Mannitol treatment of elderly patients with cerebral vascular disease caused by the clinical observation of the renal toxicity


The rate of the decline may occur similar to renal stop flow phenomenon may also cause ARF, mannitol concentration in the blood circulation is still high ,nike free tilbud, and cerebrovascular disease in patients with varying degrees of renal perfusion disorders] . 3.2 elderly patients with acute cerebrovascular disease , especially hypertension , diabetes, renal artery more atherosclerosis , glomerular ,ralph lauren paris, tubular degeneration and renal interstitial fibrosis , and increased with age ,mbt shoes, declining renal functional reserve . Reported in the literature : 4O -year-old kidney began to degeneration ,abercrombie and fitch sale, kidney function began to decline , renal blood flow and glomerular filtration rate per 10a decreased by 10 , the tubular concentration function decreased by 5 per 10a . Increased incidence of increased renal toxicity with age , so elderly patients with mannitol should take into account the physiological characteristics of this study can be seen . Other organ functional reserve of 3.3 elderly is also reduced with increasing age ,ralph lauren shop, in the event of renal failure , easily induced multiple organ dysfunction syndrome (MODS) and death . Deaths in this group of 32 cases of acute renal failure , due to merge multiple organ failure . 3.4 We believe that mannitol efficacy generally start 5d . Its toxic effects on the kidney with the medication time has become more significant , it is used for the treatment of elderly patients with acute cerebral vascular accident , where appropriate , the use of mannitol should be based on the degree of cerebral edema , rather than mechanical timing sufficient quantities of drug delivery is more consistent that the 0.25/kg reducing the intracranial pressure of 0.5 ~ 1.0/kg essentially the same , mannitol 3 ~ 5d should be based on brain edema and close monitoring of relevant indicators , in the event of renal toxicity stop using them immediately , if necessary, given the combination therapy of high-dose furosemide pulse therapy or diuretic mixture and dopamine . Dialysis therapy of acute renal failure, the preferred method of treatment , early dialysis may prevent multiple organ failure was the primary hospital for dialysis - free conditions , we believe that the mannitol -induced acute renal failure , as long as close monitoring , timely detection , most of them can be reversed . ( This article courtesy of Beijing Union Medical College Hospital, doctoral tutor Professor Li Shunwei modified. )