Mixed histology bladder cancer as a complication of clam ileocystoplasty

2021 ◽  
Vol 14 (1) ◽  
pp. e238818
Author(s):  
Lawrence Nip ◽  
Emil Salmo ◽  
Raveendra Surange ◽  
John Calleary
Keyword(s):  
Histological Analysis ◽  
Transitional Cell ◽  
Kidney Injury ◽  
Tissue Mass ◽  
Long Term Follow Up ◽  
Ct Urogram ◽  
Clam Ileocystoplasty ◽  
Mixed Histology

A 58-year-old woman with a previous clam ileocystoplasty was referred to the urology department for the investigation of haematuria. CT urogram showed a large left-sided soft tissue mass arising from the bladder. Histological analysis of the shavings from transurethral resection revealed a G3pT2 transitional cell carcinoma and T4N1Mx adenocarcinoma. The patient was referred to oncology for the discussion of palliative chemotherapy; however, in the interim she deteriorated and was admitted to hospital with a post-renal acute kidney injury. A right-sided nephrostomy was inserted relieving her obstruction and she subsequently made a good recovery. This case report illustrates the difficulties in the long-term follow-up of patients having undergone what is now a rarely performed procedure. In the absence of regular cystoscopic follow-up post ileocystoplasty, malignancy may present late and with complications from advanced disease.

Fifteen-minute consultation: how to identify and treat children with acute kidney injury

2021 ◽  
pp. edpract-2020-319928
Author(s):  
Maura Scott ◽  
Grace McCall
Keyword(s):  
Acute Kidney Injury ◽  
Fluid Management ◽  
Kidney Injury ◽  
Case Presentation ◽  
Mortality And Morbidity ◽  
Fluid Status ◽  
Close Observation ◽  
Long Term Follow Up

Acute kidney injury (AKI) is under-recognised in children and neonates. It is associated with increased mortality and morbidity along with an increased incidence of chronic kidney disease in adulthood. It is important that paediatricians are able to recognise AKI quickly, enabling prompt treatment of reversible causes. In this article, we demonstrate an approach to recognising paediatric AKI, cessation of nephrotoxic medication, appropriate investigations and the importance of accurately assessing fluid status. The mainstay of treatment is attempting to mimic the kidneys ability to provide electrolyte and fluid homeostasis; this requires close observation and careful fluid management. We discuss referral to paediatric nephrology and the importance of long-term follow-up. We present an approach to AKI through case-presentation.

Abstract 15934: Higher Midlife Serum Levels of Kidney-injury Molecule-1 (KIM-1) are Associated With Incident Fatal CHD Over Very Long-term Follow-up Among Men

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Rachel H Mackey ◽  
Greg G Grandits ◽  
Lewis H Kuller ◽  
Joel Estis ◽  
John A Todd ◽  
...  
Keyword(s):  
Risk Factor ◽  
Limit Of Detection ◽  
Kidney Injury ◽  
Multiple Risk Factor ◽  
Serum Samples ◽  
Increased Risk ◽  
Long Term Follow Up ◽  
Kidney Injury Molecule 1

Introduction: Higher levels of kidney-injury molecule-1 (KIM-1) measured in urine are associated with presence and progression of acute renal disease. A recent study reported similar results for KIM-1 measured in blood. Hypothesis: We hypothesized that KIM-1 measured in stored serum from middle-aged men who participated in the Multiple Risk Factor Intervention Trial (MRFIT) would differentiate very long-term risk of fatal CHD vs. survival to a mean age of 80 over approximately 30 year follow-up. Methods: We conducted a nested case-control study within MRFIT, which in 1973-76 randomized 12,866 high risk but CVD free men ages 35-57 to risk factor intervention vs. usual care. Serum samples were collected at baseline and stored for future use. The trial concluded in 1982 but long-term mortality follow-up was ascertained through 2005 using the National Death Index. From MRFIT participants with stored serum from baseline, we sampled 100 men who died of CHD (mean age 47.3 at baseline and 73.9 at death), and 100 men who survived to 2005 (mean age =48.4 at baseline and 80.1 in 2005.) KIM-1 was assayed from stored serum samples using high sensitivity single-molecule counting technology (Erenna ® Immunoassay System, Singulex), with limit of detection (LoD)=0.5 pg/ml, and lower limit of quantification (LLoQ)=2.0 pg/ml. Results were compared between cases and controls using Wilcoxon rank tests and logistic regression. Results: Inter-assay %CVs were 8%. Median KIM-1 was higher for smokers vs. non-smokers and for men with vs. without hypertension, but was not associated with high cholesterol. KIM-1 was significantly higher in cases (183 pg/ml (IQR: 137-239) versus controls, (161 pg/ml (IQR:109-212), p=0.03; OR (95%CI)for Q4 versus Q1 was 2.26 (1.02 - 5.02) Adjusted for age and smoking the OR(95%CI) of fatal CHD for Q4 vs. Q1 was 2.34 (1.02- 5.37), and further adjusted for diastolic BP and serum cholesterol at baseline, was 2.0 (95% CI: 0.8-4.7). Conclusions: Higher serum KIM-1 levels at midlife were associated with a ∼2-fold increased risk of fatal CHD vs. survival over ∼30 years of follow-up. This is the first report of a longitudinal association of circulating KIM-1 levels with fatal CHD in long-term follow-up.

Long-Term Follow-up of Patients with Stage T1 High-Grade Transitional Cell Carcinoma Managed by Bacille Calmette-Guérin Immunotherapy

Urology ◽  
2007 ◽  
Vol 69 (1) ◽  
pp. 78-82 ◽  
Author(s):  
David Margel ◽  
Raanan Tal ◽  
Shai Golan ◽  
Dani Kedar ◽  
Dov Engelstein ◽  
...  
Keyword(s):  
Transitional Cell Carcinoma ◽  
Cell Carcinoma ◽  
Transitional Cell ◽  
High Grade ◽  
Bacille Calmette Guerin ◽  
Long Term Follow Up ◽  
Stage T1

scholarly journals Kidney Damage After Sepsis: A Long-term Follow-up. An Experimental Study.

2021 ◽  
Author(s):  
Ana Maria Alvim Liberatore ◽  
Giovana C. Obara ◽  
Rodrigo Barbosa de Souza ◽  
Luara L. Cassiano ◽  
Ivan Hong Jun Koh
Keyword(s):  
Kidney Injury ◽  
Control Group ◽  
E Coli ◽  
Renal Histology ◽  
Long Term Follow Up ◽  
The Face ◽  
Sepsis Survivors ◽  
Long Term Impact

Abstract Background: Acute kidney injury (AKI) in sepsis is a common event. This study aims to evaluate the long-term impact of sepsis on renal hemodynamics and morphology. Methods: Wistar rats underwent sepsis and survivors (n = 24) were followed for up to six months, monitoring macro, regional and micro hemodynamics of the kidney, serum creatinine, and renal histology. The naive animals were used as the control group (n= 6), and sepsis was induced by E. coli e.v. inoculation. Surviving animals were monitored for up to six months. Results: Overall, the findings show that sepsis survivors have long-term hemodynamic and morphological compromise, as well as a progressive worsening of renal functional unit components over time. Even after six months of recovery from sepsis, severe renal hypoxia, chronic inflammation, evidence of increased vascular resistance, and renal fibrosis were observed in surviving animals. These alterations were present in animals with a healthy appearance and normal MAP. Conclusion: Those findings may represent a state of severely impaired physiology and be a contributing factor to the higher susceptibility to renal failure in the face of a new infectious challenge or to other pathological stimuli in the post-sepsis periods.

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