腎不全に対する泌尿器科的治療法に関する研究 第1編: 生体臓器灌流法特に腸管灌流法について

Abstract

So far for renal insufficiency, exchange or substituting blood transfusions, peritoneal perfusion, intestinal-loop perfusion, administration of ion exchange resin, blood dialysis with artificial kidney and renal transplantation have been tried to eliminate serum nitrogencontaining substances, to maintain electrolyte balance and to correct acid-base balance. However, renal transplantation has failed to obtain satisfactory result due to rejection phenomenon and artificial kidney has restricted its repeated uses because of expensive burden on patients although it has excellent dialysance. It is suspected that life prolongation of patient with renal insufficiency can be achieved with use of artificial kidney in proper combination with organ perfusion, although cf which dialysance is less excellent. Experimentary studies were performed on dogs to perfuse the lung, int e s tine and stomach with an identical condition and serum electrolytes and nitrogen containing substances were measured to compare the effectiveness of perfusion. The results indicated that the lung perfusion is the most excellent way of dialysis. It was also demonstrated on the isolated intestinal perfusion for hyperpotassemia that a use of ion exchange resin, Amberlite IPR-64 is effective biochemically when it is suspended in perfusing fluid. In addition the results of isolated intestinal perfusion done in 4 patients with chronic renal insufficiency proved its therapeutic effects when the procedure is carried out in combination with other kinds of therapy.