scholarly journals Acute Kidney Injury due to Fish Gallbladder Ingestion: A Case Report from Cambodia

2017 ◽  
Vol 44 (Suppl. 1) ◽  
pp. 22-25 ◽  
Author(s):  
Kanitha Sovann
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Urine Output ◽  
Food Poisoning ◽  
Kidney Injury ◽  
History Taking ◽  
Watery Stool ◽  
General Physicians ◽  
Intravenous Saline ◽  
History Of

We report the case of a 22-year-old woman with a 3-day history of watery stool, generalized abdominal pain, repeated vomiting, and decreased urine output following the consumption of fish gallbladder for self-treatment of acne. She was admitted and received empirical antiemetic, proton pump inhibitor, and intravenous saline treatment. Urine output reduced drastically with markedly elevated urea and creatinine, and she underwent urgent hemodialysis (HD). Based on thorough history taking and prompt biochemical investigations that showed extremely high urea and creatinine levels, we made a diagnosis of acute kidney injury (AKI) secondary to fish gallbladder poisoning. Renal function improved over a period of 5 weeks. Fish gallbladder poisoning is quite frequent in several developing countries in Asia. General physicians in these countries should note that various types of food poisoning can be involved in the etiology of AKI. The condition is commonly reversible, and therefore proper history taking is important and prompt biochemical investigations including blood urea and creatinine are needed to enable early diagnosis and fast institution of treatment, which may include HD.

scholarly journals Acute Kidney Injury Following Ingestion of Averrhoa bilimbi Juice

2015 ◽  
Vol 3 (2) ◽  
pp. 71-73 ◽  
Author(s):  
Md Mostarshid Billah ◽  
Md Anisur Rahman ◽  
Muhammad Abdur Rahim ◽  
Ayesha Tabassum Swarna ◽  
Palash Mitra ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
High Risk ◽  
Kidney Injury ◽  
Renal Tubules ◽  
Fasting State ◽  
Calcium Oxalate Crystals ◽  
The Family ◽  
History Of ◽  
Very High

Bilimbi/belembu fruit belongs to the family of Oxalidacae, species Averrhoa bilimbi. Freshly prepared concentrated juice of bilimbi has very high oxalic acid content and consumption carries a high risk of developing acute kidney injury (AKI) by deposition of calcium oxalate crystals in renal tubules. AKI due to Averrhoa bilimbi juice injestion is very rare. We report the case history of a 60-year-old hypertensive, dyslipidemic patient, with normal renal function, who ingested around 600ml of juice in fasting state for treating dyslipidemia. The patient developed AKI and required three sessions of hemodialysis. Her renal function returned to normal after five weeks.Bangladesh Crit Care J September 2015; 3 (2): 71-73

scholarly journals A Case of Upper Ureter Rupture With Acute Kidney Injury

2018 ◽  
Vol 11 ◽  
pp. 117954761878513
Author(s):  
Yuko Mutsuyoshi ◽  
Shohei Kaneko ◽  
Saori Minato ◽  
Katsunori Yanai ◽  
Hiroki Ishii ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Renal Injury ◽  
Urine Output ◽  
Urinary Catheter ◽  
Kidney Injury ◽  
Benign Prostatic Hypertrophy ◽  
Acute Renal Injury ◽  
Surgical Operation ◽  
Normal Range

We herein report a case of ureter rupture with severe oliguric acute renal injury due to benign prostatic hypertrophy. After insertion of an indwelling urinary catheter, the patient’s urine output immediately increased. His symptoms and renal function also rapidly improved to the normal range without a surgical operation. Clinicians should note this complication in patients with oliguria.

scholarly journals Maternal-Perinatal Variables in Patients with Severe Preeclampsia Who Develop Acute Kidney Injury

2021 ◽  
Vol 10 (23) ◽  
pp. 5629
Author(s):  
Patrocinio Rodríguez-Benitez ◽  
Irene Aracil Moreno ◽  
Cristina Oliver Barrecheguren ◽  
Yolanda Cuñarro López ◽  
Fátima Yllana ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Failure ◽  
Renal Function ◽  
Uric Acid ◽  
Caesarean Section ◽  
Serum Creatinine ◽  
Kidney Injury ◽  
Severe Preeclampsia ◽  
History Of ◽  
Nicu Admission

Introduction: At present, we are witnessing an increase in preeclampsia, especially the most severe forms, which are associated with an increased risk of maternal-perinatal morbidity and mortality. As a severity criterion, acute kidney injury (AKI) has been associated with a worse prognosis, and for this reason, the maternal and perinatal variables associated with AKI in patients with severe preeclampsia (SP) were analysed in this study. Methods: An observational, retrospective, single-centre study of patients with SP treated at a tertiary hospital between January 2007 and December 2018 was conducted. The case criteria based on the criteria established by the ACOG Practice Guidelines for Gestational Hypertension and Preeclampsia. AKI is considered when serum creatinine exceeds 1.1 mg/dL in a pregnant woman with previously normal renal function. In patients with existing chronic kidney disease (CKD), it is referred to as AKI if the baseline serum creatinine increases by 1.5 fold. Pregestational, gestational and postpartum variables were analysed up to 12 weeks postpartum using univariate and multivariate logistic regression analysis. Results: During the study period, 76,828 births were attended, and 303 pregnant women were diagnosed with SP. The annual incidence of SP increased gradually throughout the study period, reaching 1.79/100 births/year in 2018. Acute kidney injury (AKI) occurred in 24.8% of the patients. The multivariate analysis revealed an increased association with a history of previous CKD, the use of assisted reproductive techniques and caesarean section. Uric acid and thrombotic microangiopathy (TMA) had a high correlation with AKI. Indications for caesarean section are associated with AKI in SP. Regarding perinatal outcomes in cases of AKI, there was a higher percentage of neonates who required foetal lung maturation with steroids and an increased need for NICU admission. No case of maternal death was recorded; however, an increase in neonatal mortality was found among patients who did not develop AKI. After 12 weeks postpartum, 72 patients were referred to the nephrology consultation for persistent hypertension, proteinuria or renal failure. Conclusions: In preeclampsia, AKI is a common complication, especially among patients with a history of CKD, those who became pregnant using assisted reproduction techniques and those who delivered via caesarean section. The perinatal impact of AKI is mainly centred on a higher rate of NICU admission and a lower mortality rate. Among biochemical and haematological markers, the uric acid level prior to renal failure has a direct and significant correlation with the risk of AKI, as does the development of TMA in patients with preeclampsia. Therefore, the monitoring of renal function in cases of preeclampsia should be strict, and referral for a nephrology consultation may be necessary in some cases.

Acute kidney injury associated with ingestion of star fruit: Acute oxalate nephropathy: a report of two cases

2019 ◽  
Vol 8 (2) ◽  
pp. 47-51
Author(s):  
Mahmud Javed Hasan ◽  
Nitai Chandra Ray ◽  
Shaikh Shariful Islam ◽  
Shakil Azam Nahid ◽  
Tumpa Shom ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Normal Renal Function ◽  
Herbal Remedy ◽  
Case Reports ◽  
Kidney Injury ◽  
Young Male ◽  
Empty Stomach ◽  
Star Fruit ◽  
History Of

There are few case reports regarding star fruit's nephrotoxicity and neurotoxicity in chronic kidney disease patients. Star fruit (Averrhoa carambola) is commonly consumed as a herbal remedy for various ailments in tropical countries. However, the dangers associated with consumption of star fruit are not commonly known. Although star fruit induced oxalate nephrotoxicity in those with existing renal impairment is well documented, reports on its effect on those with normal renal function are infrequent. We report two unique clinical presentation patterns of star fruit nephrotoxicity following consumption of the fruit. The first patient is a 52 year-old male diabetic patient who had normal renal function prior to developing acute kidney injury (AKI) after consuming large amount of star fruit juice at once for remedy of diabetes. The second patient, a 27 years old young male who developed acute kidney injury following star fruit ingestion in empty stomach. One case needed 4 sessions of hemodialysis another case recovered over 2 weeks without the need for haemodialysis. Consumption of star fruit, especially on an empty stomach or in a state of dehydration may precipitate acute kidney injury. A history of star fruit ingestion must be actively looked for in patients presenting with unexplained acute kidney injury. The use of star fruit as a therapy for diabetes should be discouraged. CBMJ 2019 July: Vol. 08 No. 02 P: 47-51

scholarly journals Nilotinib-Induced Acute Interstitial Nephritis during the Treatment of Chronic Myeloid Leukemia

2021 ◽  
Vol 36 (2) ◽  
pp. 153-160.
Author(s):  
Min Jeong Kim
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Targeted Therapy ◽  
Chronic Myeloid Leukemia ◽  
Interstitial Nephritis ◽  
Myeloid Leukemia ◽  
Kinase Inhibitors ◽  
Kidney Injury ◽  
Acute Interstitial Nephritis ◽  
History Of

Tyrosine kinase inhibitors (TKIs) are targeted therapy drugs that selectively inhibit protein kinases. Nephrotoxicity associated with TKIs is uncommon. We report a case of a 39-year-old man with acute kidney injury that developed after nilotinib treatment for chronic myeloid leukemia (CML). The renal function of the patient decreased during treatment with nilotinib but improved when treatment was discontinued due to neutropenia. However, the renal function of the patient deteriorated again with the reintroduction of nilotinib for treatment. A renal biopsy revealed acute interstitial nephritis (AIN). The patient had no history of comorbidities and medication causing renal injury. Finally, we diagnosed the patient with nilotinib-induced AIN. After switching to imatinib mesylate, the renal function of the patient stabilized without further deterioration. Our case indicates that nilotinib can be a potential cause of renal dysfunction by inducing AIN when renal function deteriorates in patients treated with nilotinib.

scholarly journals Valacyclovir Neurotoxicity and Nephrotoxicity in an Elderly Patient Complicated by Hyponatremia

2018 ◽  
Vol 12 (1) ◽  
Author(s):  
Takuya Murakami ◽  
Tetsu Akimoto ◽  
Mari Okada ◽  
Erika Hishida ◽  
Taro Sugase ◽  
...  
Keyword(s):  
Elderly Patient ◽  
Acute Kidney Injury ◽  
Renal Function ◽  
Serum Creatinine ◽  
Serum Creatinine Level ◽  
Creatinine Level ◽  
Kidney Injury ◽  
Blood Purification ◽  
Standard Dosage ◽  
History Of

A 66-year-old women with no history of renal disease was admitted due to a coma and acute kidney injury with a serum creatinine level of 7.44 mg/dL which were ascribed to valacyclovir neurotoxicity and nephrotoxicity, respectively. She had received valacyclovir at a standard dosage for the treatment of herpes zoster and was finally discharged, having fully returned to her normal baseline mental status with a recovered serum creatinine level of 0.68 mg/dL. We feel that awareness of this pathology remains a challenge for physicians and therefore strongly recommend the further accumulation of experiences similar to our own. Our experience underscores the pitfalls of administering valacyclovir to elderly patients who barely appear to have a favorable renal function. Several concerns regarding the therapeutic management, including blood purification strategies, that emerged in this case are also discussed.

scholarly journals Influence of Polymyxin B Dose on Development and Recovery of Acute Kidney Injury

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S299-S299
Author(s):  
Lydia D’Agostino ◽  
Elena Martin ◽  
Michael Yin ◽  
Christine J Kubin
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Hospital Mortality ◽  
Low Dose ◽  
Kidney Injury ◽  
Polymyxin B ◽  
Renal Recovery ◽  
High Dose ◽  
Cart Analysis ◽  
History Of

Abstract Background Nephrotoxicity is a common adverse effect of polymyxin B (PMB) with reported acute kidney injury (AKI) rates of 20% to >60%. Data on PMB dosing to optimize efficacy while minimizing toxicity are limited. Previous studies suggest higher doses improve outcomes but are also associated with more AKI. Data are needed to evaluate optimal dosing and contributing factors to minimize AKI and to evaluate renal recovery. Methods Retrospective study evaluating PMB in adults at NewYork-Presbyterian Hospital from 2012 to 2016. Patients who received PMB dosed twice daily for ≥2 days were included. Patients on renal replacement therapy within 48 hours prior to PMB or with AKI at time of PMB initiation were excluded. A classification and regression tree (CART) analysis was performed to identify the PMB dose most predictive of AKI which defined the breakpoint for high- vs. low-dose PMB cohorts for all subsequent comparisons. The primary outcome was to determine whether high-dose PMB independently predicted AKI. Secondary outcomes included in-hospital mortality, time to AKI, and recovery of renal function. Results 246 patients were included: majority were male (59%) with median age 41 years. Median PMB dose was 2.9 mg/kg/day or 180 mg/day for a median duration of 10 days. AKI occurred in 64% and 38% had recovery of renal function by hospital discharge. The breakpoint for high-dose PMB determined by CART was 160 mg/day, putting 104 in low-dose and 142 in high-dose groups. High-dose PMB was associated with AKI compared with low-dose PMB on univariable (75% vs.. 49%, P < 0.001) and multivariable (OR 3.43; 95% CI 1.68,6.99; P = 0.001) analyses. Concomitant vancomycin (OR 3.34; 95% CI 1.74,6.41;P < 0.001), history of transplant (OR 4.96; 95% CI 2.14,11.48;P < 0.001), and previous PMB exposure (OR 2.37; 95% CI 1.23,4.57; P = 0.01) were also identified as independent predictors of AKI. No significant differences were found for in-hospital mortality (28% vs. 21%, P = 0.326), renal recovery (37% vs. 41%, P = 0.723), time to AKI (median 5 vs. 6 days, P = 0.125) between groups. Conclusion High-dose PMB (>160 mg/day) was independently associated with AKI as well as concomitant vancomycin, history of transplant, and previous PMB exposure. High-dose PMB did not have a significant impact on in-hospital mortality, recovery of renal function, or time to development of AKI. Disclosures M. Yin, Gilead Sciences: Consultant, Consulting fee.

scholarly journals Obstruction of an ileal urinary conduit in an incarcerated right inguinal hernia

2015 ◽  
Vol 97 (3) ◽  
pp. e46-e46
Author(s):  
MJ Young ◽  
PMT Weston
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Inguinal Hernia ◽  
Ileal Conduit ◽  
Kidney Injury ◽  
Full Recovery ◽  
Incarcerated Hernia ◽  
Hernial Sac ◽  
History Of

We present the case of a 72-year-old man with a history of anuria from his ileal conduit 15 months following its formation. That conduit had become incarcerated in a right-sided ingunial hernia. The patient presented with anuria and an acute kidney injury. A clincal diagnosis of an incarcerated hernia was made, and he was taken to theatre for reduction and repair of the hernia. On removal of the conduit from the hernial sac, it began to drain immediately. He made a full recovery, with normalisation of his renal function.

scholarly journals RIFLE serum creatinine and urine output criteria combined is superior to RIFLE serum creatinine criterion alone in predicting Acute Kidney Injury (AKI) in critically ill patients: A prospective observational study

2020 ◽  
Vol 8 (1) ◽  
pp. 17-23
Author(s):  
Amina Sultana ◽  
Mohammad Omar Faruq ◽  
ASM Areef Ahsan ◽  
Uzzwal Kumar Mallick ◽  
Mohammad Asaduzzaman ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Renal Replacement Therapy ◽  
Serum Creatinine ◽  
Replacement Therapy ◽  
Urine Output ◽  
Data Entry ◽  
Kidney Injury ◽  
Adult Patients ◽  
Icu Admission

Background: Approximately 7% of all hospitalized patients and 20% of acutely ill patients develop signs of AKI. AKI incidence is very high worldwide among intensive care unit patients. Previously long known term, acute renal failure (ARF) is largely replaced by acute kidney injury (AKI), reflecting the recognition that smaller decrements in kidney function that do not result in overt organ failure are of substantial clinical relevance and are associated with increased morbidity and mortality. Objectives: We designed this study to diagnose even mild renal dysfunction earlier than usual time frame with the combined effect of both serum creatinine and urine output criteria, when compared with serum creatinine criterion alone. To establish this objective we used RIFLE serum creatinine and urine output (UO) criteria combined (Scr+UO) and compared with RIFLE serum creatinine (Scr) alone to diagnose AKI early (in days). Design: Prospective observational cohort study. Duration of the study was one year (01 year), from January 2014 to December 2014 Method: All adult patients admitted into department of critical care medicine, BIRDEM General Hospital, DHAKA who received treatment for 48 hours and fulfilled the inclusion and exclusion criteria was included in the study. Representative serum creatinine value was obtained either from the day of admission in hospital, day of admission into or transfer to ICU or any document within last six months. The lesser of pre-ICU admission serum creatinine (SCr) and ICU admission SCr would serve as baseline renal function. Weight in kilogram, representative serum urea/BUN, co-morbidities and reason for ICU admission were incorporated in it. Patient’s daily data entry of renal replacement therapy, daily creatinine value, urinary output over 6 hours, 12 hours, and 24 hours, episode of anuria over 12 hours, if present were documented. Data collected on renal replacement therapy at the time of discharge, if any and outcome in terms of loss and ESRD status were collected. APACHE II data and SAPS II data were calculated and analyzed. Result: Total 236 adult patients were enrolled in the study to assess their renal function status using RIFLE (Risk, Injury, Failure, Loss, End Stage Renal Disease). Serum creatinine was estimated daily for seven days. Those patients who fulfilled the creatinine criteria for RIFLE were categorized into RIFLE serum creatinine (Scr) group. Those patients who met both the criteria for urine output and serum creatinine according to RIFLE was designated as RIFLE serum creatinine and urine output criteria Combined (Scr+ UO) group. In our study, mean of number of days needed for diagnosis of AKI using RIFLE creatinine (Scr) was 3.25 (±1.24) and using RIFLE combined (Scr+uo) criteria was 2.84(±1.03). Conclusion: The present study concludes that RIFLE serum creatinine criterion (Scr) alone delays the diagnosis of AKI in comparison to RIFLE serum creatinine and urine output criteria combined (Scr+UO). AKI should be graded using both the criteria of RIFLE serum creatinine and urine output criteria combined (Scr+UO). Urine output should not be underestimated in AKI diagnosis in ICU patients. Bangladesh Crit Care J March 2020; 8(1): 17-23

scholarly journals MO160COVID-19 INFECTION AND ACUTE TUBULOINTERSTITIAL NEPHRITIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Juan Carlos León ◽  
Irene Agraz ◽  
Ander Vergara Arana ◽  
Natalia Ramos Terrada ◽  
Clara García Carro ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Kidney Function ◽  
Nosocomial Pneumonia ◽  
Tubulointerstitial Nephritis ◽  
Kidney Injury ◽  
Acute Tubulointerstitial Nephritis ◽  
History Of

Abstract Background COVID-19 infection manifests as pneumonia associated with multiple organ failure, and death. Acute kidney injury is a risk factor for mortality. There is limited scientific literature on COVID-19 infection and allergic tubulointerstitial nephritis, its clinical course and short- and long-term prognosis. Method We performed a retrospective study where medical records of 60 patients with histological diagnosis of allergic tubulointerstitial nephritis from January 2009 to November 2020. In these patients, we studied the incidence of COVID-19 infection, clinical characteristics and prognosis from March to the actual date. Results Of 60 patients with allergic tubulointerstitial nephritis, 6 (10%) patients were diagnosed with COVID-19. The first case, an 85-year-old woman with a history of metastatic melanoma treated with nivolumab and allergic tubulointerstitial nephritis by immunobiological agents in 2018, diagnosed with mild COVID-19 infection in April 2020 without deterioration of renal function in controls at 3 and 6 months of follow-up. The second case, a 51-year-old woman with a history of large B-cell lymphoma with plasmacytic differentiation and progression to multiple myeloma of lambda light chains and allergic tubulointerstitial nephritis due to chemotherapy since 2019, admitted for acute pyelonephritis and PRES syndrome secondary to first dose of bortezomib complicated with COVID-19 nosocomial pneumonia and acute pancreatitis treated with corticosteroids and broad spectrum antibiotic therapy; she died of abdominal refractory septic shock. The third patient, a 64-year-old man without prior renal impairment, was admitted for severe COVID-19 pneumonia and acute kidney injury secondary to acute tubulointerstitial nephritis of uncertain etiology that required orotracheal intubation and continuous veno-venous hemodiafiltration for a week who received methylprednisolone in bolus for 3 days and continued treatment with corticosteroid therapy with complete recovery of renal function and improvement in proteinuria at 3 months of follow-up. The fourth patient, an 82-year-old woman with acute kidney injury AKIN 3 secondary to acute allergic tubulointerstitial nephritis related to ciprofloxacin complicated with severe COVID-19 nosocomial pneumonia, who died despite ventilatory support and high-dose steroids therapy and tocilizumab. The fifth patient, a 75-year-old with a history of metastatic lung adenocarcinoma treated with immunobiological agents and allergic tubulointerstitial nephritis in  2018, admitted in march 2020 for mild COVID-19 pneumonia treated with steroids and hydroxychloroquine without deterioration of respiratory and kidney function.  The sixth patient, an 86-years-old man with acute kidney injury AKIN 3 due to acute allergic tubulointerstitial nephritis secondary to proton-binding inhibitors and nosocomial COVID-19 infección with improvement of kidney function with steroids therapy only.  Conclusion Our 6 patients with allergic tubulointerstitial nephritis and COVID-19 infection presented different spectrum of the disease. It seems that nosocomial COVID-19 infection in patients admitted with recent diagnosis of acute allergic tubulointerstitial nephritis presented a worse clinical prognosis compared with long-term diagnosed acute tubulointerstitial nephritis. Further studies with a larger sample size are needed.

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