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      Changes in Osmolal Gap and Osmolality in Children with Chronic and End-Stage Renal Failure

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          Most cited references 7

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          Brain swelling after dialysis: old urea or new osmoles?

          The pathogenesis of brain swelling and neurological deterioration after rapid hemodialysis (dialysis disequilibrium syndrome) is controversial. The "reverse urea hypothesis" suggests that hemodialysis removes urea more slowly from the brain than from the plasma, creating an osmotic gradient that results in cerebral edema. The "idiogenic osmole hypothesis" proposes that an osmotic gradient between brain and plasma develops during rapid dialysis because of newly formed brain osmoles. In this review, the experimental basis for the two hypotheses are critically examined. Based on what is known about the physiology of urea and water diffusion across the blood-brain barrier, and empiric observations of brain solute composition after experimental hemodialysis, we conclude that the "reverse urea hypothesis" remains a viable explanation for dialysis disequilibrium and that rapid reduction of a high urea level in and of itself predisposes to this condition.
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            Osmol gaps revisited: Normal values and limitations

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              Inter-dialytic variations in blood volume and total body water in uraemic patients treated by dialysis

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                Author and article information

                Journal
                NEP
                Nephron Physiol
                10.1159/issn.1660-2137
                Nephron Physiology
                S. Karger AG
                1660-2137
                2007
                January 2007
                30 November 2006
                : 105
                : 2
                : p19-p21
                Affiliations
                Departments of aPediatric Nephrology, cBiochemistry and dBiostatistics, Çukurova University School of Medicine, and bDepartment of Pediatric Nephrology, Adana Teaching and Medical Research Center, Baskent University School of Medicine, Adana, Turkey
                Article
                97604 Nephron Physiol 2007;105:p19–p21
                10.1159/000097604
                17139190
                © 2006 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Tables: 1, References: 12, Pages: 1
                Product
                Self URI (application/pdf): https://www.karger.com/Article/Pdf/97604
                Categories
                Minireview

                Cardiovascular Medicine, Nephrology

                Osmolality, Chronic renal failure, Osmolal gap

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