scholarly journals Extended Peritoneal Dialysis and Renal Recovery in HIV-Infected Patients with Prolonged AKI: A Report of 2 Cases

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Donlawat Saengpanit ◽  
Pongpratch Puapatanakul ◽  
Piyaporn Towannang ◽  
Talerngsak Kanjanabuch
Keyword(s):  
Chronic Kidney Disease ◽  
Human Immunodeficiency Virus ◽  
Acute Kidney Injury ◽  
Peritoneal Dialysis ◽  
Kidney Injury ◽  
Renal Recovery ◽  
Stage 4 ◽  
Ckd Stage ◽  
Immunodeficiency Virus ◽  
Small Solute

Peritoneal dialysis (PD) has recently been established as a treatment option for renal replacement therapy (RRT) in patients with acute kidney injury (AKI). Its efficacy in providing fluid and small solute removal has also been demonstrated in clinical trials and is equivalent to hemodialysis (HD). However, effect of RRT modality on renal recovery after AKI remains a controversy. Moreover, the setting of human immunodeficiency virus- (HIV-) infected patients with AKI requiring RRT makes the decision on RRT initiation and modality selection more complicated. The authors report here 2 cases of HIV-infected patients presenting with severe AKI requiring protracted course of acute RRT. PD had been performed uneventfully in both cases for 4–9 months before partial renal recovery occurred. Both patients eventually became dialysis independent but were left in chronic kidney disease (CKD) stage 4. These cases highlight the example of renal recovery even after a prolonged course of dialysis dependence. Thus, PD might be a suitable option for HIV patients with protracted AKI.

P0624INCREASED URINARY BIOMARKERS OF KIDNEY INJURY IN PATIENTS AFTER ALLOGENETICHEMATOPOETIC STEM CELL TRANSPLANTATION REFLECT KIDNEY DAMAGE EVEN IN NORMALN KIDNEY FUNCTION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Malgorzata Kepska ◽  
Inga Chomicka ◽  
Ewa Karakulska-Prystypiuk ◽  
Agnieszka Tomaszewska ◽  
Grzegorz Basak ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Stem Cell ◽  
Kidney Disease ◽  
Healthy Volunteers ◽  
Kidney Function ◽  
Kidney Injury ◽  
Allogeneic Hsct ◽  
Ckd Stage ◽  
Nephrotoxic Drugs

Abstract Background and Aims Chronic kidney disease (CKD) and acute kidney injury (AKI) are common complications of hematopoietic stem cell transplantation (HSCT) associated with increased morbidity and mortality. On the other hand, presence of CKD is often used as an exclusion criterion when selecting patients who undergo HSCT, especially when fludarabine in conditioning or GVHD prophylaxis with a calcineurin inhibitor is contemplated. There is also no threshold (CKD stage, level of serum creatinine etc) below which patients should not undergo allogeneic HSCT. Kidney function in patients undergoing HSCT is frequently worsened by previous chemotherapy and exposure to a variety of nephrotoxic drugs. Several biomarkers were widely investigated for early diagnosis of acute kidney injury, including neutrophil gelatinase associated lipocalin (NGAL), urinary liver-type fatty acid-binding protein (uL-FABP) and others, however, in patients undergoing HSCT, the published literature is exceptionally scarce. A few studies with inconclusive results stress the knowledge gap and need for further research. The aim of the study was to assess biomarkers of kidney injury in patients at least 3 months after HSCT (to avoid the effect of calcineurin inhibitors) under ambulatory care of Hematology, Oncology and Internal Medicine Department, University Teaching Hospital. Method We studied 80 prevalent patients after allogeneic HSCT and 32 healthy volunteers to obtained normal ranges for biomarkers. In this cross-sectional study following biomarkers of kidney injury in urine were evaluated: IGFBP-7/TIMP2 (insulin growth factor binding protein-7/, tissue inhibitor of metalloproteinases-2), netrin-1, semaphorin A2 using commercially available assays. Results All the biomarkers studied were significantly higher in patients after HSCT when compared to healthy volunteers (all p<0.001). When we divided patients according to kidney function (below and over 60 ml./min/1.72m2), we found that only concentration of IGFBP-7 was significantly higher in 23 patients with CKD stage 3 (i.e. eGFR below 60ml.min/1.72m2) relative to patients with eGFR over 60 ml.min.1.72m2. All biomarkers in both subgroups of patients with eGFR below and over 60 ml./min/1.72m2 were significantly higher relative to healthy volunteers. In univariate correlations sempahorinA2 was related to netrin 1 (r=0.47, p<0.001), IGFBP7 (r=0.35, p<0.01), TIMP2 (r=0.32, p<0.01), whereas IGFBP7 was positively related to serum creatinine (r=0.38, p<0.001) and inversely to eGFR (r=-0.36, p<0.001). Conclusion Concluding, patients after allogeneic HSCT despite normal or near normal kidney function show evidence of kidney injury, which might be due to comorbidities, previous chemotherapy, conditioning regimen,complement activation, calcineurin therapy after HSCT, other possible nephrotoxic drugs etc. Nephroprotective strategies are to be considered as chronic kidney disease is a risk factor for increased morbidity and mortality in this vulnerable population.

scholarly journals A Rare Cause of Acute Kidney Injury: Primary Renal Lymphoma in a Patient with Human Immunodeficiency Virus

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Ruslinda Mustafar ◽  
Lydia Kamaruzaman ◽  
Beh Hui Chien ◽  
Azyani Yahaya ◽  
Noor’Ain Mohd Nasir ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Acute Kidney Injury ◽  
Hematological Malignancy ◽  
Kidney Injury ◽  
B Cell Lymphoma ◽  
Hiv Disease ◽  
Large B Cell Lymphoma ◽  
Renal Lymphoma ◽  
Immunodeficiency Virus ◽  
Combined Antiretroviral Therapy

We reported a case of primary renal lymphoma (PRL) presented with non-oliguric acute kidney injury and bilateral kidney infiltrates in an individual with human immunodeficiency virus (HIV) disease. Acute kidney injury secondary to lymphoma infiltrates is very rare (less than 1% of hematological malignancy). A 37-year-old gentleman with underlying human immunodeficiency virus (HIV) disease was on combined antiretroviral therapy since diagnosis. He presented to our center with uremic symptoms and gross hematuria. Clinically, bilateral kidneys massively enlarged and were ballotable. Blood investigations showed hemoglobin of 3.7 g/L, urea of 65.6 mmol/L, and serum creatinine of 1630 µmol/L with hyperkalemia and metabolic acidosis. An urgent hemodialysis was initiated, and he was dependent on regular hemodialysis subsequently. Computed tomography renal scan showed diffuse nonenhancing hypodense lesion in both renal parenchyma. Diagnosis of diffuse large B cell lymphoma with germinal center type, CD20 positive, and proliferative index 95% was confirmed via renal biopsy, and there was no bone marrow infiltrates. Unfortunately, the patient succumbs prior to initiation of chemotherapy.

scholarly journals Severity and Duration of Acute Kidney Injury and Chronic Kidney Disease after Cardiac Surgery

2021 ◽  
Vol 10 (8) ◽  
pp. 1556
Author(s):  
Suk Hyung Choe ◽  
Hyeyeon Cho ◽  
Jinyoung Bae ◽  
Sang-Hwan Ji ◽  
Hyun-Kyu Yoon ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Kidney Disease ◽  
Primary Outcome ◽  
Kidney Injury ◽  
Transient Stage ◽  
Ckd Stage ◽  
Stage 1 ◽  
New Onset

We aimed to evaluate whether the duration and stage of acute kidney injury (AKI) are associated with the occurrence of chronic kidney disease (CKD) in patients undergoing cardiac or thoracic aortic surgery. A total of 2009 cases were reviewed. The patients with postoperative AKI stage 1 and higher stage were divided into transient (serum creatinine elevation ≤48 h) or persistent (>48 h) AKI, respectively. Estimated glomerular filtration rate (eGFR) values during three years after surgery were collected. Occurrence of new-onset CKD stage 3 or higher or all-cause mortality was determined as the primary outcome. Multivariable Cox regression and Kaplan–Meier survival analysis were performed. The Median follow-up of renal function after surgery was 32 months. The cumulative incidences of our primary outcome at one, two, and three years after surgery were 19.8, 23.7, and 26.1%. There was a graded significant association of AKI with new-onset CKD during three years after surgery, except for transient stage 1 AKI (persistent stage 1: HR 3.11, 95% CI 2.62–4.91; transient higher stage: HR 4.07, 95% CI 2.98–6.11; persistent higher stage: HR 13.36, 95% CI 8.22–18.72). There was a significant difference in survival between transient and persistent AKI at the same stage. During three years after cardiac surgery, there was a significant and graded association between AKI stages and the development of new-onset CKD, except for transient stage 1 AKI. This association was stronger when AKI lasted more than 48 h at the same stage. Both duration and severity of AKI provide prognostic value to predict the development of CKD.

scholarly journals Rating score of renal medical care in Ukraine 2017

2018 ◽  
pp. 3-8
Author(s):  
M. Kolesnyk ◽  
N. Kozliuk ◽  
S. Nikolaenko
Keyword(s):  
Health Care ◽  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Peritoneal Dialysis ◽  
Kidney Injury ◽  
Evaluation Methodology ◽  
Rating Score ◽  
Analytical Research ◽  
Nephrological Care ◽  
Use Of Health Care

The aim of the work was to conduct a rating evaluation of nephrological services in the regions of Ukraine by using the method of complex statistical coefficients. Materials and methods. Evaluation of nephrological services in the regions of Ukraine was made by using indicators that characterize the structure, use of health care resources, quality and efficiency of its provision submitted to National Register of patients with chronic kidney disease and patients with acute kidney injury (2017). Results. The sum of integral indicators in different areas of our analytical research has identified Top-3 regions by number: nephrologists; hemodialysis (GD) machines, patients receiving GD; patients treated with peritoneal dialysis (PD); patients with functional transplanted kidney and in the prevalence of acute kidney damage (GFR) per million population. Summary. By using rating evaluation methodology, it was identified place of relevant region by each indicator of nephrological care in the region as a whole.

Contrast-induced acute kidney injury

2010 ◽  
pp. 478-486
Author(s):  
Peter A. McCullough
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Clinical Trials ◽  
Kidney Injury ◽  
Acute Kidney Injury Network ◽  
Glomerular Function ◽  
Catheterization Laboratory ◽  
Sustained Reduction ◽  
Ckd Stage ◽  
Definition Of

Contrast-induced acute kidney injury (AKI), previously known as contrast-induced nephropathy (CIN) is an important complication in the catheterization laboratory. The most commonly used definition in clinical trials was a rise in serum creatinine (Cr) of 44.2mmol/L (0.5mg/dL) or a 25% increase from the baseline value, assessed at 48h after the procedure. In 2007, the Acute Kidney Injury Network proposed the definition to a rise in serum Cr ≥26.5mmol/L (0.3mg/dL) or a 50% rise in Cr with oliguria which is compatible with previous definitions and is a new standard to follow. If there is a sustained reduction in estimated glomerular function (eGFR) from a baseline above 60 to a new baseline below 60mL/min/1.73m2 at 90 days after the procedure, then a definition of chronic kidney disease (CKD) (Stage 3) would be met as a late outcome of this complication.

Nephrology

2019 ◽  
pp. 413-436
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Nephrotic Syndrome ◽  
Peritoneal Dialysis ◽  
Kidney Injury ◽  
Renal Diseases ◽  
Glomerular Diseases ◽  
Conservative Care ◽  
Clinical Syndromes ◽  
Intravenous Fluid Administration

Nephrology is the study of the kidney and its diseases. This chapter describes the aetiology, presentation, and management of the main clinical syndromes of acute kidney injury, chronic kidney disease, glomerular diseases causing nephrotic syndrome, and glomerulonephritis, and the different modalities of renal replacement therapy: haemodialysis, peritoneal dialysis, renal transplantation, and conservative care. Practical skills of fluid assessment and intravenous fluid administration are discussed, as well as procedures including renal biopsy, dialysis line insertion, and arteriovenous fistula creation. Key components of the ‘renal examination’ and renal investigations are summarized. Renal diseases in the setting of multisystem disorders such as myeloma, rhabdomyolysis, and liver disease are also described.

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