scholarly journals Rhabdomyolysis and Acute Kidney Injury due to Severe Heat Stroke

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Máximo H. Trujillo ◽  
Carlos Fragachán G.
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Heat Stroke ◽  
Ventilatory Support ◽  
Kidney Injury ◽  
Multiple Organ ◽  
Strenuous Exercise ◽  
Acute Seizures ◽  
Healthy Female ◽  
Icu Treatment

We present a case of heat stroke (HS) and acute kidney injury (AKI) due to severe rhabdomyolysis in a 14-year-old previously healthy female patient. When she was practicing strenuous exercise she suffered acute seizures and high fever. These symptoms were followed by coma and multiple organ failure (MOF), which included AKI, encephalopathy, fulminant hepatic failure (FHF), and disseminated intravascular coagulation (DIC). The patient was managed in the ICU with renal replacement therapy, ventilatory support, and other vital supporting measures. After three weeks of ICU treatment she made a full recovery.

Renal support therapy

2021 ◽  
pp. 338-350
Author(s):  
Claudio Ronco ◽  
Stefano Romagnoli ◽  
Zaccaria Ricci
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Multiple Organ Failure ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Multiple Organ ◽  
Acute Illness ◽  
Renal Support Therapy ◽  
Critical Patients ◽  
Renal Support

Renal dysfunction is known to be frequently a component of multiple organ failure, a complex syndrome affecting the most severely ill critical patients. Bidirectional interaction between the kidneys and other organs has always been suspected; evidence suggests that severe kidney injury is an important protagonist in acute illness, even when managed by dialysis. In fact, if it seems that increasing the dose of renal replacement therapy does not reduce mortality, it could be inferred that acute kidney injury influences mortality through means that are not reversed by conventional renal support, either because the putative culprit toxins are not removed by renal replacement therapy or because renal replacement therapy is started too late to prevent these effects. It is known that the kidneys exert effects on other organs, such as the lung, liver, heart, and brain, in a process called 'crosstalk'. This effect means that the kidney is not only a victim, but also a culprit regarding the malfunction of other organs. This chapter will detail some traditional aspects of different renal replacement therapy modalities and prescription schedules, but it will also describe the most recent evidence on the management and support of the kidney during failure of other organs.

Renal support therapy

2016 ◽  
Author(s):  
Claudio Ronco ◽  
Zaccaria Ricci
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Multiple Organ Failure ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Multiple Organ ◽  
Acute Illness ◽  
Renal Support Therapy ◽  
Critical Patients ◽  
Renal Support

Renal dysfunction is known to be frequently a component of multiple organ failure, a complex syndrome affecting the most severely ill critical patients. Bidirectional interaction between the kidneys and other organs has always been suspected; evidence suggests that severe kidney injury is an important protagonist in acute illness, even when managed by dialysis. In fact, if it seems that increasing the dose of renal replacement therapy does not reduce mortality, it could be inferred that acute kidney injury influences mortality through means that are not reversed by conventional renal support, either because the putative culprit toxins are not removed by renal replacement therapy or because renal replacement therapy is started too late to prevent these effects. It is known that the kidneys exert effects on other organs, such as the lung, liver, heart, and brain, in a process called ‘crosstalk’. This effect means that the kidney is not only a victim, but also a culprit regarding the malfunction of other organs. This chapter will detail some traditional aspects of different renal replacement therapy modalities and prescription schedules, but it will also describe the most recent evidence on the management and support of the kidney during failure of other organs.

Renal support therapy

2015 ◽  
Author(s):  
Claudio Ronco ◽  
Zaccaria Ricci
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Multiple Organ Failure ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Multiple Organ ◽  
Acute Illness ◽  
Renal Support Therapy ◽  
Critical Patients ◽  
Renal Support

Renal dysfunction is known to be frequently a component of multiple organ failure, a complex syndrome affecting the most severely ill critical patients. Bidirectional interaction between the kidneys and other organs has always been suspected; evidence suggests that severe kidney injury is an important protagonist in acute illness, even when managed by dialysis. In fact, if it seems that increasing the dose of renal replacement therapy does not reduce mortality, it could be inferred that acute kidney injury influences mortality through means that are not reversed by conventional renal support, either because the putative culprit toxins are not removed by renal replacement therapy or because renal replacement therapy is started too late to prevent these effects. It is known that the kidneys exert effects on other organs, such as the lung, liver, heart, and brain, in a process called ‘crosstalk’. This effect means that the kidney is not only a victim, but also a culprit regarding the malfunction of other organs. This chapter will detail some traditional aspects of different renal replacement therapy modalities and prescription schedules, but it will also describe the most recent evidence on the management and support of the kidney during failure of other organs.

P1123HEMOPERFUSION COMBINED WITH CRRT IN SEPTIC SHOCK AKI PATIENTS CAUSED BY OSTEOFASCIAL COMPARTMENT SYNDROME

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Xiaohua Sheng ◽  
Niansong Wang ◽  
Weifeng Huang ◽  
Gang Yu ◽  
Hongda Bao ◽  
...  
Keyword(s):  
Septic Shock ◽  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Compartment Syndrome ◽  
Blood Circulation ◽  
Kidney Injury ◽  
Lower Leg ◽  
Multiple Organ ◽  
History Of ◽  
The Right

Abstract Background and Aims Although Osteofascial compartment syndrome is rare, it can cause severe complications, including septic shock and acute kidney injury. Most commonly found on the palmar side of the forearm and lower leg. This article reported two cases of septic shock with acute kidney injury caused by osteofascial compartment syndrome, and explored the application of hemoperfusion combined with continuous renal replacement therapy in these two severe patients. Method Two young men, patient A was 38 years old and patient B was 44 years old. Hospitalized in June 2016 and February 2018, respectively. Previous healthy, after questioning, patient A had a history of type 1 diabetes and patient B had a history of gout. Patient A had a history of being beaten by his wife, patient B has no clear history of injury. Patient A showed swelling and pain in the right forearm and patient B showed swelling and pain in the right lower leg. After admission, they quickly developed shock, oliguria, acute kidney injury, multiple organ dysfunction. They were received fluid resuscitation, vasopressors, anti-infectives, respiratory support, nutritional support, and vital signs monitoring. Blood culture of patient A showed a case of group A hemolytic streptococcus, patient B showed streptococcus pyogenes and staphylococcus hemolytic. Patient A was performed CRRT for 3 days, combined with two hours hemoperfusion (HA-330, Jafron, Zhuhai City, China) on the first day of CRRT, once every 24 hours for two days. Patient B was performed CRRT for 16 days. combined with two hours hemoperfusion (HA-330, Jafron, Zhuhai City, China) on the first day of CRRT, once every 24 hours for two days. Both patients underwent multiple orthopaedic surgeries. Patient A underwent right upper limb amputation and patient B underwent right thigh amputation. Results After hemoperfusion, the amount of norepinephrine was significantly reduced, and the circulation became stable. Finally, two patients improved and were discharged from the hospital, and their renal function returned to normal. Conclusion Once the osteofascial compartment syndrome is diagnosed, the fascia should be decompressed immediately. After local incision and decompression, blood circulation is improved, and a large number of toxins from necrotic tissue enter the blood circulation, which can lead to serious complications such as sepsis, shock, acute kidney injury, and multiple organ failure. Renal replacement therapy and amputation surgery may save lives. Hemoperfusion can reduce the amount of norepinephrine, improve circulation and win surgical opportunities.

scholarly journals Clinical characteristics and outcome of critically ill COVID-19 patients with Acute Kidney Injury: A single centre cohort study

2020 ◽  
Author(s):  
Richard Lowe ◽  
Matteo Ferrari ◽  
Myra Nasim-Mohi ◽  
Alexander Jackson ◽  
Ryan Meacham ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Cohort Study ◽  
Intensive Care ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Critically Ill ◽  
Ventilatory Support ◽  
Kidney Injury ◽  
Hospital Length Of Stay

Abstract BackgroundAcute kidney injury (AKI) is a common manifestation among patients critically ill with SARS-CoV-2 infection (Coronavirus 2019) and is associated with significant morbidity and mortality. The pathophysiology of renal failure in this context is not fully understood, but likely to be multifactorial. The intensive care unit outcomes of patients following COVID-19 acute critical illness with associated AKI have not been fully explored. We conducted a cohort study to investigate the risk factors for acute kidney injury in patients admitted to and intensive care unit with COVID-19, its incidence and associated outcomes.MethodsWe reviewed the medical records of all patients admitted to our adult intensive care unit suffering from SARS-CoV-2 infection from 3rd March 2020 until 10th May 2020. Acute kidney injury was defined using the Kidney Disease Improving Global Outcome (KDIGO) criteria. The outcome analysis was assessed up to date as 15th of June 2020.ResultsA total of 81 patients admitted during this period. All patients had acute hypoxic respiratory failure and needed either noninvasive or invasive mechanical ventilatory support. Thirty-six patients (44%) had evidence of AKI (Stage I-33%, Stage II-22%, Renal Replacement Therapy (RRT)-44%). All patients with AKI stage III had RRT. Age, diabetes mellitus, immunosuppression, lymphopenia, high D-Dimer levels, increased APACHE II and SOFA scores, mechanical ventilation and use of inotropic or vasopressor support were significantly associated with AKI. The peak AKI was at day 4 and mean duration of RRT was 9 days. The mortality was 25% for the AKI group compared to 7% in those without AKI. Among those received RRT and survived their illness, the renal function recovery is complete and back to baseline in 92% of patients. Conclusion Acute kidney injury and renal replacement therapy is common in critically ill patients presenting with COVID-19. It is associated with increased severity of illness on admission to ICU, increased mortality and prolonged ICU and hospital length of stay.

scholarly journals Delayed Admission and Management of Pediatric Acute Kidney Injury and Multiple Organ Dysfunction Syndrome in Children with Multiple Wasp Stings: A Case Series

2019 ◽  
Vol 9 (3) ◽  
pp. 137-148 ◽  
Author(s):  
Cahyani Gita Ambarsari ◽  
Risti Maulani Sindih ◽  
Meilania Saraswati ◽  
Partini Pudjiastuti Trihono
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Organ Dysfunction ◽  
Steroid Therapy ◽  
Kidney Injury ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
First Case ◽  
Wasp Stings

Multiple wasp stings may cause fatal complications, such as anaphylactic reactions, intravascular hemolysis, rhabdomyolysis, acute kidney injury (AKI), increased levels of liver enzymes, clotting abnormalities, or even death. AKI-related mortality due to multiple wasp stings may reach 25%, occurring within the early onset of disease; therefore, renal function should be continuously monitored within the first few days following the stings. Herein, we report 2 cases of AKI due to multiple stings of wasp (Vespa affinis). In both cases, delayed hospital admissions and gradual loss of kidney function along with hemolysis and anemia without rhabdomyolysis were observed. Diuresis was reduced on the 10th day following the stings in the first case, whereas it occurred on the 5th day in the second case. Both cases had biopsy results of acute tubular injury and acute interstitial nephritis. The first case improved with intermittent hemodialysis, whereas the second required continuous renal replacement therapy and plasma exchange because hemolysis was more severe, which was presumably caused by a greater number of stings and larger amount of toxins involved. Multiple organ dysfunction syndrome was also observed in the second case; hence, high-dose steroid therapy was administered to alleviate interstitial fibrosis. Both cases showed that although AKI occurring after multiple wasp stings usually have fatal consequences. Administering fluid treatment and steroid therapy and selecting accurate renal replacement therapy modalities during the few first days after the stings may result in favorable long-term outcomes.

scholarly journals Primary Injuries and Secondary Organ Failures in Trauma Patients with Acute Kidney Injury Treated with Continuous Renal Replacement Therapy

Scientifica ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Sigrid Beitland ◽  
Ingrid Os ◽  
Kjetil Sunde
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Multiple Organ Failure ◽  
Replacement Therapy ◽  
Organ Failure ◽  
Kidney Injury ◽  
Multiple Organ ◽  
Trauma Patients ◽  
Organ Failures

Background. Acute kidney injury (AKI) treated with continuous renal replacement therapy (CRRT) is a severe complication in trauma patients. The aim of the study was to assess primary traumatic injuries and secondary organ failures in severe posttraumatic AKI.Methods. Retrospective review of adult trauma patients admitted to the trauma centre at Oslo University Hospital Ullevål. Injury severity score (ISS) was used to assess the severity of primary injuries, and sequential organ failure assessment (SOFA) score was utilized to measure secondary organ failures.Results. Forty-two (8%) of 506 trauma patients admitted to intensive care unit developed AKI treated with CRRT, whereof 40 (95%) suffered blunt trauma mechanisms. Patients had extensive primary organ injuries with median (interquartile range) ISS 36 (27–49). The majority of the patients had respiratory (93% intubated) and cardiovascular (67% with inotropic and/or vasoactive medication) failure within 24 hours after admission. AKI was often part of multiple organ failure, most frequently respiratory and cardiovascular failure, affecting 33 (75%) and 30 (71%) of the patients, respectively.Conclusion. Trauma patients with AKI undergoing CRRT often had severe primary injuries due to blunt trauma. Most of them suffered from secondary multiple organ failure concomitant to AKI.

Renal support therapy

2018 ◽  
Author(s):  
Claudio Ronco ◽  
Zaccaria Ricci
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Multiple Organ Failure ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Multiple Organ ◽  
Acute Illness ◽  
Renal Support Therapy ◽  
Critical Patients ◽  
Renal Support

Renal dysfunction is known to be frequently a component of multiple organ failure, a complex syndrome affecting the most severely ill critical patients. Bidirectional interaction between the kidneys and other organs has always been suspected; evidence suggests that severe kidney injury is an important protagonist in acute illness, even when managed by dialysis. In fact, if it seems that increasing the dose of renal replacement therapy does not reduce mortality, it could be inferred that acute kidney injury influences mortality through means that are not reversed by conventional renal support, either because the putative culprit toxins are not removed by renal replacement therapy or because renal replacement therapy is started too late to prevent these effects. It is known that the kidneys exert effects on other organs, such as the lung, liver, heart, and brain, in a process called ‘crosstalk’. This effect means that the kidney is not only a victim, but also a culprit regarding the malfunction of other organs. This chapter will detail some traditional aspects of different renal replacement therapy modalities and prescription schedules, but it will also describe the most recent evidence on the management and support of the kidney during failure of other organs.

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