SP254EARLY HIGH INTENSITY BLOOD PURIFICATION FOR SEVERE WASP VENOM POISONING WITH ACUTE KIDNEY INJURY BLOOD PURIFICATION FOR SEVERE WASP VENOM POISONING WITH ACUTE KIDNEY INJURY

The skin is the most commonly affected organ. Wasp venom causes both local and systemic reactions, but acute kidney injury (AKI) is the most serious complication, with a 20% mortality rate. Acute kidney injury can occur from single or multiple stings. Diagnosis depends on history, clinical findings, and investigations. Treatment protocol is same as other causes of AKI, including dialysis, and prognosis is good with early treatment.

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Net ultrafiltration rate and its impact on mortality in patients with acute kidney injury receiving continuous renal replacement therapy

Clinical Kidney Journal ◽

10.1093/ckj/sfz179 ◽

2019 ◽

Cited By ~ 1

Author(s):

Shahrzad Tehranian ◽

Khaled Shawwa ◽

Kianoush B Kashani

Keyword(s):

Acute Kidney Injury ◽

Renal Replacement Therapy ◽

Continuous Renal Replacement Therapy ◽

Replacement Therapy ◽

High Intensity ◽

Kidney Injury ◽

Ultrafiltration Rate ◽

Baseline Serum ◽

Fluid Removal ◽

The Impact

Abstract Background Fluid overload, a critical consequence of acute kidney injury (AKI), is associated with worse outcomes. The optimal fluid removal rate per day during continuous renal replacement therapy (CRRT) is unknown. The purpose of this study is to evaluate the impact of the ultrafiltration rate on mortality in critically ill patients with AKI receiving CRRT. Methods This was a retrospective cohort study where we reviewed 1398 patients with AKI who received CRRT between December 2006 and November 2015 at the Mayo Clinic, Rochester, MN, USA. The net ultrafiltration rate (UFNET) was categorized into low- and high-intensity groups (<35 and ≥35 mL/kg/day, respectively). The impact of different UFNET intensities on 30-day mortality was assessed using logistic regression after adjusting for age, sex, body mass index, fluid balance from intensive care unit (ICU) admission to CRRT initiation, Acute Physiologic Assessment and Chronic Health Evaluation III and sequential organ failure assessment scores, baseline serum creatinine, ICU day at CRRT initiation, Charlson comorbidity index, CRRT duration and need of mechanical ventilation. Results The mean ± SD age was 62 ± 15 years, and 827 (59%) were male. There were 696 patients (49.7%) in the low- and 702 (50.2%) in the high-intensity group. Thirty-day mortality was 755 (54%). There were 420 (60%) deaths in the low-, and 335 (48%) in the high-intensity group (P < 0.001). UFNET ≥35 mL/kg/day remained independently associated with lower 30-day mortality (adjusted odds ratio = 0.47, 95% confidence interval 0.37–0.59; P < 0.001) compared with <35 mL/kg/day. Conclusions More intensive fluid removal, UFNET ≥35 mL/kg/day, among AKI patients receiving CRRT is associated with lower mortality. Future prospective studies are required to confirm this finding.

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The dark side of high-intensity renal replacement therapy of acute kidney injury in critically ill patients

International Urology and Nephrology ◽

10.1007/s11255-010-9733-8 ◽

2010 ◽

Vol 42 (2) ◽

pp. 435-440 ◽

Cited By ~ 10

Author(s):

Helmut Schiffl

Keyword(s):

Acute Kidney Injury ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Critically Ill ◽

Critically Ill Patients ◽

High Intensity ◽

Kidney Injury ◽

Dark Side

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Clinical Rhabdomyolysis With Acute Kidney Injury Secondary to High-Intensity Rosuvastatin Use: A Case Report

Cureus ◽

10.7759/cureus.10932 ◽

2020 ◽

Author(s):

Deepak Chitralli ◽

Ronak Raheja ◽

Kishore Br

Keyword(s):

Acute Kidney Injury ◽

Case Report ◽

High Intensity ◽

Kidney Injury

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Acute Kidney Injury Biomarker Responses to Short-Term Heat Acclimation

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17041325 ◽

2020 ◽

Vol 17 (4) ◽

pp. 1325 ◽

Cited By ~ 3

Author(s):

Riana R. Pryor ◽

J. Luke Pryor ◽

Lesley W. Vandermark ◽

Elizabeth L. Adams ◽

Rachel M. Brodeur ◽

...

Keyword(s):

Acute Kidney Injury ◽

Relative Humidity ◽

Serum Creatinine ◽

High Intensity ◽

Kidney Injury ◽

Heat Acclimation ◽

High Intensity Exercise ◽

Strenuous Exercise ◽

Hot Environment ◽

Clinical Biomarkers

The combination of hyperthermia, dehydration, and strenuous exercise can result in severe reductions in kidney function, potentially leading to acute kidney injury (AKI). We sought to determine whether six days of heat acclimation (HA) mitigates the rise in clinical biomarkers of AKI during strenuous exercise in the heat. Twenty men completed two consecutive 2 h bouts of high-intensity exercise in either hot (n = 12, 40 °C, 40% relative humidity) or mild (n = 8, 24 °C, 21% relative humidity) environments before (PreHA) and after (PostHA) 4 days of 90–120 min of exercise per day in a hot or mild environment. Increased clinical biomarkers of AKI (CLINICAL) was defined as a serum creatinine increase ≥0.3 mg·dL−1 or estimated glomerular filtration rate (eGFR) reduction >25%. Creatinine similarly increased in the hot environment PreHA (0.35 ± 0.23 mg·dL−1) and PostHA (0.39 ± 0.20 mg·dL−1), with greater increases than the mild environment at both time points (0.11 ± 0.07 mg·dL−1, 0.08 ± 0.06 mg·dL−1, p ≤ 0.001), respectively. CLINICAL occurred in the hot environment PreHA (n = 9, 75%), with fewer participants with CLINICAL PostHA (n = 7, 58%, p = 0.007), and no participants in the mild environment with CLINICAL at either time point. Percent change in plasma volume was predictive of changes in serum creatinine PostHA and percent changes in eGFR both PreHA and PostHA. HA did not mitigate reductions in eGFR nor increases in serum creatinine during high-intensity exercise in the heat, although the number of participants with CLINICAL was reduced PostHA.

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