Early detection and treatment of diabetic nephropathy.

Renal involvement in diabetes, known as diabetic nephropathy (DN), is a progressive disease and occurs as a result of direct and indirect effects of hyperglycemia. DN is a serious public health concern because it is the leading cause of end stage renal disease (ESRD) in most developed countries and is associated with increased cardiovascular mortality and morbidity. DN is characterized by an initial period of glomerular hyperfiltration, associated with progressively increasing proteinuria, followed by a gradual decline in glomerular filtration rate, resulting in ESRD.

Early clinical, quality-of-life, and biochemical changes of "daily hemodialysis" (6 dialyses per week).

Background: Advantages associated with an increased frequency of hemodialysis have been reported previously. However, previous studies were either small or not controlled and did not detail early clinical, biochemical, quality-of-life, urea kinetic, and dynamic changes when patients switched from a conventional (3 times/wk) dialysis regimen to "daily" (6 times/wk) dialysis therapy when total weekly dialysis time was unchanged.

Methods: A prospective sequential study with 21 patients as their own controls was performed.

Preparing the azotemic diabetic patient for surgery.

Azotemic diabetic patients have more risk of complications during or after surgery than those without diabetes and azotemia. These complications include infection, excessive bleeding, cardiovascular events, and electrolyte imbalance. The appropriate preoperative evaluation, measures to be taken to avoid the complications, and how to adequately manage blood sugar during surgery is discussed.

Use of Systemic Blood Urea Nitrogen Levels Obtained 30 Minutes before the End of Hemodialysis to Portray Equilibrated, Postdialysis Blood Urea Nitrogen Values.

Blood urea nitrogen (BUN) levels obtained at 30 minutes before the end of dialysis were found to be closely similar to equilibrated, postdialysis BUN values obtained 30 minutes after the end of dialysis. Because of this similarity, the former BUN values can be used to derive equilibrated urea reduction ratio, or equilibrated Kt/V instead.

Recurrent central diabetes insipidus secondary to cryptococcal meningitis.

Meningitis is often associated with hyponatremia due to inappropriate secretion of antidiuretic hormone, and diabetes insipidus is associated with bacterial meningitis. This article describes a patient with acquired immunodeficiency syndrome who experienced recurrent episodes of central diabetes insipidus in association with recurrent fungal meningitis. Desmopressin was effective in controlling the polyuria until the episodes of meningitis resolved.