Observation of 13 Autopsy cases in Patients Treated with Hemodialysis

• Published in: Nihon Jinzo Gakkai shi Vol. 21; no. 2; pp. 91 - 100
• Main Authors: Muraski, Gen'i, Tatematsu, Masae, Hirose, Masao, Ito, Nobuyuki, Kawahara, Hirohisa, Yamazaki, Chikao, Hatta, Masahiro, Masuko, Minako, Masuko, Kazuo, Ohkura, Takanobu
• Format: Journal Article
• Language: Japanese
• Published: Japan Japanese Society of Nephrology 01.02.1979
• Subjects: Adult; Aged; Female; Humans; Kidney - pathology; Kidney Failure, Chronic - pathology; Kidney Failure, Chronic - therapy; Liver - pathology; Male; Middle Aged; Renal Dialysis; Spleen - pathology
• ISSN: 0385-2385; 1884-0728
• DOI: 10.14842/jpnjnephrol1959.21.91

Hemodialysis is widely used in the treatment of patients with chronic renal failure m Nevertheless morbidity and mortality among these patients is significant. Thus, it is important to study the effects of hemodialysis in such patients. In this report, 13 autopsy cases of patients treated with hemodialysis were histopathologically studied and compared with 15 autopsy cases of non-hemodialyzed patients with chronic renal failure, In the patients treated with hemodialysis, there were significant findings in many organs. Causes of death in the non-hemodialysis cases were mostly uremia, but in hemodialysis cases they consisted of 4 cases of massive bleeding from multiple gastric and duodenal ulcers, 3 cases of circulatory failure, 3 cases of severe infection and one case of cerebral bleeding. In hemodialysis cases the kidneys were strongly atrophic, and these surfaces showed a fine granular appearence. Microscopically, hyalinized glomeruli, tubules filled with colloid-like material, interstitial fibrosis, small round cell infiltration and arteriolar sclerosis were frequently observed. Common pathological changes of other organs in hemodialysis cases included multiple gastric and duodenal ulcers (69%), hepatic centrolobular fatty changes (77%) and chronic pancreatitis (31%). The frequency of these findings was higher than in non-hemodialysis cases. In the patients treated with long term hemodialysis, atherosclerotic changes of aorta and of the arterioles in several organs were more severe than those in the same-aged patients not on hemodialysis.