[Acute dialysis treatment of urologic patients]

51 urologic patients were dialyzed following acute indications during 1968-77. The 47 adults were 31-81 (average 59) years old. Due to the frequency of occurrence the predominant diseases were: Urolithiasis (combined with pyonephrosis, urosepsis, nephrocirrhosis), malignant tumors, and bladder neck adenomas. 18 patients were postoperative cases. 32 patients suffered from severe diseases or complications outside the urogenital tract. According to a differentiation of three risk groups, there were 33 patients belonging to the most severe group III. The patients' admission to the dialysis unit was late in most cases: 13 patients were already in coma or precoma, 18 patients overhydrated, 11 patients' serum potassium was more than 7 mval/1,28 patients' serum creatinine was more than 10 mg/dl. A prophylactic dialysis was possible in 11 cases only. We have accepted all 51 acute urologic patients, admitted to our clinic, for dialysis treatment. Peritoneal dialysis was performed in all 51 patients, only in 6 of them this treatment was followed by haemodialyses. The reasons for prefering peritoneal dialysis were haemorrhages or the danger of haemorrhages, a critical cardiovascular state, or an extreme acotaemia. In 143 peritoneal dialyses with 91 insertions of stilet catheters, one perforation of the small intestine occurred. The patient survived the resulting peritonitis. 13 of 15 patients with this indication got into an operable state in the course of dialysis treatment. Lethality of 61 per cent (31 of the 51 patients died) was related to the severity of the basic urologic disease. 4 of these latter patients could have been admitted to a regular dialysis treatment. In further 6 cases this would have been possible after a special urologic treatment.