Outcome predictors of ultrafiltration in patients with refractory congestive heart failure and renal failure.

This study is an attempt to identify predictors of outcome from the use of ultrafiltration (UF) in patients with refractory congestive heart failure (CHF) and renal failure. The authors studied 30 patients in NYHA functional class IV in whom UF was utilized in the management of refractory CHF. Patients were retrospectively divided into two groups according to their outcome.

Cefotetan-induced hemolytic anemia causing severe hypophosphatemia.

Phosphorus is a major component of proteins, phospholipids, and nucleotides. The increased uptake of phosphorus by cells during erythropoiesis can result in severe hypophosphatemia. A case of severe hypophosphatemia due to accelerated erythropoiesis in response to Cefotetan-induced hemolytic anemia is described.

Complications associated with arteriovenous fistulas in patients undergoing chronic hemodialysis.

Over a two-year period, 100 venous angiograms were performed on 75 patients because of difficulty with vascular access. Seventy percent of the patients had decreased arterial flow or increased venous resistance. High output failure, sepsis, and aneurysm formation were also found.

Resistance to endogenous norepinephrine in Bartter's syndrome: reversion during indomethacin administration.

In five patients with Bartter's syndrome, mean (+/-SE) plasma norepinephrine concentrations increased from 324 +/- 75 pg/ml with the patients in the supine position to 550 +/- 100 pg/ml, 753 +/- 104 pg/ml and 808 +/- 116 pg/ml after 2,5 and 10 minutes, respectively, in the standing position, levels significantly higher than normal. Plasma epinephrine concentrations were indistinguishable from normal. One patient was shown to resistant the pressor (but not the metabolic) effects of intravenously administered norepinephrine prior to treatment with reversion to normal pressor responsiveness during indomethacin administration.

Hypomagnesemia and impaired parathyroid hormone secretion in chronic renal disease.

Severe hypocalcemia secondary to magnesium depletion has been described in numerous patients with gastrointestinal disorders. The development of profound hypomagnesemia in chronic renal disease is a rare finding. We studied three patients with advanced renal failure and magnesium depletion.