ARTIFICIAL KIDNEY IN THE TREATMENT OF UREMIA ASSOCIATED WITH ACUTE GLOMERULONEPHRITIS (WITH A NOTE ON REGIONAL HEPARINIZATION)

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Abstract
When ultrafiltration and regional heparinization are used and other precautions are taken, the alleged dangers of dialysis, such as cerebral hemorrhage, hypertension, and convulsions are minimal. Chemical indications for dialysis are (1) blood urea content greater than 200 mg%; (2) serum K approaching 7 meq/l; (3) HCO3" less than 12 meq/l. Clinical indications are: (1) stupor, coma or drowsiness; (2) a wild, disoriented or unmanageable patient; (3) shortness of breath and impending or actual pulmonary edema (ultrafiltration used with dialysis effects a prompt response); (4) infections, poorly healing wounds, peritonitis; (5) hypertension and/or convulsions (ultrafiltration is to be used). Regional heparinization prevents systemic heparin effects. Ganglionic blocking agents and other measures usually will control the eventual rise of blood pressure. Two children and 2 adults with acute glomerulonephritis were treated. One, a 58-year-old man with extensive arteriosclerosis and renal disease, died; the 3 other patients recovered.