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Postcards or outpatients: an alternative method of follow-up.

1979; BMJ; Volume: 1; Issue: 6174 Linguagem: Inglês

10.1136/bmj.1.6174.1321

0959-8138

Adante Hart, Pamela Edmond, D J Varman,

Primary Care and Health Outcomes

5-7 mg/100 ml), and phosphate 7-9 mmol/l (24-5 mg/100 ml).Intravenous urography and retrograde pyelography disclosed regular enlarged kidneys with normal ureters and renal outlines.Haemodialysis was performed a few hours after admission.Thereafter blood calcium concentration was 1-6 mmol/l (6-4 mg/100 ml) and phosphate 6-7 mmol/l (20-7 mg/100 ml).The patient became anuric and underwent dialysis five times between 18 and 25 June.On 24 June serum calcium was 2-25 mmol/l (9 mg 100 ml) and phosphate 3-1 mmol/l (9 6 mg/100 ml).The patient died on 27 June from gastrointestinal haemorrhage.Postmortem renal histological examination (see figure ) showed interstitial oedema and dilatation of tubules with flattening and necrosis of tubular epithelium; several tubular lumens were obstructed by crystalline deposits with concentric structure, coloured by von Kossa stain.No lymphomatous infiltrates were found.Glomeruli were normal.4. t.~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ . . . . .