A 45-year-old married man with chronic renal failure due to obstructive uropathy from kidney stones. Six years ago, he had kidney stones, which led to cystolithotripsy (stone fragmentation) and subsequent surgical lithotomy (stone removal). Since then, urine volume has decreased, and hypertension developed. He takes atenolol and nifedipine at 10 mg.
Further observation revealed progressive renal failure and kidneys significantly reduced in size. Hemodialysis was started 6 months ago, 3 times a week.
The patient sought treatment at our clinic but came very irregularly due to time spent on hemodialysis. For the first 2 weeks, treatment was conducted 3 times a week, then 2 times over 3 weeks. He was advised to collect urine in a container, measure the volume with a syringe, and keep records. Urine output remained unchanged over the past 6 months.
Results: From the start of treatment, urine output increased as follows:
After 14 sessions, urine volume did not change and remained at 130-145 ml/day.
Side Effects: On the day of treatment, the patient sometimes felt a mild headache that did not interfere with work.
Comments: Urine volume increased by 60-70%, but the baseline is still very low to consider discontinuing hemodialysis. Treatment is quite limited for hemodialysis patients if the baseline is low. With continued treatment, further urine increase might be possible, but to what extent is unknown. However, one might expect a doubling of urine volume before reaching a plateau.
In this case, the urine volume increased, but the patient could not come on schedule, only once a week, as he spends 3-4 hours on dialysis 3 times a week at the dialysis center.
Further observation revealed progressive renal failure and kidneys significantly reduced in size. Hemodialysis was started 6 months ago, 3 times a week.
The patient sought treatment at our clinic but came very irregularly due to time spent on hemodialysis. For the first 2 weeks, treatment was conducted 3 times a week, then 2 times over 3 weeks. He was advised to collect urine in a container, measure the volume with a syringe, and keep records. Urine output remained unchanged over the past 6 months.
Results: From the start of treatment, urine output increased as follows:
- Before treatment — 80 ml/day
- 5th day — 115 ml/day
- 7th day — 125 ml/day
- 14th day — 145 ml/day
After 14 sessions, urine volume did not change and remained at 130-145 ml/day.
Side Effects: On the day of treatment, the patient sometimes felt a mild headache that did not interfere with work.
Comments: Urine volume increased by 60-70%, but the baseline is still very low to consider discontinuing hemodialysis. Treatment is quite limited for hemodialysis patients if the baseline is low. With continued treatment, further urine increase might be possible, but to what extent is unknown. However, one might expect a doubling of urine volume before reaching a plateau.
In this case, the urine volume increased, but the patient could not come on schedule, only once a week, as he spends 3-4 hours on dialysis 3 times a week at the dialysis center.