End-stage renal disease in developing countries
End-stage renal disease in developing countries
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DOI：
10.1046/j.1523-1755.2002.00426.x
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发表时间：
2002-07-01
影响因子：
19.6
通讯作者：
Singhal, M
中科院分区：
文献类型：
--
作者：
Kher, V;Singhal, M
患者1.一名24岁男性，是一家小商店的非技术工人，因两天呼吸急促和感觉改变入院。此前，他曾两次被送往政府医院。第一次是在4年前，他出现了水肿和高血压。 24小时蛋白质排泄量为3.2克；肌酐清除率，26毫升/分钟；血清肌酐，3.8 mg/dL；和血尿素，100 mg/dL；超声检查发现双侧肾脏较小。未进行肾活检。他接受氨氯地平治疗，每次 10 毫克，每天两次；哌唑嗪，5 mg，每日两次；和碳酸钙，500 mg，每日 3 次，随餐服用。建议他监测血压并定期监测。他没有听从建议。第二次入院发生在六周前，当时他出现晚期氮质血症。他通过双腔股动脉导管接受了两次血液透析，出院后建议继续门诊血液透析，并在家里寻找肾脏捐赠者。直到目前承认为止，他一直违约。
Patient 1. A 24-year-old man, an unskilled worker in a small shop, was admitted with a two-day history of shortness of breath and altered sensorium. He had been admitted to a government hospital twice previously. The first time, 4 years earlier, he had edema and high blood pressure. The 24-hour protein excretion was 3.2 g; creatinine clearance, 26 mL/min; serum creatinine, 3.8 mg/dL; and blood urea, 100 mg/dL; ultrasound examination disclosed bilaterally small kidneys. A renal biopsy was not performed. He was given amlodipine, 10 mg twice daily; prazosin, 5 mg twice daily; and calcium carbonate, 500 mg three times daily with meals. He was advised to monitor his blood pressure and be monitored regularly. He did not comply with the advice.The second admission occurred six weeks ago, when he presented with advanced azotemia. He underwent two hemodialysis sessions through a double-lumen femoral catheter and was discharged and advised to continue hemodialysis as an outpatient and look for a kidney donor in the family. He defaulted until the current admission.