MO402ACUTE OBSTRUCTIVE RENAL FAILURE IN URGENT HEMODIALYSIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Imane Failal ◽  
Sanae Ezzaki ◽  
Rania Elafifi ◽  
Mohamed Zamd ◽  
Naoufal Mtioui ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Failure ◽  
Pulmonary Edema ◽  
Creatinine Level ◽  
Descriptive Study ◽  
Percutaneous Nephrostomy ◽  
Acute Pulmonary Edema ◽  
Uremic Syndrome ◽  
Cancer Of The Cervix ◽  
Obstructive Renal Failure

Abstract Background and Aims Acute obstructive renal failure is secondary to obstruction of the upper excretory tract occurring bilaterally or in a single anatomical or functional kidney. It accounts for 8 to 14% of all acute renal failure in Morocco. They constitute serious conditions which can jeopardize the functional prognosis of the kidney . The objective of our study is to describe the profile of patients on emergency hemodialysis for acute obstructive renal failure (AKI), the main indications for hemodialysis and to assess the risk factors for mortality. Method It was a 2-year retrospective and descriptive study from January 2018 to December 2019; performed in the nephrology and hemodialysis department CHU IBN ROCHD CASABLANCA. Results A total of 118 patients were counted: 43 women, 75 men or 36.4%, 63.5%, with an average age of 54.3 years "+/- 10.3". The circumstances of discovery were: Oligo anuria 51.5%, hematuria 25%, AEG 24%. The obstacle was neoplastic in 67.79%; lithiasis 26.27%; on pregnancy in 0.84%; bladder malformation 0.84%, and unknown etiologies in 4.2%. The neoplastic origin was cancer of the cervix, followed by the bladder and then the prostate. The average creatinine level was 89.7mg / l. The indication for hemodialysis was: threatening hyperkalemia, uremic syndrome, acidosis and acute pulmonary edema in 56%, 25.8%, 9.6% and 10% of cases, respectively The total number of hemodialysis sessions was 227 hemodialysis sessions with an average number of 1.91. Obstacle removal was performed by percutaneous nephrostomy in 70.8% of cases, by mounting a double J probe in 10% of cases and by ureterostomy in 4.2% of cases. The course was good in 77.9% of the cases, 13.5% progressed to the IRCT. Mortality was 8.4%. Risk factors for mortality were: age, etiology of neoplasia. Conclusion A total of 118 patients were counted: 43 women, 75 men or 36.4%, 63.5%, with an average age of 54.3 years "+/- 10.3". The circumstances of discovery were: Oligo anuria 51.5%, hematuria 25%, AEG 24%. The obstacle was neoplastic in 67.79%; lithiasis 26.27%; on pregnancy in 0.84%; bladder malformation 0.84%, and unknown etiologies in 4.2%. The neoplastic origin was cancer of the cervix, followed by the bladder and then the prostate. The average creatinine level was 89.7mg / l. The indication for hemodialysis was: threatening hyperkalemia, uremic syndrome, acidosis and acute pulmonary edema in 56%, 25.8%, 9.6% and 10% of cases, respectively The total number of hemodialysis sessions was 227 hemodialysis sessions with an average number of 1.91. Obstacle removal was performed by percutaneous nephrostomy in 70.8% of cases, by mounting a double J probe in 10% of cases and by ureterostomy in 4.2% of cases. The course was good in 77.9% of the cases, 13.5% progressed to the IRCT. Mortality was 8.4%. Risk factors for mortality were: age, etiology of neoplasia.

scholarly journals Risk factors for maternal death in patients with severe preeclampsia and eclampsia

2001 ◽  
Vol 1 (3) ◽  
pp. 237-247
Author(s):  
Melania Maria Ramos de Amorim ◽  
Luiz Carlos Santos ◽  
Ana Maria Feitosa Porto ◽  
Leila Katz Dias Martins
Keyword(s):  
Risk Factors ◽  
Renal Failure ◽  
Prenatal Care ◽  
Pulmonary Edema ◽  
Maternal Death ◽  
Hellp Syndrome ◽  
Odds Ratio ◽  
Severe Preeclampsia ◽  
Acute Pulmonary Edema ◽  
Chronic Hypertension

OBJECTIVES: to determine the principal death causes in patients with severe preeclampsia/eclampsia and identify related risk factors. METHODS: a case-control study was performed comprising all cases of maternal death (n = 20) in patients with severe preeclampsia or eclampsia (n = 2.541). 80 controls (survivors) were randomly selected. The odds ratio and an estimate of maternal death relative risk were determined, and a multiple logistic regression analysis performed to determine the adjusted odds ratio. RESULTS: the basic causes for death were: acute pulmonary edema, disseminated intravascular coagulopathy, hemorrhagic shock, pulmonary embolism, acute renal failure, sepsis and three cases of undetermined causes of death. The principal risk factors were: age > 25 years old, multiparity, gestational age < 32 weeks, lack of prenatal care, diastolic pressure > 110mmHg, convulsions, chronic systemic arterial hypertension, HELLP syndrome, pulmonary edema, normally inserted abruptio placenta, disseminated intravascular coagulation, acute renal failure. Variables persistently related to maternal death were: HELLP syndrome, eclampsia, acute pulmonary edema, eclampsia, chronic hypertension and lack of prenatal care. CONCLUSIONS: the principal risk factors for death in women with preeclampsia/eclampsia are the lack of prenatal care, associated to chronic hypertension, HELLP syndrome, eclampsia and acute pulmonary edema.

Risk factors and prognostic implication of acute pulmonary edema in resuscitated out-of-hospital cardiac arrest patients

Resuscitation ◽  
2013 ◽  
Vol 84 ◽  
pp. S78
Author(s):  
Joonghee Kim ◽  
Taeyun Kim ◽  
Kyuseok Kim ◽  
Joong Eui Rhee ◽  
You Hwan Jo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Arrest ◽  
Pulmonary Edema ◽  
Acute Pulmonary Edema ◽  
Prognostic Implication ◽  
Hospital Cardiac Arrest

Reversible Acute Pulmonary Edema due to Uncontrolled Hyperglycemia in Diabetic Individuals with Renal Failure

Diabetes Care ◽  
1982 ◽  
Vol 5 (5) ◽  
pp. 506-511 ◽  
Author(s):  
A. Kaldany ◽  
G. A. Curt ◽  
N. M. Estes ◽  
L. A. Weinrauch ◽  
A. R. Christlieb ◽  
...  
Keyword(s):  
Renal Failure ◽  
Pulmonary Edema ◽  
Acute Pulmonary Edema

scholarly journals Presentation of acute pulmonary edema in severe pre-eclamptic pregnant women: a case report

2021 ◽  
Vol 10 (9) ◽  
pp. 3620
Author(s):  
Karishma Chaudhary ◽  
Mamta Tyagi ◽  
Smriti Gupta ◽  
Manvi Gupta ◽  
Yamini Verma ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Report ◽  
Pulmonary Edema ◽  
Cardiac Disease ◽  
Fluid Overload ◽  
Severe Infection ◽  
Acute Pulmonary Edema ◽  
Predisposing Factor ◽  
Multiple Gestations ◽  
Excessive Accumulation

Pulmonary edema refers to an excessive accumulation of fluid in the pulmonary interstitial and alveolar spaces. It may occur in low risk pregnancies but one very important predisposing factor is association with pre-eclampsia. Acute pulmonary edema during pregnancy is very rare and occurs in 0.08% pregnancies. About 3% of severe pre-eclamptic patients develop acute pulmonary edema. Several risk factors have been identified: preeclampsia or eclampsia, use of tocolytic therapy, severe infection, cardiac disease, iatrogenic fluid overload, and multiple gestations. This case examines one such presentation and reviews some of the diagnostic possibilities.

scholarly journals APPORT DE LHEMODIALYSE DANS LINSUFFISANCE RENALE AIGUE OBSTRUCTIVE : BENEFICES ET RISQUES

2021 ◽  
Vol 9 (08) ◽  
pp. 524-531
Author(s):  
O. Assal ◽  
◽  
L. Driouch ◽  
N. Ouzeddoun ◽  
R. Bayahia ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Descriptive Study ◽  
Hemodynamic Instability ◽  
Independent Factor ◽  
Significant Morbidity ◽  
Dialysis Patients ◽  
Etiological Diagnosis ◽  
Life Threatening ◽  
Uremic Syndrome

Obstructive acute renal failureis a life-threatening medical and surgical emergency, sometimes requiring emergency hemodialysis.The objective of our work is to describe the profile of emergency dialysis patients forobstructive acute renal failure, to determine the main indications of hemodialysis, and to identify the prognostic factors of mortality. Material and methods:This is a prospective and descriptive study including patients who presented an obstructive acute renal failurerequiring urgent hemodialysis before a possible removal of the obstacle. Results:Over 2 years, we collected 106 patients with a sex ratio of 1.4 and a mean age of 59.4 ± 14.5 years. Thehemodialysis indication is retained in the event of hyperkalemia (83%), and/or severe acidosis (38.7%), and/or poorly tolerated anemia (33%), and/or clinical uremic syndrome (13.2%), and/or an acute pulmonary edema (3.8%). Regarding the etiological diagnosis ofobstructive acute renal failure, the obstacle is of neoplastic origin in 73%.Complications related to dialysis are dominated by hemodynamic instability in per-dialysis in 22% of cases, as well as those related to catheter in 20% of cases. Kidney function normalized in 30% of cases, while 70% progressed to CKD.We recorded 13 deaths and hemodynamic instability in per-dialysis is an independent factor of mortality. Conclusion:The need for emergency dialysis is fraught with significant morbidity and mortality, particularly complications linked to KT of hemodialysis.

scholarly journals P1537HEMODIALYSIS EMERENGIES IN A NEPHROLOGY DEPARTEMENT : ABOUT 117 CASES

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Chifaa Triqui
Keyword(s):  
Renal Failure ◽  
Metabolic Acidosis ◽  
Pulmonary Edema ◽  
Kidney Injury ◽  
Biological Data ◽  
Acute Pulmonary Edema ◽  
Preventive Strategy ◽  
Severe Renal Failure ◽  
Cross Sectional ◽  
Treatment Protocols

Abstract Background and Aims Hemodialysis (HD) emergencies in nephrology are very common. Prompt diagnosis and management are needed as it can be life-threatening. We aim to determine epidemiological, clinical, biological aspects as well as the etiological profile of our population. Method We conducted a cross-sectional study during 3 months (February, March and April 2019) collecting patients who underwent at least one session of HD at our nephrology department. Were included patients aged over 18 years old. Were excluded chronic dialysis patients presenting for their usual session. Data collection was conducted from HD registers. We collected the following parameters: age, gender, comorbidities, initial nephropathy, clinical data(blood pressure, pulmonary auscultation, diuresis, oxygen saturation),the current treatment and biological data( creatinin, kalemia, hemoglobin, and gasometry). Data were entered and analyzed using SPSS software. Chi-squared test with a level of significance of 0.05 was used for the qualitative variables. Results A total of 117 patients were included, mean aged 60.71 years old (range:28-90) with a sex ratio M/F at 1.3. Our population consists in 42 chronic HD patients(37.9%), 34 Patients with moderate to severe renal failure(RF) (29.9%) and 41 patients with acute kidney injury (AKI) (35%). Initial nephropathy causes were vascular in (40%), glomerular in(25%) and undetermined in(35%) of cases. Our patients had hypertension, diabetes, dyslipidemia in respectively (58%),(45%) and (7.6%). Twenty two chronic HD patients were anuric (48.8%). Seventy-nine patients were admitted from the emergency department(68%), 21 patients from the surgical and urology departments(18.4%),8 patients from the intensive care unit (7.6%) and 4 patients from other departments(4.2%). HD indications were acute pulmonary edema in (41.8%), metabolic acidosis in (41.8%), hyperkalemia in (37.6%), Uremic signs in (22.2%). Inadequate hyperkalaemic treatment was noted in( 22.7% )of cases. Conventional HD was performed with mean session duration of 3 hours. Ultrafiltration was required in 46 cases (36.8%) with an average of 1860ml(range:500-4000). Perdialytic complications were observed in(12.5%)of cases. Hypotension was the most common complication which leads to the interruption of the session in(5.9%)of cases. Disequilibrium syndrome was observed in 2 patients. Arrhythmia and acute cardiac failure were noted in 2 patients. Death occurred in 1 case caused by arrhythmia. Advanced age, anuria and underlying RF were independent risk factors of emergency dialysis with respectively (p=0.02, p=0.01 and p=0.05). Conclusion: Dialysis emergencies remain frequent in our country. Acute Pulmonary edema and metabolic acidosis were the main indications followed by hyperkalemia and anuria. Poor and delayed chronic renal failure management could explain the frequent use of emergency HD. The analysis of the causes and dialysis modalities in emergency situations, contributes to adopt a preventive strategy in order to identify high-risk patients and to optimize treatment protocols.

scholarly journals The risk factors and prognostic implication of acute pulmonary edema in resuscitated cardiac arrest patients

2015 ◽  
Vol 2 (2) ◽  
pp. 110-116 ◽  
Author(s):  
Dae-hyun Kang ◽  
Joonghee Kim ◽  
Joong Eui Rhee ◽  
Taeyun Kim ◽  
Kyuseok Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Arrest ◽  
Pulmonary Edema ◽  
Acute Pulmonary Edema ◽  
Prognostic Implication
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