£45.49

VS Verlag für Sozialwissenschaften Einzelfunktionen der Niere beim akuten Nierenversagen: 1423 (Forschungsberichte des Landes Nordrhein-Westfalen, 1423)

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Description

Der plötzliche Zusammenbruch der Nierenfunktion war früher ein fast immer töd lich ausgehendes Ereignis. Die metabolischen Folgen der akuten Niereninsuffizi enz (Azotämie, Entgleisung des Wasser-, Elektrolyt-und Säure-Basen-Haushaltes) führten innerhalb kurzer Zeit zum klinischen Bild der Urämie mit schließlichem Exitus. Die Fähigkeit der Niere zu weitgehender morphologischer und funktioneller Restitution nach akuter Schädigung ist jedoch erheblich. Hierzu bedarf es aber eines längeren Zeitraums. Er steht in der Mehrzahl der Fälle nur dann zur Verfü gung' wenn die Entwicklung des Vollbildes der letztlich zum Tode führenden Urämie hintangehalten oder verhindert wird. Neue Behandlungsverfahren, insbe sondere die extrakorporale Hämodialyse, ermöglichen dies. Damit konnte die Letalität des akuten Nierenversagens wesentlich gesenkt werden. Sie liegt seither zwischen 32 und 52% und wird im wesentlichen nicht durch die eigentlichen meta bolischen Folgen der Niereninsuffizienz als vielmehr durch Komplikationen und die Schwere des ursächlich verantwortlichen Grundleidens bestimmt (ALWALL; BLUEMLE, WEBSTER und ELKlNTON; KELEMEN und KOLFF; REUBl, SARTORIUS, SWAN und MERRlLL; TEscHAN und Mitarbeiter; WETZELS). Den Fortschritten der Therapie verdankt es daher der Kliniker, daß er heute in der Lage ist, das Verhalten der Nierenfunktion im Verlauf des akuten Nieren versagens mit zunächst bestehender schwerster Insuffizienz und anschließender allmählicher Restitution an einem größeren Krankengut zu verfolgen und dabei definierte Einzelleistungen des Nierenparenchyms zu untersuchen.

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