Hypercalcaemia in Mycobacterium kansasii pulmonary infection

2021 ◽  
Vol 14 (11) ◽  
pp. e245800
Author(s):  
Robert Costigan Flowers ◽  
Javier Ocampo ◽  
Justin Krautbauer ◽  
Warren L Kupin
Keyword(s):  
Pulmonary Infection ◽  
Case Reports ◽  
Kidney Injury ◽  
Disease Status ◽  
Altered Mental Status ◽  
Mycobacterium Kansasii ◽  
End Stage Kidney Disease ◽  
Granulomatous Diseases ◽  
End Stage ◽  
Work Up

A gentleman in his 60s with end-stage kidney disease status post kidney transplantation on prednisone and tacrolimus presented with generalised weakness for 7 days, associated with altered mental status. Investigations revealed pancytopenia, acute kidney injury, hypercalcaemia, decreased parathyroid hormone (PTH) and normal calcitriol levels. CT of the chest showed multifocal lung opacities suspicious for malignancy. Bronchoscopy with biopsy yielded no malignant cells, and bronchoalveolar lavage specimens grew Mycobacterium kansasii. The patient was treated with bisphosphonates, calcitonin and antibiotics for non-tuberculous mycobacteria pulmonary infection, with improvement in serum calcium levels, and was discharged after 5 weeks of hospitalisation.The work-up for hypercalcaemia begins with PTH measurement, and low PTH levels are consistent with malignancy, immobilisation and granulomatous diseases. Hypercalcaemia in the lattermost is classically caused by overproduction of calcitriol by activated macrophages. However, there are case reports of mycobacterial infections with hypercalcaemia despite normal calcitriol levels, supporting the existence of an additional mechanism of hypercalcaemia in granulomatous infections.

Chronic kidney disease, pregnancy and haemodialysis: Case reports from a single centre in Kenya and literature review

2021 ◽  
pp. 1753495X2098540
Author(s):  
Samuel K Kabinga ◽  
Jackline Otieno ◽  
John Ngige ◽  
Seth O Mcligeyo
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Case Reports ◽  
Tertiary Hospital ◽  
Reproductive Age ◽  
Review Of Literature ◽  
Single Centre ◽  
End Stage Kidney Disease ◽  
Women Of Reproductive Age ◽  
End Stage

Chronic kidney disease (CKD) and end stage kidney disease are prevalent even in women of reproductive age. These are known to reduce fertility and successful pregnancy. There are chances of conception even in advanced CKD, though laden with complications. We present two cases of women who conceived in advanced CKD and are on haemodialysis in a tertiary hospital in Kenya and review of literature.

MO436PLASMA OXALATE VALUES IN PATIENTS WITH END-STAGE KIDNEY DISEASE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Ella Metry ◽  
Sander Garrelfs ◽  
Michiel Oosterveld ◽  
Aegida Neradova ◽  
Joost Bijlsma ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Plasma Concentrations ◽  
Maintenance Hemodialysis ◽  
Healthy Individuals ◽  
End Stage Kidney Disease ◽  
Waste Products ◽  
Therapeutic Work ◽  
Reference Limit ◽  
End Stage ◽  
Work Up

Abstract Background and Aims Patients with end-stage kidney disease (ESKD) are known to have higher plasma concentrations of metabolic waste products than healthy individuals. Patients with Primary Hyperoxaluria (PH), a rare congenital cause of ESKD, suffer from hepatic overproduction of the metabolic end product oxalate. Plasma oxalate (POx) levels are determined in the diagnostic and therapeutic work-up for PH. Remarkably, correct interpretation of these values is hampered by the absence of knowledge concerning POx levels in patients with ESKD due to common causes. Method In this observational study, we obtained POx values in patients with ESKD due to another cause than PH, to establish reference values in this patient group. We collected blood samples from 120 adults with eGFR < 15 mL/min/1.73 m2 who required maintenance hemodialysis or peritoneal dialysis at the Amsterdam UMC. Results While there was a wide variation in POx levels in patients with ESKD, the median was 50 umol/L and lowest values were twice the upper reference limit that applies to healthy individuals (6.7 umol/L). Conclusion This study shows that POx levels of 50 umol/L are not necessarily suggestive for PH which contradicts the current literature. This study could lead to a paradigm shift in the diagnostic and therapeutic work-up for patients with ESKD.

Alteration of the gut microbiota by vinegar is associated with amelioration of hyperoxaluria-induced kidney injury

2020 ◽  
Vol 11 (3) ◽  
pp. 2639-2653
Author(s):  
Wei Zhu ◽  
Yang Liu ◽  
Xiaolu Duan ◽  
Chenglin Xiao ◽  
Yu Lan ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Gut Microbiota ◽  
Renal Injury ◽  
Kidney Injury ◽  
End Stage Kidney Disease ◽  
End Stage

Hyperoxaluria is well known to cause renal injury and end-stage kidney disease.

scholarly journals Kidney complications following COVID-19 vaccination; a review of the literature

2021 ◽  
Vol 11 (1) ◽  
pp. e1-e1
Author(s):  
Shakiba Hassanzadeh ◽  
Arjang Djamali ◽  
Leila Mostafavi ◽  
Aiyoub Pezeshgi
Keyword(s):  
Case Reports ◽  
Kidney Injury ◽  
Scleroderma Renal Crisis ◽  
Igg4 Related Disease ◽  
Granulomatous Vasculitis ◽  
Renal Complications ◽  
Potential Risks ◽  
Stage Renal Disease ◽  
End Stage

Objective: To review the reported cases of kidney injury following vaccination for coronavirus disease 2019 (COVID-19) with a focus on renal pathology. Methods: We searched for case reports of kidney complications after COVID-19 vaccine in PubMed. Results: A total of 36 articles including 49 case reports were reported. These included minimal change disease (n=17), IgA nephropathy (IgAN) (n=15), IgA nephritis/vasculitis (n=5), ANCA glomerulonephritis/vasculitis (n=5), anti-glomerular basement membrane (GBM) nephritis (n=2), and 1 case of each granulomatous vasculitis, acute tubulointerstitial nephritis, scleroderma renal crisis, IgG4-related disease nephritis, and primary membranous nephropathy (MN). Conclusion: We give an overview of the reported cases of post-COVID-19 renal complications. Further investigations of the underlying pathogenesis of post-COVID-19 vaccination renal adverse events are required, as prompt workup, diagnosis, and treatment of patients with renal complications may lead to complete remission, prevent kidney failure, and long-term complications such as end-stage renal disease (ESRD). However, these complications are overall extremely rare and the benefit of vaccination outweighs the potential risks.

The effect of chronic renal failure on critical illness

2016 ◽  
Author(s):  
Sinead Kinsella ◽  
John Holian
Keyword(s):  
Critical Illness ◽  
Kidney Disease ◽  
Renal Disease ◽  
Kidney Injury ◽  
Scoring Systems ◽  
Disease Status ◽  
Icu Admission ◽  
Critical Care Management ◽  
End Stage

The incidence of chronic kidney disease (CKD) and end-stage kidney disease (ESKD) is increasing, reflecting an increase in the incidence and prevalence of hypertension and type 2 diabetes. Patients with CKD and ESKD frequently experience episodes of critical illness and require treatment in an intensive care unit (ICU)setting. Management requires specific consideration of their renal disease status together with their acute illness. Mortality in critically-ill patients with ESKD is frequently related to their co-morbid conditions, rather than their ESKD status. Illness severity scoring systems allocate high points for renal variables and tend to overestimate actual mortality. Patients with ESKD and CKD requiring ICU admission have better ICU and in-hospital survival than patients with denovo acute kidney injury requiring renal replacement therapy. Appropriately selected patients benefit from ICU admission and full consideration for ICU care should be given to these patients if required, despite their renal disease status. Cardiovascular disease and sepsis account for the majority of ICU admissions in this population and the aetiology of these conditions differs from that in patients without kidney disease. Optimal critical care management of patients with ESKD and CKD requires that these differences are recognized.

scholarly journals The influence of multiple episodes of acute kidney injury on survival and progression to end stage kidney disease in patients with chronic kidney disease

PLoS ONE ◽  
2019 ◽  
Vol 14 (7) ◽  
pp. e0219828 ◽  
Author(s):  
Lynne Sykes ◽  
Ozgur Asar ◽  
James Ritchie ◽  
Maharajan Raman ◽  
Diana Vassallo ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Kidney Injury ◽  
End Stage Kidney Disease ◽  
End Stage ◽  
Multiple Episodes

Sugammadex: What to Know for Your Daily Practice

2018 ◽  
Vol 69 (2) ◽  
pp. 391-395
Author(s):  
Mirela Tiglis ◽  
Ioana Cristina Grintescu ◽  
Tiberiu Paul Neagu ◽  
Flavia Liliana Turcu ◽  
Andra Maria Cocolos ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Case Reports ◽  
Daily Practice ◽  
High Price ◽  
Receptor Interaction ◽  
Morbidly Obese ◽  
End Stage Kidney Disease ◽  
Muscular Disease ◽  
End Stage ◽  
Moderate Renal Insufficiency

Sugammadex (Bridion) represents a class named muscle relaxant encapsulator. It can be used to reverse the neuromuscular blockade induced by rocuronium or vecuronium in case of general anesthesia. Its molecular weight is 2.178 g/mol, with a structure consisting in a ring of eight negative charges. It has no receptor interaction in human body and it is eliminated via kidney, being contraindicated in end-stage kidney disease patients. Sugammadex has few side effects but there are same case reports about allergic reactions. Only three drugs can actually interact with sugammadex: toremifene, flucloxacillin and fusidic acid. It can be used in elderly and pediatric patients, in morbidly obese patients, patients with hepatic insufficiency or mild and moderate renal insufficiency or in muscular disease. Despite its beneficial use, the high price remains its main issue.

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