An unusual cause of elevated serum creatinine after kidney transplantation in an adolescent: Questions

We report a case of VURD syndrome in a three day old neonate who was diagnosed with hydronephrosis on a prenatal ultrasound. Severe tortuosity and dilation of the upper urinary tracts in the presence of progression of hydronephrosis or a persistently elevated creatinine may favor a proximal urinary diversion rather than primary valve ablation or cutaneous vesicostomy. Because of a persistently elevated serum creatinine, a nonfunctioning kidney with grade 4/5 vesicoureteral reflux and worsening contralateral hydronephrosis despite lower tract drainage, a left cutaneous pyelostomy was performed, contralateral to the kidney involved with VURD. Postoperatively the serum creatinine stabilized at 1.0 mg/dl and decreased to 0.3 mg/dl at one month of age.

Download Full-text

Nitromethane-containing fuel toxicity causing falsely elevated serum creatinine

Clinical Kidney Journal ◽

10.1093/ndtplus/sfm018 ◽

2007 ◽

Vol 1 (1) ◽

pp. 30-31 ◽

Cited By ~ 1

Author(s):

S. Patel ◽

S. Dikkala ◽

R. J. Marcus

Keyword(s):

Serum Creatinine ◽

Elevated Serum ◽

Elevated Serum Creatinine

Download Full-text

The Impact of Renal Impairment on the Management of Patients with Lower Urinary Tract Obstruction

Tropical Doctor ◽

10.1177/004947559702700208 ◽

1997 ◽

Vol 27 (2) ◽

pp. 75-77 ◽

Cited By ~ 3

Author(s):

B C Ogbonna ◽

A G Madziga ◽

E A Anteyi

Keyword(s):

Urinary Tract ◽

Renal Impairment ◽

Serum Creatinine ◽

Lower Urinary Tract ◽

Urinary Tract Obstruction ◽

Elevated Serum ◽

Elevated Serum Creatinine ◽

Urethral Strictures ◽

Lower Urinary Tract Obstruction ◽

Lower Urinary

One hundred patients with lower urinary tract obstruction (LUTO) seen over a 10-month period were prospectively studied. Nineteen (19%) had an elevated serum creatinine (>125 μmol/l); 13% had benign prostatic hyperplasia (BPH); 4% had urethral strictures; and two had congenital anomalies. Though urethral strictures are more common than BPH they cause less renal impairment, probably because the patients are younger and also because a urinary fistula may form proximal to the stricture when the intravesical pressure rises very high. Eighty per cent of the patients with renal impairment had a urinary tract infection (UTI), and in these the reduction in serum creatinine following relief of obstruction was slow and erratic. In three patients who did not have UTI the serum creatinine dropped steadily at a rate which varied from 6.8–845 μmol/l/week following continuous bladder drainage and appropriate supportive management. All patients with elevated serum creatinine had delayed surgery and required prolonged preoperative hospitalization, with a resultant sharp increase in the cost of their treatment.

Download Full-text

Acute Kidney Injury in Children with Severe Malaria Is Common and Associated with Adverse Hospital Outcomes

Journal of Tropical Pediatrics ◽

10.1093/tropej/fmz057 ◽

2019 ◽

Vol 66 (2) ◽

pp. 218-225

Author(s):

Eunice O Oshomah-Bello ◽

Christopher I Esezobor ◽

Adaobi U Solarin ◽

Fidelis O Njokanma

Keyword(s):

Acute Kidney Injury ◽

Serum Creatinine ◽

Severe Malaria ◽

Complete Blood Count ◽

Univariate Analysis ◽

Elevated Serum ◽

Kidney Injury ◽

Hospital Outcomes ◽

Elevated Serum Creatinine ◽

Sub Saharan

Abstract Background The prevalence of acute kidney injury (AKI) in children with severe malaria in sub-Saharan African may have been underestimated. The study aimed to determine the prevalence of AKI in children with severe malaria and its association with adverse hospital outcomes. Methods At presentation, we measured complete blood count, serum bilirubin, and serum electrolytes, urea and creatinine in children with severe malaria. At 24 h after hospitalization, we repeated serum creatinine measurement. Urine passed in the first 24 h of hospitalization was also measured. We defined AKI and its severity using the Kidney Disease: Improving Global Outcome AKI guidelines. Results The study involved 244 children (53.3% males) with a median age of 3.5 (1.9–7.0) years. One hundred and forty-four (59%) children had AKI, and it reached maximum Stages 1, 2 and 3 in 56 (23%), 45 (18.4%) and 43 (17.6%) children, respectively. The majority (86.1%) with AKI had only elevated serum creatinine. Mortality increased with increasing severity of AKI on univariate analysis but weakened on multiple logistic regression. Mortality was also higher in those with both oliguria and elevated serum creatinine than in those with elevated serum creatinine only (50% vs. 4.8%, p < 0.001). Furthermore, children with AKI spent three days more in hospital than those without AKI (p < 0.001). Conclusions Acute kidney injury complicates severe malaria in 6 out of every 10 children and is commonly identified using elevated serum creatinine. It is also associated with adverse hospital outcome.

Download Full-text