Pathophysiology of Anephric Patients Over a Decade
Although maintenance hemodialysis (MH) was introduced as a treatment for chronic uremia in 1960,1 there have been few reports of patients surviving for more than ten years. Earlier fears that death from complications of accelerated atherosclerosis would limit dialysis longevity2 have not been substantiated.3 As the population of hemodialysis patients rises above 100,000 worldwide, it is of increasing importance to define the natural history of life sustained by an artificial kidney. To explore the pathobiology present in those who survived for long periods, we studied a subset of patients kept alive by repeated hemodialyses for at least a decade, and compared their clinical findings with a control maintenance hemodialysis population. From this investigation we infer that our earlier identification of parathyroid hormone as an important uremic toxin4,5 may now be extended to this group of ten-year survivors.
KeywordsMaintenance Hemodialysis Motor Nerve Conduction Velocity Artificial Kidney Subtotal Parathyroidectomy Anephric Patient
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