Experiences with Hemodialysis in Surgical Patients

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Abstract
Renal insufficiency is not an infrequent occurrence on a surgical service. Preoperatively profound uremia may be present and associated with chronic or acute obstructive uropathy. Postoperatively acute renal failure can develop secondary to shock, interruption of renal blood flow, and transfusion reaction from mismatched blood. With expanding surgical techniques in both radical cancer and cardiovascular surgery, an increasing incidence of acute renal failure may be expected. The danger of perfusing mismatched blood during extended procedures is always present. The treatment of acute renal failure cannot always be adequately handled by conservative medical management, and a more effective method of correcting the blood chemical abnormalities is necessary. Presently hemodialysis can most adequately accomplish this end. Hemodialysis can be performed through natural or artificial membranes. Inasmuch as the process through natural membranes, vivodialysis, is slow and less effective than that through artificial membranes in an extracorporeal circuit, the latter is preferred. Our

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