Acute Kidney Injury and Atypical Features during Pediatric Poststreptococcal Glomerulonephritis

The most common acute glomerulonephritis in children is poststreptococcal glomerulonephritis (PSGN) usually occurring between 3 and 12 years old. Hypertension and gross hematuria are common presenting symptoms. Most PSGN patients do not experience complications, but rapidly progressive glomerulonephritis and hypertensive encephalopathy have been reported. This paper reports 17 patients seen in 1 year for PSGN including 4 with atypical PSGN, at a pediatric tertiary care center. Seventeen children (11 males), mean age of 8 years, were analyzed. Ninety-four percent had elevated serum BUN levels and decreased GFR. Four of the hospitalized patients had complex presentations that included AKI along with positive ANA or ANCAs. Three patients required renal replacement therapy and two were thrombocytopenic. PSGN usually does not occur as a severe nephritis. Over the 12-month study period, 17 cases associated with low serum albumin in 53%, acute kidney injury in 94%, and thrombocytopenia in 18% were treated. The presentation of PSGN may be severe and in a small subset have associations similar to SLE nephritis findings including AKI, positive ANA, and hematological anomalies.

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Clinical profile and outcomes of acute kidney injury patients in an intensive care unit in India

International Journal of Clinical Trials ◽

10.18203/2349-3259.ijct20204481 ◽

2020 ◽

Vol 7 (4) ◽

pp. 245

Author(s):

Vivek S. Narayan Pillai ◽

C. Joe Varghese ◽

Christopher C. Pais ◽

Vijay Gopal Rai ◽

Mahabala Chakrapani

Keyword(s):

Intensive Care Unit ◽

Acute Kidney Injury ◽

Intensive Care ◽

Mortality Rate ◽

Care Center ◽

Tertiary Care ◽

Kidney Injury ◽

Clinical Profile ◽

Treatment Modalities ◽

Presenting Symptoms

Background: The limited epidemiological and outcome data of acute kidney injury (AKI) is available in developing countries. The current single-center study determined the clinical profile of AKI by attempting to identify the presenting symptoms, etiologies, treatment modalities, and disease prognosis in patients admitted in intensive care unit at a tertiary care center in Mangalore, India.Methods: This retrospective study enrolled 70 AKI patients between October 2001 and October 2003, admitted at Wenlock district hospital, Mangalore, KMC hospital Attawar, Mangalore and KMC hospital, Jyothi circle, Mangalore, having a serum creatinine level greater than 1.4 mg/dl and blood urea greater than 53 mg/dl.Results: Amongst the enrolled patients, 45.7% of patients were 40-60 years old and 49 were males with no significant (p=0.412) gender difference. The most common presenting symptom was diminished micturition present in 47.1% of patients and the most common etiology of AKI was sepsis found in 27.1% of patients with the highest (17.1%) mortality. Amongst the patients who underwent conservative treatment (n=52) the mortality rate was 42.8%, while in those who underwent hemodialysis (n=18) the mortality rate was 4.2%. The overall survival rate in the study was 52.9%.Conclusions: The epidemiological data obtained in this study is similar to the previous studies in India with hemodialysis appearing to have better disease outcomes compared to conservative therapy.

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Preoperative Albuminuria and Intraoperative Chloride Load: Predictors of Acute Kidney Injury Following Major Abdominal Surgery

Journal of Clinical Medicine ◽

10.3390/jcm7110431 ◽

2018 ◽

Vol 7 (11) ◽

pp. 431 ◽

Cited By ~ 5

Author(s):

Diamantina Marouli ◽

Kostas Stylianou ◽

Eleftherios Papadakis ◽

Nikolaos Kroustalakis ◽

Stavroula Kolyvaki ◽

...

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Abdominal Surgery ◽

Care Center ◽

Chronic Kidney Disease Stage ◽

Tertiary Care ◽

Kidney Injury ◽

Major Abdominal Surgery ◽

Disease Stage ◽

Postoperative Aki

Background: Postoperative Acute Kidney Injury (AKI) is a common and serious complication associated with significant morbidity and mortality. While several pre- and intra-operative risk factors for AKI have been recognized in cardiac surgery patients, relatively few data are available regarding the incidence and risk factors for perioperative AKI in other surgical operations. The aim of the present study was to determine the risk factors for perioperative AKI in patients undergoing major abdominal surgery. Methods: This was a prospective, observational study of patients undergoing major abdominal surgery in a tertiary care center. Postoperative AKI was diagnosed according to the Acute Kidney Injury Network criteria within 48 h after surgery. Patients with chronic kidney disease stage IV or V were excluded. Logistic regression analysis was used to evaluate the association between perioperative factors and the risk of developing postoperative AKI. Results: Eleven out of 61 patients developed postoperative AKI. Four intra-operative variables were identified as predictors of AKI: intra-operative blood loss (p = 0.002), transfusion of fresh frozen plasma (p = 0.004) and red blood cells (p = 0.038), as well as high chloride load (p = 0.033, cut-off value > 500 mEq). Multivariate analysis demonstrated an independent association between AKI development and preoperative albuminuria, defined as a urinary Albumin to Creatinine ratio ≥ 30 mg·g−1 (OR = 6.88, 95% CI: 1.43–33.04, p = 0.016) as well as perioperative chloride load > 500 mEq (OR = 6.87, 95% CI: 1.46–32.4, p = 0.015). Conclusion: Preoperative albuminuria, as well as a high intraoperative chloride load, were identified as predictors of postoperative AKI in patients undergoing major abdominal surgery.

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Acute kidney injury: A pediatric experience over 10 years at a tertiary care center

Journal of Nephropathology ◽

10.5812/nephropathol.7534 ◽

2012 ◽

Vol 1 (2) ◽

pp. 101-108 ◽

Cited By ~ 15

Author(s):

Alaleh Gheissari ◽

Pardis Mehrasa ◽

Alireza Merrikhi ◽

Yahya Madihi

Keyword(s):

Acute Kidney Injury ◽

Care Center ◽

Tertiary Care ◽

Kidney Injury ◽

Tertiary Care Center

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Statins and Incidence of Contrast-Induced Acute Kidney Injury Following Coronary Angiography - Five Year Experience at a Tertiary Care Center

Cardiovascular Revascularization Medicine ◽

10.1016/j.carrev.2018.09.012 ◽

2019 ◽

Vol 20 (8) ◽

pp. 654-658

Author(s):

Jayakumar Sreenivasan ◽

Muhammad Shahzeb Khan ◽

Heyi Li ◽

Min Zhuo ◽

Axi Patel ◽

...

Keyword(s):

Acute Kidney Injury ◽

Coronary Angiography ◽

Care Center ◽

Tertiary Care ◽

Kidney Injury ◽

Tertiary Care Center

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Epidemiology and outcomes of community-acquired-acute kidney injury in women: A study from tertiary care center in South India

Journal of Renal Nutrition and Metabolism ◽

10.4103/jrnm.jrnm_3_21 ◽

2021 ◽

Vol 7 (1) ◽

pp. 21

Author(s):

Manjusha Yadla ◽

Pradeep Khandavali

Keyword(s):

Acute Kidney Injury ◽

South India ◽

Care Center ◽

Tertiary Care ◽

Kidney Injury ◽

Tertiary Care Center

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1481. A Study for Risk Factors of Acute Kidney Injury in Leptospirosis in a Tertiary Health Center in South India

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1345 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S540-S540

Author(s):

Bhavana Surapareddy ◽

Muralidhar Varma ◽

Shashidhar V

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Early Recognition ◽

Care Center ◽

Tertiary Care ◽

Laboratory Data ◽

Kidney Injury ◽

Serum Lactate ◽

Significant Difference ◽

Serum Bicarbonate Level

Abstract Background Leptospirosis is the most widespread zoonotic disease in the world. In India, it is endemic in coast lined states. Renal failure is a severe complication with mortality approaching 22%, early recognition of which helps clinicians in acting fast. This study aimed to investigate the predictors of Acute Kidney Injury (AKI) in Leptospirosis Methods This is a prospective, case–control study done in a tertiary care center in Southern India carried out between October 2017 and December 2018. Patients with confirmed Leptospirosis as per CDC 2013 and Faine’s criteria (2012) having AKI as per KDIGO criteria were defined as cases. Subjects without AKI were controls. Demographic, clinical and laboratory data were compared between the groups and analyzed. Logistic regression was performed to analyze the possible risk factors associated with AKI in Leptospirosis. Results A total of 329 subjects met the inclusion criteria of the study. 187 patients with AKI (CASES) and 142 patients without AKI (CONTROLS) were studied. Patients with AKI were older, (mean age- 46.99 ± 13.21 vs. 42.99 ± 15.15 years) had longer hospital stay (9.04 ± 5.62 vs. 6.27 ± 3.27 days) had higher SOFA (7.97 ±2.9 vs. 3.37 ± 2.6) and APACHE 2 scores (14.37±5.93 vs. 4.66 ± 4.4), lower mean arterial pressure (84.01 ± 14.45 vs. 89.01 ± 10.63 mmHg; P = 0.001) lower serum bicarbonate level (21.70 ± 2.35 vs. 18.73 ± 3.78 mEq/dL; P < 0.001). Factors like serum lactate, AST, ALT had no significant difference between the groups. Serovar identification was done in 88 patients, of which 57 had AKI. Australis (16.7%), Pyrogenes (16.7%) and Grippotyphosa (11.1%) were the commonest serovars isolated. Serovar most commonly associated with AKI was Pyrogenes (17.5%) Predictors for AKI were jaundice (P = 0.01, OR 2.25; CI 1.21 –3.26), vomiting (P = 0.017, OR 1.9, CI 1.12- 3.26) Hypotension (P = 0.02, OR = 12.3, CI 1.85 – 107.2), tachypnea (P = 0.006, OR = 2.55, CI 1.11- 3.24), leukocytosis (P < 0.001, OR 5.45, CI 1.86- 4.89), thrombocytopenia (P < 0.001, OR 6.49, CI 2.33 – 6.75) Conclusion Identification of features like hypotension, tachypnea, acidosis, leukocytosis, thrombocytopenia, the occurrence of serovar Pyrogenes should alert the clinician on risk of developing AKI Disclosures All authors: No reported disclosures.

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Profile of Acute Kidney Injury in Patients with Decompensated Cirrhosis at a Tertiary-Care Center in Uttarakhand, India

Digestive Diseases ◽

10.1159/000504836 ◽

2019 ◽

Vol 38 (4) ◽

pp. 335-343

Author(s):

Manjot S. Arora ◽

Reshma Kaushik ◽

Shahbaj Ahmad ◽

Rajeev Mohan Kaushik

Keyword(s):

Acute Kidney Injury ◽

Care Center ◽

Tertiary Care ◽

Kidney Injury ◽

International Normalized Ratio ◽

Meld Score ◽

Decompensated Cirrhosis ◽

Total Leucocyte Count ◽

Bacterial Peritonitis ◽

Ctp Score

Objectives: To study the clinical profile and predictors of acute kidney injury (AKI) in patients with decompensated cirrhosis. Materials and Methods: This observational study was conducted at Himalayan Institute of Medical Sciences, Dehradun, India, on 175 consecutive patients with decompensated cirrhosis. Patients were studied for AKI as per International Club of Ascites-AKI criteria. Results: The prevalence of AKI was 40.6%, with prerenal AKI 67.6%, hepatorenal syndrome (HRS) 23.8%, intrinsic renal AKI 7%, and postrenal AKI 1.4%. Mean arterial pressure (MAP), platelet count, and serum albumin were significantly lower and total leucocyte count (TLC), blood urea nitrogen, serum creatinine (SCr), total bilirubin, aspartate aminotransferase, international normalized ratio, Child-Turcotte-Pugh (CTP) score, and model for end-stage liver disease (MELD) score higher in cirrhosis patients with AKI than without AKI (p < 0.05 each). MAP, hemoglobin, TLC, and SCr were significantly different in various types of AKI (p < 0.05 each). AKI had a significant association with CTP score, alcohol, spontaneous bacterial peritonitis (SBP), sepsis, and shock (p < 0.05 each). Type of AKI had significant association with SBP, sepsis, and shock (p < 0.05 each). Mortality occurred in 33.8% patients with AKI with 64.7% mortality in patients with HRS. Outcome had significant association with AKI, stage and type of AKI (p < 0.05 each). Multivariate analysis showed SBP, sepsis, and shock as independent predictors of AKI (p < 0.05 each). Conclusions: AKI occurred commonly in patients with decompensated cirrhosis. Prerenal AKI and HRS were the most common types of AKI. SBP, sepsis, and shock were important predictors of AKI.

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