scholarly journals COVID-19 Infection and Acute Kidney Injury: Cause or Complication?

2021 ◽  
pp. 1-4
Author(s):  
Matthias Arnaldo Cassia ◽  
Roberta Casazza ◽  
Pietro Napodano ◽  
Mario Cozzolino
Keyword(s):  
Acute Kidney Injury ◽  
Diagnostic Tests ◽  
Bacterial Infections ◽  
Scientific Community ◽  
Distress Syndrome ◽  
Kidney Injury ◽  
Severe Hyponatremia ◽  
Case Identification ◽  
Atypical Presentations ◽  
Parenchymal Damage

Management of COVID-19 infection is the trend topic in the scientific community and case identification is a key step to contain the pandemic. While pneumonia and acute respiratory distress syndrome represent the typical severe manifestations of the disease, atypical presentations pose significant diagnostic and therapeutic challenges for physicians, especially when diagnostic tests are repeatedly negative. Clinical picture of COVID-19 patients is often complicated by bacterial infections or thrombotic events. Here, we present and discuss a case report identified in our center as example of a challenging diagnosis and 2 uncommon complications: severe hyponatremia and acute kidney injury requiring renal replacement therapy, caused by parenchymal damage and with a possible direct involvement of the virus.

Acute Kidney Injury in Pediatric Acute Respiratory Distress Syndrome

2020 ◽  
pp. 088506662094404
Author(s):  
Shubhi Kaushik ◽  
Sindy Villacres ◽  
Ruth Eisenberg ◽  
Shivanand S. Medar
Keyword(s):  
Acute Kidney Injury ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Invasive Mechanical Ventilation ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Oxygenation Index ◽  
Significant Difference

Objectives: To describe the incidence of and risk factors for acute kidney injury (AKI) in children with acute respiratory distress syndrome (ARDS) and study the effect of AKI on patient outcomes. Design: A single-center retrospective study. Setting: A tertiary care children’s hospital. Patients: All patients less than 18 years of age who received invasive mechanical ventilation (MV) and developed ARDS between July 2010 and July 2013 were included. Acute kidney injury was defined using p-RIFLE (risk, injury, failure, loss, and end-stage renal disease) criteria. Interventions: None. Measurements and Main Results: One hundred fifteen children met the criteria and were included in the study. Seventy-four children (74/115, 64%) developed AKI. The severity of AKI was risk in 34 (46%) of 74, injury in 19 (26%) of 74, and failure in 21 (28%) of 74. The presence of AKI was associated with lower Pao 2 to Fio 2 (P/F) ratio ( P = .007), need for inotropes ( P = .003), need for diuretics ( P = .004), higher oxygenation index ( P = .03), higher positive end-expiratory pressure (PEEP; P = .01), higher mean airway pressure ( P = .008), and higher Fio 2 requirement ( P = .03). Only PEEP and P/F ratios were significantly associated with AKI in the unadjusted logistic regression model. Patients with AKI had a significantly longer duration of hospital stay, although there was no significant difference in the intensive care unit stay, duration of MV, and mortality. Recovery of AKI occurred in 68% of the patients. A multivariable model including PEEP, P/F ratio, weight, need for inotropes, and need for diuretics had a better receiver operating characteristic (ROC) curve with an AUC of 0.75 compared to the ROC curves for PEEP only and P/F ratio only for the prediction of AKI. Conclusions: Patients with ARDS have high rates of AKI, and its presence is associated with increased morbidity and mortality.

scholarly journals Spectrum of bacterial infections and predictors of mortality in adult cirrhotic patients

2019 ◽  
Author(s):  
Chandrashekar Udyavara Kudru ◽  
Vandana Kalwaje Eshwara ◽  
Shivashankara Kaniyoor Nagiri ◽  
Vasudeva Guddattu
Keyword(s):  
Acute Kidney Injury ◽  
Hepatic Encephalopathy ◽  
Ascitic Fluid ◽  
Bacterial Infections ◽  
Multivariate Logistic Regression Analysis ◽  
Kidney Injury ◽  
Multivariate Logistic Regression ◽  
Factors Associated ◽  
Organ Systems ◽  
Cirrhotic Patients

Introduction. Bacterial infections are more frequent in patients with decompensated cirrhosis than those with compensated liver disease and account for significant morbidity and mortality in them. Once an infection develops, it induces excessive production of pro-inflammatory cytokines leading to organ failure and death. Aims. This study aims to identify the clinical characteristics and outcome of bacterial infections affecting various organ systems in patients with liver cirrhosis and to determine factors associated with mortality. Materials and methods. A cross sectional study was performed on subjects with cirrhosis having microbiologically proven bacterial infection involving various organ systems, admitted to a tertiary care hospital in southern India. Demographic, clinical data, laboratory parameters and outcome details were noted. Univariate associations and subsequent multivariate logistic regression analysis was performed to determine factors associated with mortality. Results. The study included 158 patients. Chronic alcohol intake was the most common etiology of cirrhosis (66.4%). Community acquired infections occurred more frequently than hospital acquired infections (85.5% vs 14.5%). The common site of isolation of etiological agent was ascitic fluid (38.3%) followed by blood (24.3%), respiratory tract (15.5%) and urinary tract (14.5%). Gram negative bacterial infections were more common (74.3%), Escherichia coli being the most frequent pathogen (38.5%). Mortality was noted in 38 (24%) patients. The factors associated with mortality were the type of infection, Child Pugh category, acute kidney injury, hepatic encephalopathy, urinary tract infection, and creatinine and bilirubin levels. Multivariate logistic regression analysis revealed that type of infection (OR: 0.33, 95% CI: 0.11-1.01), ascitic fluid infection (OR: 2.81, 95% CI: 1.11-7.12), hepatic encephalopathy (OR: 0.17, 95% CI: 0.070-0.422) and acute kidney injury (OR: 0.19, 95% CI: 0.077-0.502) were significantly associated with in-hospital mortality. Conclusion. This study indicates that the type of infection, hepatic encephalopathy, ascitic fluid infection and acute kidney injury are associated with mortality in cirrhotic patients. Early effective treatment and prevention of these complications may help modify the outcome.

scholarly journals COVID-19- or Tramadol-induced Seizure: A Differential Diagnosis in Young People

2020 ◽  
Vol 10 (4) ◽  
pp. 32009.1-32009.2
Author(s):  
Solmaz Nekoueifard ◽  
◽  
Mohammad Majidi ◽  
Keyword(s):  
Myocardial Infarction ◽  
Acute Kidney Injury ◽  
Differential Diagnosis ◽  
Acute Respiratory Distress Syndrome ◽  
Distress Syndrome ◽  
Kidney Injury ◽  
World Health ◽  
The World ◽  
Life Threatening ◽  
Health Organization

Coronavirus disease 2019 (COVID-19) was first declared in December 2019 from Wuhan, China [1, 2]. It then has been reported a pandemic in March 2020 by the World Health Organization [3]. Clinical features of COVID-19 are different from asymptomatic to mild to moderate symptoms, such as fever, headache, myalgia, sore throat, anosmia, cough, fatigue headache, hemoptysis, and dyspnea to the life-threatening complications, including shock, pneumonia, acute respiratory distress syndrome, myocarditis, myocardial infarction, acute kidney injury, multi-organ failure, and even death [1, 2].

scholarly journals Respiratory parameters and acute kidney injury in acute respiratory distress syndrome: a causal inference study

2019 ◽  
Vol 7 (23) ◽  
pp. 742-742
Author(s):  
Tacyano Tavares Leite ◽  
Cícero Abdon Malheiro Gomes ◽  
Juan Miguel Cosquillo Valdivia ◽  
Alexandre Braga Libório
Keyword(s):  
Acute Kidney Injury ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Causal Inference ◽  
Distress Syndrome ◽  
Kidney Injury ◽  
Respiratory Parameters
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