Electrolyte disturbances in some urological conditions

Dinwoodie, Alison J (1962) Electrolyte disturbances in some urological conditions. PhD thesis, University of Glasgow.

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Changes in electrolyte balance have been studied in 3 groups of urological conditions, (1) in patients with ureterocolic transplants (2) in patients with acute renal failure and uraemia, and (3) in those with renal calculi. In addition a special study was made of changes in (4) magnesium levels and (5) blood cell potassium under the variety of conditions encountered. 1. In the patients with ureterocolic transplants hyperohloraemic acidosis was present in addition to a moderately raised urea. Hyppisalaemia also occurred in a significant number. This imbalance was found to occur any time from a fortnight to a year or more following operation, with sorae stabilisation eventually taking place. Balance experiments showed that it was due to a disproportionate retention of chloride, this was minimised by a low chloride diet and administration of sodium bicarbonate or lactate corrected the acidosis. Balance experiments also showed that considerable potassium deficiencies could develop due to the increased excretion of potassium, and this was not always obvious from the plasma figures. In particular, rapid correction of severe acidosis led in many cases to marked hypolcalaemla and unless precautions are taken this could be fatal. 2. In the patients with acute renal failure, changes in plasma electrolytes were followed from day to day. Comparison of plasma phosphorus and urea levels were considered as an aid to prognosis, the relative height of the phosphorus occasionally giving an earlier indication of return of renal function. Some patients were treated with anabolic steroids, and although conditions were not always comparable, there was some benefit obtained. 3. Tests of parathyroid activity were investigated in patients with renal calculi. Factors affecting the tests, differential diagnosis and the value of repeated determinations are discussed. Calcium infusion tests and phosphorus/creatinine ratios were found to be of little value in borderline cases. 4. Serum magnesium was estimated in many of the patients referred to above. It tended to act reciprocally to calcium, for example, in the calcium infusion tests and the uraemic patients, but there was no definite relationship between it and serum potassium, e.g. in the potassium deficient patients and the uraemic ones, nor in the acidosis of the uraemic or transplant patients. The effect of operation on serum and urine magnesium was also studied, but the effects were too slight for any significant trend to show. A few estimations were also made in patients with endocrine disorders, but results were again variable. 5. Blood cell potassium was estimated in many cases to evaluate its use as a guide to the state of body potassium. It was found that other factors affected it, in particular the state of acid-base equilibrium and the tonicity of the extracellulor fluid, while in the potassium fluid, while in the potassium deficient patients it was deficient patients it was often normal, and low in the anric patients where there was no overall deficiency. A few tissue analyses were carried out which confirmed this. It was concluded that blood cell potassium estimations are unreliable guides to tissue potassium, unless these limitations are borne in mind.

Item Type: Thesis (PhD)
Qualification Level: Doctoral
Additional Information: Adviser: J Baton
Keywords: Medicine
Date of Award: 1962
Depositing User: Enlighten Team
Unique ID: glathesis:1962-73832
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 14 Jun 2019 08:56
Last Modified: 14 Jun 2019 08:56
URI: https://theses.gla.ac.uk/id/eprint/73832

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