scholarly journals Recurrent Acute Kidney Injury with Severe Loin Pain and Patchy Renal Ischaemia after Anaerobic Exercise without Renal Hypouricaemia in a New Zealand European Male

2021 ◽  
pp. 176-182
Author(s):  
Richard Kelly ◽  
David Semple ◽  
Alana Harper
Keyword(s):  
Acute Kidney Injury ◽  
New Zealand ◽  
Kidney Injury ◽  
Clinical Syndrome ◽  
Anaerobic Exercise ◽  
Renal Ischaemia ◽  
Preventative Strategy ◽  
Elite Level ◽  
Loin Pain ◽  
Renal Hypouricaemia

Acute kidney injury with severe loin pain and patchy renal ischaemia after anaerobic exercise (ALPE) is a rare clinical syndrome. ALPE has predominantly been described in Japanese and Korean populations to date. Many cases and most recurrent examples are associated with renal hypouricaemia. We describe a 28-year-old New Zealand European male without renal hypouricaemia who developed recurrent ALPE whilst performing elite-level sport. Avoiding elite-level anaerobic exercise was successful at preventing further episodes. This report confirms the first known case of ALPE in a New Zealand European male and raises the possibility that ALPE is an under-recognized condition. Long-term outcomes of recurrent ALPE remain unclear, and preventative strategies should be implemented to preserve renal function. Avoiding intense anaerobic exercise is an effective preventative strategy.

scholarly journals Non-urate transporter 1, non-glucose transporter member 9-related renal hypouricemia and acute renal failure accompanied by hyperbilirubinemia after anaerobic exercise: a case report

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Yoshitaka Furuto ◽  
Mariko Kawamura ◽  
Akio Namikawa ◽  
Hiroko Takahashi ◽  
Yuko Shibuya ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Kidney Injury ◽  
Renal Ischemia ◽  
Anaerobic Exercise ◽  
Fluid Replacement ◽  
Renal Hypouricemia ◽  
Urate Transporter ◽  
Loin Pain

Abstract Background Renal hypouricemia (RHUC) is an inherited heterogenous disorder caused by faulty urate reabsorption transporters in the renal proximal tubular cells. Anaerobic exercise may induce acute kidney injury in individuals with RHUC that is not caused by exertional rhabdomyolysis; it is called acute renal failure with severe loin pain and patchy renal ischemia after anaerobic exercise (ALPE). RHUC is the most important risk factor for ALPE. However, the mechanism of onset of ALPE in patients with RHUC has not been elucidated. The currently known genes responsible for RHUC are SLC22A12 and SLC2A9. Case presentation A 37-year-old man presented with loin pain after exercising. Despite having a healthy constitution from birth, biochemical examination revealed hypouricemia, with a uric acid (UA) level of < 1 mg/dL consistently at every health check. We detected acute kidney injury, with a creatinine (Cr) level of 4.1 mg/dL, and elevated bilirubin; hence, the patient was hospitalized. Computed tomography revealed no renal calculi, but bilateral renal swelling was noted. Magnetic resonance imaging detected cuneiform lesions, indicating bilateral renal ischemia. Fractional excretion values of sodium and UA were 0.61 and 50.5%, respectively. Urinary microscopy showed lack of tubular injury. The patient’s older sister had hypouricemia. The patient was diagnosed with ALPE. Treatment with bed rest, fluid replacement, and nutrition therapy improved renal function and bilirubin levels, and the patient was discharged on day 5. Approximately 1 month after onset of ALPE, his Cr, UA, and TB levels were 0.98, 0.8, and 0.9 mg/dL, respectively. We suspected familial RHUC due to the hypouricemia and family history and performed genetic testing but did not find the typical genes responsible for RHUC. A full genetic analysis was opposed by the family. Conclusions To the best of our knowledge, this is the first report of ALPE with hyperbilirubinemia. Bilirubin levels may become elevated as a result of heme oxygenase-1 activation, occurring in exercise-induced acute kidney injury in patients with RHUC; this phenomenon suggests renal ischemia-reperfusion injury. A new causative gene coding for a urate transporter may exist, and its identification would be useful to clarify the urate transport mechanism.

scholarly journals Determinants of Outcomes of Acute Kidney Injury: Clinical Predictors and Beyond

2021 ◽  
Vol 10 (6) ◽  
pp. 1175
Author(s):  
Emaad M. Abdel-Rahman ◽  
Faruk Turgut ◽  
Jitendra K. Gautam ◽  
Samir C. Gautam
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Complete Recovery ◽  
Severe Form ◽  
Clinical Syndrome ◽  
Current Evidence ◽  
Clinical Predictors ◽  
End Stage

Acute kidney injury (AKI) is a common clinical syndrome characterized by rapid impairment of kidney function. The incidence of AKI and its severe form AKI requiring dialysis (AKI-D) has been increasing over the years. AKI etiology may be multifactorial and is substantially associated with increased morbidity and mortality. The outcome of AKI-D can vary from partial or complete recovery to transitioning to chronic kidney disease, end stage kidney disease, or even death. Predicting outcomes of patients with AKI is crucial as it may allow clinicians to guide policy regarding adequate management of this problem and offer the best long-term options to their patients in advance. In this manuscript, we will review the current evidence regarding the determinants of AKI outcomes, focusing on AKI-D.

Acute kidney injury in two children caused by renal hypouricaemia type 2

2012 ◽  
Vol 27 (8) ◽  
pp. 1411-1415 ◽  
Author(s):  
Blanka Stiburkova ◽  
Judy Taylor ◽  
Anthony M. Marinaki ◽  
Ivan Sebesta
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Renal Hypouricaemia

scholarly journals The impact of biomarkers of acute kidney injury on individual patient care

2019 ◽  
Vol 35 (8) ◽  
pp. 1295-1305 ◽  
Author(s):  
Jay L Koyner ◽  
Alexander Zarbock ◽  
Rajit K Basu ◽  
Claudio Ronco
Keyword(s):  
Acute Kidney Injury ◽  
Patient Care ◽  
Kidney Injury ◽  
Clinical Syndrome ◽  
Functional Markers ◽  
Close Monitoring ◽  
Clinical Implementation ◽  
Care Bundles ◽  
Increased Risk ◽  
The Impact

Abstract Acute kidney injury (AKI) remains a common clinical syndrome associated with increased morbidity and mortality. In the last several years there have been several advances in the identification of patients at increased risk for AKI through the use of traditional and newer functional and damage biomarkers of AKI. This article will specifically focus on the impact of biomarkers of AKI on individual patient care, focusing predominantly on the markers with the most expansive breadth of study in patients and reported literature evidence. Several studies have demonstrated that close monitoring of widely available biomarkers such as serum creatinine and urine output is strongly associated with improved patient outcomes. An integrated approach to these biomarkers used in context with patient risk factors (identifiable using electronic health record monitoring) and with tests of renal reserve may guide implementation and targeting of care bundles to optimize patient care. Besides traditional functional markers, biochemical injury biomarkers have been increasingly utilized in clinical trials both as a measure of kidney injury as well as a trigger to initiate other treatment options (e.g. care bundles and novel therapies). As the novel measures are becoming globally available, the clinical implementation of hospital-based real-time biomarker measurements involves a multidisciplinary approach. This literature review discusses the data evidence supporting both the strengths and limitations in the clinical implementation of biomarkers based on the authors’ collective clinical experiences and opinions.

scholarly journals Study of causes and prognosis of acute kidney injury (AKI) in tertiary care institute

2017 ◽  
Vol 4 (4) ◽  
pp. 1165
Author(s):  
Nagabhushana S. ◽  
Ranganatha M. ◽  
Ranjith Kumar G. K. ◽  
Kamath Virupakshappa
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Tertiary Care ◽  
Emergency Obstetric Care ◽  
Kidney Injury ◽  
Obstetric Care ◽  
Clinical Syndrome ◽  
Oral Rehydration ◽  
Medical Wards ◽  
Wbc Count

Background: Acute kidney injury (AKI) is a common clinical syndrome with a broad aetiological profile. It is associated with major morbidity and significant mortality. This study is to determine the various causes of AKI, in our hospital and to find out the incidence of AKI by using renal failure indices and to analyze outcome of AKI pertaining to the aetiology.Methods: Study is conducted on 100 AKI patients on haemodialysis admitted in various medical wards of the Mc Gann Hospital attached to Shimoga institute of medical sciences, Shimoga. From January 1st, 2017 to June 30th, 2017 detailed history was taken in all the patients and a through physical examination was done. Baseline and peak levels of serum Creatinine, urine output was documented. Data regarding laboratory investigations were collected to confirm the etiology of AKI.Results: There were 65 males and 35 females. The highest number of cases are in age group 51 to 60 year (32%). Average age is 56±5.6 years. Fever, nausea and oliguria are the most common clinical features seen 66,66 and 64 percentage respectively, followed by edema (23%) and loses tools (17%). Blood urea (>100), serum Creatinine (>4) in 44% and 46% respectively. Hb <10 gm/dl in 54%. WBC count >12000 in 65%. Sepsis and gastroenteritis are leading medical causes 25% and 12% respectively. Surgical causes are 14% and obstetrics causes are 11%.Conclusions: AKI remains a common disorder among critically ill patients Consistent with other studies from developing world; this study has also shown that infections, nephrotoxins and gastroenteritis are the primary causes of AKI at our institute. Most of these causes can be prevented with simple interventions such as health education on oral rehydration, quality prenatal and emergency obstetric care, appropriate management of infections and taking appropriate precautions when prescribing potentially nephrotoxic medications.

scholarly journals Biomarkers of acute kidney disease. potential application in practice

2021 ◽  
Vol 23 (1) ◽  
pp. 15-19
Author(s):  
Ekaterina S. Schelkanovtseva ◽  
◽  
Ekaterina S. Schelkanovtseva ◽  
Olga Iu. Mironova ◽  
Viktor V. Fomin ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Potential Application ◽  
Kidney Injury ◽  
Clinical Syndrome ◽  
Acute Kidney Disease ◽  
Definition Of ◽  
New Biomarkers

Acute kidney injury (AKI) is a common clinical syndrome. Its variety of presentation explains the absence of “kidney troponin”. Many research projects of new biomarkers are ongoing now. The enormous number of biomarkers has been identified already. It makes difficult to choose the correct test and dictates the importance of the fastest and most accurate introduction of AKI biomarkers into clinical practice. The integration of appropriately selected biomarkers in routine clinical practice for high-risk patients of AKI is very important. Currently, serum creatinine (sCr) and urine output are used to define AKI in accordance with the definition of KDIGO (Kidney Disease: Improving Global Outcomes), which have a number of significant limitations for practitioners, including the inability to diagnose AKI before serum creatinine levels increase. Practitioners need systematic information about the latest AKI markers and possible situations, when and for which patient groups they can be used. This is the main goal of our review. Keywords: acute kidney injury, biomarkers, NGAL, TIMP-2, IGFBP7, cystatin C, markers, injury, kidney stress For citation: Schelkanovtseva ES, Mironova OIu, Fomin VV. Biomarkers of acute kidney disease. Potential application in practice. Consilium Medicum. 2021; 23 (1): 15–19. DOI: 10.26442/20751753.2021.1.200729

Diagnosis of oliguria and acute kidney injury

2016 ◽  
Author(s):  
John A. Kellum
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Extracellular Volume ◽  
Kidney Injury ◽  
Clinical Problem ◽  
Clinical Syndrome ◽  
Volume Depletion ◽  
International Consensus ◽  
Tubular Necrosis ◽  
Diagnosis And Classification

Diagnosis and classification of acute pathology in the kidney is major clinical problem. Azotemia and oliguria represent not only disease, but also normal responses of the kidney to extracellular volume depletion or a decreased renal blood flow. Clinicians routinely make inferences about both the presence of renal dysfunction and its cause. Pure prerenal physiology is unusual in hospitalized patients and its effects are not necessary benign. Sepsismay alter renal function without the characteristic changes in urine indices. The clinical syndrome known as acute tubular necrosis does not actually manifest the histological changes that the name implies. Acute kidney injury (AKI) is a term proposed to encompass the entire spectrum of the syndrome from minor changes in renal function to a requirement for renal replacement therapy. Criteria based on both changes in serum creatinine and urine output represent a broad international consensus for diagnosing and staging AKI.

scholarly journals Effect of renal ischaemia/reperfusion‐induced acute kidney injury on pharmacokinetics of midazolam in rats

2019 ◽  
Vol 71 (12) ◽  
pp. 1792-1799 ◽  
Author(s):  
Ayako Tokunaga ◽  
Hirotaka Miyamoto ◽  
Shintaro Fumoto ◽  
Koyo Nishida
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Renal Ischaemia ◽  
Ischaemia Reperfusion

scholarly journals Acute Kidney Injury due to Rhabdomyolysis

2016 ◽  
Vol 11 (1) ◽  
pp. 93-95
Author(s):  
Tania Mahbub ◽  
Ferdous Jahan ◽  
Dewan Masudul Haque ◽  
Md Nizam Uddin Chowdhury
Keyword(s):  
Acute Kidney Injury ◽  
Muscle Injury ◽  
Kidney Injury ◽  
Armed Forces ◽  
Clinical Syndrome ◽  
College Hospital ◽  
Medical College ◽  
High Rise ◽  
Dark Colour ◽  
Common Clinical Presentation

Rhabdomyolysis was first described as crush syndrome, during the London blitz of world war-ll. lt is a common clinical syndrome resulting from muscle injury there after release of toxic cellular component especially myoglobin. Muscle injury may results from a variety of causes. Most common clinical presentation of rhabdomyolysis is triad of myalgia, weakness and dark colour urine. But presentation may be varied. Very often it causes acute kidney injury and demands renal replacement therapy. Acute Renal Failure (ARF) is usually associated with very high rise of Creatinine Kinase(CK) >10,000 u/L1. In this series, there are few cases with rhabdomyolysis who were admitted and treated in Dhaka Medical College Hospital (DMCH) during July 2010 to April 2011. These cases of rhabdomyolysis normally developed acute kidney injury who were managed with dialysis support.Journal of Armed Forces Medical College Bangladesh Vol.11(1) 2015: 93-95

Sign in / Sign up

Export Citation Format

Share Document