Uremic frost in end stage renal disease nejmicm1716367 (pdf io)

Uremic Frost in End-Stage Renal Disease Joana M Martins, M.D., and Rita Magriỗo, M.D August 16, 2018 N Engl J Med 2018; 379:669 DOI: 10.1056/NEJMicm1716367 A 39-year-old man with end-stage renal disease [bệnh thận giai đoạn cuối] presented to the emergency department [khoa cấp cứu] with anorexia [chán ăn], nausea [buồn nôn], vomiting [nôn], and oliguria [thiểu niệu] Five months earlier, he had stopped attending his regular hemodialysis [thẩm tách máu (chạy thận nhân tạo)] sessions; he reported that he had thought that the sessions were not needed because he continued to have urine [nước tiểu] output On physical examination [thăm khám lâm sàng], his blood pressure [huyết áp] was 167/80 mm Hg He was lethargic [ngủ gà, lơ mơ] and had slowed speech [nói chậm] and edema [phù] of the legs, and his breath [hơi thở] had a urine-like odor [mùi giống nước tiểu] His skin [da] had diffuse [adj - lan tỏa] crystalline [adj- tinh thể] white deposits [chất lắng, cặn] that were distributed mainly on his face [mặt] (Panel A), abdomen [bụng] (Panel B), and arms [cánh tay] Laboratory studies showed a blood urea nitrogen[BUN] level of 231 mg per deciliter (82.5 mmol per liter), a creatinine level of 20.0 mg per deciliter (1770 μmol per liter), a sodium [Natri] level of 125 mmol per liter, and a potassium [Kali] level of 7.7 mmol per liter The patient underwent immediate [lập tức] hemodialysis Uremic frost is associated with severe azotemia [tăng azote máu] and results from crystallization [sự kết tinh] of urea on the skin after sweat [mồ hôi] evaporates [bốc hơi] It is a rare finding in locations where hemodialysis is widely available The patient’s lethargy [tình trạng ngủ gà, lơ mơ] abated as he resumed regular hemodialysis sessions, and he had complete regression of the uremic frost at weeks after presentation Joana M Martins, M.D Rita Magriỗo, M.D Hospital Garcia de Orta, Lisbon, Portugal ... [hơi thở] had a urine-like odor [mùi giống nước tiểu] His skin [da] had diffuse [adj - lan tỏa] crystalline [adj- tinh thể] white deposits [chất lắng, cặn] that were distributed mainly on his face... hemodialysis Uremic frost is associated with severe azotemia [tăng azote máu] and results from crystallization [sự kết tinh] of urea on the skin after sweat [mồ hôi] evaporates [bốc hơi] It is a rare finding...because he continued to have urine [nước tiểu] output On physical examination [thăm khám lâm sàng], his blood pressure [huyết áp] was 167/80