Is the Presence of a Solitary Kidney an Independent Risk Factor for Acute Kidney Injury after Contrast-enhanced CT?

<p>A critical appraisal and clinical application of Tao SM, Kong X, Schoepf UJ, et al. Acute kidney injury in patients with nephrotic syndrome undergoing contrast-enhanced CT for suspected venous thromboembolism: a propensity score-matched retrospective cohort study. <em>European Radiology</em>. 2018;28(4):1585-1593. doi: <a href="https://doi.org/10.1007/s00330-017-5109-0">10.1007/s00330-017-5109-0</a></p>

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Giant bladder stone resulting in acute kidney injury; a case report and review of literature

10.21203/rs.3.rs-1229208/v1 ◽

2022 ◽

Author(s):

Feysel Hassen Issack ◽

Kaleab Habtemichael Gebresellasie ◽

Fitsum Gebreegziabher Gebrehiwot ◽

Mubarek Bargicho Adem ◽

Ferid Ousman Mummed ◽

...

Keyword(s):

Acute Kidney Injury ◽

Wound Care ◽

Kidney Injury ◽

Bladder Stone ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Urinary Tract Symptoms ◽

Lower Urinary

Abstract A giant bladder stone is very rare in adults. We report a case of giant bladder stone causing acute kidney injury in a 23-year-old male, who presented with lower urinary tract symptoms (LUTS) characterized by both irritative and obstructive LUTS. In addition, he also had episodes of reddish urine for the past decade. A non-contrast-enhanced CT scan was used for the diagnosis. Open cystolithotomy was performed and a 500g weighing stone was removed. He developed a superficial surgical site infection which was treated with wound care. He was discharged improved. Improvement in symptoms and serum creatinine was noted on follow-up.

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Abstract 504: Cystatin-C Risk-Stratifies Patients for Acute Kidney Injury and 1-Year Major Vascular Events Following Contrast -Enhanced CT Imaging in the Emergency Care Setting

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvb.35.suppl_1.504 ◽

2015 ◽

Vol 35 (suppl_1) ◽

Author(s):

Alice M Mitchell ◽

Jeffrey A Kline ◽

Roxanne Y Williams ◽

David P Basile ◽

Shawn D Teague ◽

...

Keyword(s):

Acute Kidney Injury ◽

Cystatin C ◽

Emergency Care ◽

Care Setting ◽

Kidney Injury ◽

Ct Imaging ◽

Vascular Events ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct

Background: Despite poor sensitivity in acutely ill patients, serum creatinine (and estimated glomerular filtration rate [eGFR SCR ]) remains the sole means of risk-stratifying patients for acute kidney injury (AKI) prior to contrast-enhanced CT imaging (CECT). Hypothesis: We hypothesized that an acute phase marker of renal dysfunction, cystatin-C (expressed as eGFR CYS ), would more accurately predict contrast-induced nephropathy (CIN) than eGFR SCR . Given the risk of arterial vascular events subsequent to AKI, we also evaluated eGFR CYS in risk-stratifying patients for major adverse events (MAE) within 1 year of CECT. Methods: We followed 462 consecutive adults, without end-stage renal disease, undergoing CECT (any indication) in the outpatient, emergency care setting for CIN and 1-year MAE: death, renal failure, myocardial infarction, stroke, and/or peripheral vascular event requiring intervention (blinded, adjudicated outcome). We excluded patients with life-threatening CECT indications and collected serum for eGFR SCR and eGFR CYS prior to CECT. Predictive accuracy was defined as the area under the receiver operating characteristic curve (AUROC) and likelihood ratios (LR+ and LR-). A threshold of ≤60 ml/min/m 2 defined an abnormal eGFR SCR or eGFR CYS . Results: CIN occurred in 14% and a MAE in 17% (low observer variability, κ>0.9) of our heterogeneous population: mean age 50 yrs (±16 yrs), 51% discharged after CECT, 16% with diabetes mellitus (DM), and only 16% with eGFR SCR ≤60ml/min/m 2 . CIN was associated with 1-year MAE: RR 2.4 (1.5-4.0) after adjusting for age and existing co-morbidities (active malignancy, CHF, DM, and CAD). The AUROC, LR+ and LR- for eGFR SCR were 0.55 (0.47-0.63), 0.9 (0.4-2.1) and 1.0 (0.9-1.1). In comparison, the AUROC, LR+, and LR- for eGFR CYS were 0.79 (0.62-0.96), 5.5 (3.9-7.6) and 0.43 (0.31-0.57), respectively. The MAE rate did not differ in patients with normal (13%) or abnormal (15%, p=0.5) pre-CECT eGFR SCR . Whereas, an abnormal eGFR SCR was associated with a 29% (p<0.01) increase in MAE. Conclusions: In patients undergoing CECT in the outpatient setting, eGFR CYS more accurately predicted CIN and more effectively risk-stratified patients for 1-year MAE than eGFR SCR . These findings warrant prospective validation.

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Giant bladder stone resulting in acute kidney injury; a case report and review of literature

10.21203/rs.3.rs-1229208/v2 ◽

2022 ◽

Author(s):

Fitsum Gebreegziabher Gebrehiwot ◽

Mubarek Bargicho Adem ◽

Feysel Hassen Issack ◽

Kaleab Habtemichael Gebresellasie ◽

Ferid Ousman Mummed ◽

...

Keyword(s):

Acute Kidney Injury ◽

Wound Care ◽

Kidney Injury ◽

Bladder Stone ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Urinary Tract Symptoms ◽

Lower Urinary

Abstract A giant bladder stone is very rare in adults. We report a case of giant bladder stone causing acute kidney injury in a 23-year-old male, who presented with lower urinary tract symptoms (LUTS) characterized by both irritative and obstructive LUTS. In addition, he also had episodes of reddish urine for the past decade. A non-contrast-enhanced CT scan was used for the diagnosis. Open cystolithotomy was performed and a 500g weighing stone was removed. He developed a superficial surgical site infection which was treated with wound care. He was discharged improved. Improvement in symptoms and serum creatinine was noted on follow-up.

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Contrast-Induced Acute Kidney Injury: Definition, Epidemiology, and Outcome

BioMed Research International ◽

10.1155/2014/859328 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 25

Author(s):

Felix G. Meinel ◽

Carlo N. De Cecco ◽

U. Joseph Schoepf ◽

Richard Katzberg

Keyword(s):

Acute Kidney Injury ◽

Renal Function ◽

Renal Insufficiency ◽

Time Window ◽

Contrast Material ◽

Kidney Injury ◽

Preventive Strategy ◽

Iodinated Contrast ◽

Contrast Enhanced Ct ◽

Contrast Enhanced

Contrast-induced acute kidney injury (CI-AKI) is commonly defined as a decline in kidney function occurring in a narrow time window after administration of iodinated contrast material. The incidence of AKI after contrast material administration greatly depends on the specific definition and cutoff values used. Although self-limiting in most cases, postcontrast AKI carries a risk of more permanent renal insufficiency, dialysis, and death. The risk of AKI from contrast material, in particular when administered intravenously for contrast-enhanced CT, has been exaggerated by older, noncontrolled studies due to background fluctuations in renal function. More recent evidence from controlled studies suggests that the risk is likely nonexistent in patients with normal renal function, but there may be a risk in patients with renal insufficiency. However, even in this patient population, the risk of CI-AKI is probably much smaller than traditionally assumed. Since volume expansion is the only preventive strategy with a convincing evidence base, liberal hydration should be encouraged to further minimize the risk. The benefits of the diagnostic information gained from contrast-enhanced examinations will still need to be balanced with the potential risk of CI-AKI for the individual patient and clinical scenario.

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Incidence and Predictors of Acute Kidney Injury Among Women With Severe Pre-eclampsia at Mbarara Regional Referral Hospital

10.21203/rs.3.rs-1093153/v1 ◽

2021 ◽

Author(s):

Mariam Hassan ◽

Roland Mayanja ◽

Wasswa G.M Ssalongo ◽

Natumanya Robert ◽

Lugobe Henry Mark ◽

...

Keyword(s):

Acute Kidney Injury ◽

Risk Factor ◽

Serum Creatinine ◽

Independent Risk Factor ◽

Statistical Significance ◽

Kidney Injury ◽

Referral Hospital ◽

Chronic Hypertension ◽

Baseline Serum ◽

Regional Referral Hospital

Abstract BackgroundThe presence of acute kidney injury (AKI) in pre-eclampsia complicates treatment including; increasing length of hospital stay and a need to access services like dialysis which are largely expensive in resource-limited settings. We aimed to determine incidence and predictors of acute kidney injury among women with severe pre-eclampsia at Mbarara Regional Referral Hospital in southwestern Uganda. MethodsWe carried out a hospital-based prospective cohort study from 16 November 2018 to 18 April 2019, among pregnant women with severe preeclampsia followed up in the hospital. We enrolled 70 mothers with severe pre-eclampsia and eclampsia; we excluded patients with a history of chronic renal disease, chronic hypertension, and gestational hypertension.Data on socio-demographics, laboratory parameters, health system, obstetric and medical factors were collected. Baseline serum creatinine, complete blood count, and CD4 T-cell count were all done at admission (0-hour). Second serum creatinine was done at 48-hours to determine the presence of AKI. AKI was defined as a rise in serum creatinine of 0.3mg/dl or more from the baseline. The proportion of women diagnosed with acute kidney injury among the total number of women with severe pre-eclampsia was reported as incidence proportion. Univariate and multivariate logistic regression was used to establish the association of acute kidney injury and severe pre-eclampsia.ResultsIncidence of acute kidney injury was high (41.4%) among women with severe pre-eclampsia. Antenatal care attendance was protective 0.36 (0.16, 0.80), p<0.013 at bivariate analysis but had no statistical significance at multivariate analysis. Eclampsia was an independent risk factor for acute kidney injury. (aRR 2.74 (1.06, 7.08), P<0. 037.ConclusionThe incidence of acute kidney injury in patients with preeclampsia is high. Eclampsia is an independent risk factor of acute kidney injury.

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