Coronavirus disease 2019 presenting with rhabdomyolysis

2020 ◽  
pp. 201010582094391
Author(s):  
Trina Jo Mah ◽  
Ying Hui Lum ◽  
Bingwen Eugene Fan
Keyword(s):  
Skeletal Muscle ◽  
Acute Kidney Injury ◽  
Early Treatment ◽  
Clinical Condition ◽  
Viral Infections ◽  
Kidney Injury ◽  
Young Male ◽  
Intravenous Hydration

Rhabdomyolysis is a clinical condition characterised by the breakdown of skeletal muscle. It has been attributed to viral infections. We describe a case of coronavirus disease 2019 (COVID-19) in a young male who presented with rhabdomyolysis. Myalgia and fatigue are common complaints in COVID-19 patients. We suggest that patients with COVID-19 be screened for rhabdomyolysis in order to facilitate early treatment with intravenous hydration, thus preventing complications such as acute kidney injury.

Acute Kidney Injury Detection: An Alarm System to Improve Early Treatment

2017 ◽  
pp. 57-63
Author(s):  
Ana Rita Nogueira ◽  
Carlos Abreu Ferreira ◽  
João Gama
Keyword(s):  
Acute Kidney Injury ◽  
Early Treatment ◽  
Kidney Injury ◽  
Alarm System

scholarly journals A Rare Case Report of Hydronephrosis and Acute Kidney Injury Secondary to Gonadal Vein Thrombosis in a Young Male

2017 ◽  
Vol 3 (1) ◽  
pp. 119-122
Author(s):  
Jason M. Sandberg ◽  
Raymond B. Dyer ◽  
Majid Mirzazadeh
Keyword(s):  
Acute Kidney Injury ◽  
Case Report ◽  
Rare Case ◽  
Kidney Injury ◽  
Young Male ◽  
Vein Thrombosis ◽  
Gonadal Vein ◽  
Rare Case Report

scholarly journals Acute kidney injury due to multiple wasp stings: a case report

2021 ◽  
Vol 61 (2) ◽  
pp. 115-8
Author(s):  
Tahmina Khandkar ◽  
Amina Akter ◽  
Asaduzzaman Asaduzzaman ◽  
Ranjit Ranjan Roy ◽  
Golam Muinuddin
Keyword(s):  
Acute Kidney Injury ◽  
Case Report ◽  
Mortality Rate ◽  
Early Treatment ◽  
Treatment Protocol ◽  
Kidney Injury ◽  
Clinical Findings ◽  
Wasp Venom ◽  
Systemic Reactions ◽  
Wasp Stings

The skin is the most commonly affected organ. Wasp venom causes both local and systemic reactions, but acute kidney injury (AKI) is the most serious complication, with a 20% mortality rate. Acute kidney injury can occur from single or multiple stings. Diagnosis depends on history, clinical findings, and investigations. Treatment protocol is same as other causes of AKI, including dialysis, and prognosis is good with early treatment.

P0647ACUTE KIDNEY INJURY SECONDARY TO SUCROSE CONTAING INTAVENOUS IMMUNOGLOBULIN

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Sadiq Al Lawati ◽  
Issa Al Salmi ◽  
SUAD Hannawi
Keyword(s):  
Acute Kidney Injury ◽  
Serum Level ◽  
Kidney Function ◽  
Viral Infections ◽  
Kidney Transplant Recipient ◽  
Transplant Rejection ◽  
Organ Transplant ◽  
Vital Signs ◽  
Kidney Injury ◽  
Kaposi Sarcoma

Abstract Background and Aims Intravenous immunoglobulins (IVIG) are pooled polyvalent IgG antibodies extracted from the human plasma. While the initial indications were mainly immune deficiency states and some autoimmune diseases, the usage has been widened to include several immune mediated diseases, viral infections, and organ transplant rejection. Stabilizers in IVIG may include sugars, such as sucrose, glucose, or maltose. Sucrose in IVIG preparations may cause acute kidney injury. We report the case of a renal transplant patient who developed acute kidney injury due to sucrose nephropathy following the administration of sucrose containing IVIG. Method Four months after transplantation he was referred to our Hospital for deterioration of kidney function with eGFR (by MDRD formula) of 27ml/min. Cytomegalovirus virus (CMV) PCR turned positive (3300 copies/ml). Cyclosporine levels were high (C2: 2937 ng/ml) and hence, cyclosporine dose was adjusted. Induction therapy with Injection Ganciclovir for 2 weeks, followed by therapeutic dose of oral Valganciclovir was administered for the treatment of CMV infection. Skin examination revealed annular purple patches, suspicious of Kaposi Sarcoma, on the upper limbs. Skin biopsy confirmed the diagnosis. It was planned to give total IVIG of 2 gm/ kg in four daily divided doses. After completion of the second dose, serum creatinine increased to 370 µmol/L. He was clinically asymptomatic, euvolumic, vital signs were stable, and his urine output remained normal and his urinalysis was inactive. Results The ultrasound of the transplant kidney was normal with normal resistivity index. IVIG was stopped. He was well hydrated and underwent ultrasound guided biopsy. The graft biopsy showed acute tubular injury with flattening and vacuolation of tubular epithelial cells. Mitosis indicating tubular regeneration was seen. There was mild focal interstitial inflammation (20%) with mild lymphocytic tubulitis not amounting to graft rejection. Immunohistochemistry for C4d and polyomavirus (BKV) were both negative. The features were most consistent with sucrose induced nephropathy (Figure 1). Subsequent visits showed a decrease in BKV-PCR serum level and eventually undetected serum level of BKV-PCR at follow up about a month later. Conclusion In this paper, we presented a case of a living unrelated kidney transplant recipient who developed BKV nephropathy and developed impaired kidney function. The patient also had new onset diabetes mellitus after kidney transplantation (NODAT) but was otherwise in good general health. Treatment included sucrose containing IVIG. The patient subsequently developed acute kidney injury. The outcome was favorable with recovery of filtration rate to the baseline within 21 days without the need for dialysis. We conclude that the administration of sucrose containing IVIG may lead to acute kidney injury. We recommend the use of sucrose-free IVIG whenever possible. In all cases, caution is required when administrating IVIG.

scholarly journals MP271IMPORTANCE OF SKELETAL MUSCLE MASS ON THE LONG TERM SURVIVAL IN ELDERLY ACUTE KIDNEY INJURY PATIENTS WHO UNDERWENT CONTINUOUS RENAL REPLACEMENT THERAPY

2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii527-iii527
Author(s):  
Ihm Soo Kwak ◽  
Harin Rhee ◽  
Il-Young Kim ◽  
Sang-Heon Song ◽  
Eun-Young Seong ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Kidney Injury ◽  
Term Survival

scholarly journals Intravenous Hydration and Contrast‐Induced Acute Kidney Injury: Too Much of a Good Thing?

2016 ◽  
Vol 5 (6) ◽  
Author(s):  
Rajesh Gupta ◽  
Ankush Moza ◽  
Christopher J. Cooper
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Good Thing ◽  
Intravenous Hydration

scholarly journals Resuscitation with PEGylated carboxyhemoglobin preserves renal cortical oxygenation and improves skeletal muscle microcirculatory flow during endotoxemia

2020 ◽  
Vol 318 (5) ◽  
pp. F1271-F1283 ◽  
Author(s):  
Philippe Guerci ◽  
Bülent Ergin ◽  
Aslı Kandil ◽  
Yasin Ince ◽  
Paul Heeman ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Acute Kidney Injury ◽  
Plasma Levels ◽  
Kidney Injury ◽  
Albino Rats ◽  
Heme Oxygenase 1 ◽  
Animal Group ◽  
Phosphorescence Quenching ◽  
Time Control ◽  
Microcirculatory Flow

PEGylated carboxyhemoglobin (PEGHbCO), which has carbon monoxide-releasing properties and plasma expansion and oxygen-carrying properties, may improve both skeletal microcirculatory flow and renal cortical microcirculatory Po2 (CµPo2) and, subsequently, limit endotoxemia-induced acute kidney injury. Anesthetized, ventilated Wistar albino rats ( n = 44) underwent endotoxemic shock. CµPo2 was measured in exposed kidneys using a phosphorescence-quenching method. Rats were randomly assigned to the following five groups: 1) unresuscitated lipopolysaccharide (LPS), 2) LPS + Ringer’s acetate (RA), 3) LPS + RA + 0.5 µg·kg·−1min−1 norepinephrine (NE), 4) LPS + RA + 320 mg/kg PEGHbCO, and 5) LPS + RA + PEGHbCO + NE. The total volume was 30 mL/kg in each group. A time control animal group was used. Skeletal muscle microcirculation was assessed by handheld intravital microscopy. Kidney immunohistochemistry and myeloperoxidase-stained leukocytes in glomerular and peritubular areas were analyzed. Endotoxemia-induced histological damage was assessed. Plasma levels of IL-6, heme oxygenase-1, malondialdehyde, and syndecan-1 were assessed by ELISA. CµPo2 was higher in the LPS + RA + PEGHbCO-resuscitated group, at 35 ± 6mmHg compared with 21 ± 12 mmHg for the LPS+RA group [mean difference: −13.53, 95% confidence interval: (−26.35; −0.7156), P = 0.035]. The number of nonflowing, intermittent, or sluggish capillaries was smaller in groups infused with PEGHbCO compared with RA alone ( P < 0.05), while the number of normally perfused vessels was greater ( P < 0.05). The addition of NE did not further improve CµPo2 or microcirculatory parameters. Endotoxemia-induced kidney immunohistochemistry and histological alterations were not mitigated by PEGHbCO 1 h after resuscitation. Renal leukocyte infiltration and plasma levels of biomarkers were similar across groups. PEGHbCO enhanced CµPo2 while restoring skeletal muscle microcirculatory flow in previously nonflowing capillaries. PEGHbCO should be further evaluated as a resuscitation fluid in mid- to long-term models of sepsis-induced acute kidney injury.

scholarly journals Heme oxygenase-2 protects against ischemic acute kidney injury: influence of age and sex

2019 ◽  
Vol 317 (3) ◽  
pp. F695-F704 ◽  
Author(s):  
Karl A. Nath ◽  
Vesna D. Garovic ◽  
Joseph P. Grande ◽  
Anthony J. Croatt ◽  
Allan W. Ackerman ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Heme Oxygenase ◽  
Kidney Injury ◽  
Young Male ◽  
Young Female ◽  
Renal Ischemia ◽  
Sirtuin 1 ◽  
Male Mice ◽  
Phosphorylated Stat3

Heme oxygenase (HO) activity is exhibited by inducible (HO-1) and constitutive (HO-2) proteins. HO-1 protects against ischemic and nephrotoxic acute kidney injury (AKI). We have previously demonstrated that HO-2 protects against heme protein-induced AKI. The present study examined whether HO-2 is protective in ischemic AKI. Renal ischemia was imposed on young and aged HO-2+/+ and HO-2−/− mice. On days 1 and 2 after renal ischemia, there were no significant differences in renal function between young male HO-2+/+ and HO-2−/− mice, between young female HO-2+/+ and HO-2−/− mice, or between aged female HO-2+/+ and HO-2−/− mice. However, in aged male mice, HO-2 deficiency worsened renal function on days 1 and 2 after ischemic AKI, and, on day 2 after ischemia, such deficiency augmented upregulation of injury-related genes and worsened histological injury. Renal HO activity was markedly decreased in unstressed aged male HO-2−/− mice and remained so after ischemia, despite exaggerated HO-1 induction in HO-2−/− mice after ischemia. Such exacerbation of deficiency of HO-2 protein and HO activity may reflect phosphorylated STAT3, as activation of this proinflammatory transcription factor was accentuated early after ischemia in aged male HO-2−/− mice. This exacerbation may not reflect impaired induction of nephroprotectant genes, since the induction of HO-1, sirtuin 1, and β-catenin was accentuated in aged male HO-2−/− mice after ischemia. We conclude that aged male mice are hypersensitive to ischemic AKI and that HO-2 mitigates such sensitivity. We speculate that this protective effect of HO-2 may be mediated, at least in part, by suppression of phosphorylated STAT3-dependent signaling.

scholarly journals Skeletal Muscle Resistance to Leucine Induced Signal Transduction and Regulation of Autophagy in Acute Kidney Injury (AKI)

2012 ◽  
Vol 26 (S1) ◽  
Author(s):  
Kevin McIntire ◽  
Yu Chen ◽  
Sumita Sood ◽  
Ralph Rabkin
Keyword(s):  
Skeletal Muscle ◽  
Signal Transduction ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Induced Signal
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