Reading

Citations

Feb 14, 2012·Neurocritical Care·Karen G HirschRomergryko G Geocadin
Sep 13, 2003·Neurologia Medico-chirurgica·Ibrahim M ZiyalTunçalp Ozgen
Jun 18, 2004·Neurologia Medico-chirurgica·Mamoru MurakamiKiyohito Kakita
Dec 26, 2012·Advances in Chronic Kidney Disease·Karen G Hirsch, S Andrew Josephson
Jul 22, 2008·Hemodialysis International·Andrew Davenport
Nov 10, 2010·Hemodialysis International·Andrew Davenport
Dec 4, 2004·Surgical Neurology·Kiyoyuki YanakaTadao Nose
Aug 4, 2004·Renal Failure·Mei-Fen PaiTun-Jun Tsai

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