scholarly journals Recovery of methotrexate-induced anuric acute kidney injury after glucarpidase therapy

2017 ◽  
Vol 5 ◽  
pp. 2050313X1770505 ◽  
Author(s):  
James Harms ◽  
Ayaz Khawaja ◽  
Maria Taylor ◽  
Xiaosi Han ◽  
Michal Mrug
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Rescue Therapy ◽  
Kidney Injury ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Dose Methotrexate ◽  
Renal Function Recovery ◽  
Function Recovery ◽  
Lethal Complications

Objectives: This case report describes two cases of high-dose methotrexate–induced nephrotoxicity: death in the case of conventional supportive care and successful renal function recovery in a patient treated with glucarpidase and continuous dialysis. Methods: High dose methotrexate is widely used for management of adult and pediatric malignancies. However, high-dose methotrexate–induced renal nephrotoxicity may cause severe, even lethal complications. Here we present examples of such outcomes. Results: We present one case of lethal high-dose methotrexate nephrotoxicity in a patient treated with conventional rescue therapy. We contrast this outcome with another patient with high-dose methotrexate–induced anuric acute kidney injury, who has recovered renal function following therapy with glucarpidase and continuous dialysis. Conclusions: This is only the second reported case of high-dose methotrexate–induced anuric acute kidney injury, and the only one with a reported clinical outcome. This first report of recovery from high-dose methotrexate–induced anuric acute kidney injury after glucarpidase administration supports available evidence pointing to the effectiveness of this therapy.

Impact of polymyxin-B-associated acute kidney injury in 1-year mortality and renal function recovery

2018 ◽  
Vol 52 (1) ◽  
pp. 86-89 ◽  
Author(s):  
Eduardo C. Gomes ◽  
Diego R. Falci ◽  
Pedro Bergo ◽  
Alexandre P. Zavascki ◽  
Maria Helena Rigatto
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Kidney Injury ◽  
Polymyxin B ◽  
Renal Function Recovery ◽  
Function Recovery

Identification of Risk Factors in High-Dose Methotrexate-Induced Acute Kidney Injury in Childhood Acute Lymphoblastic Leukemia

Chemotherapy ◽  
2018 ◽  
Vol 63 (2) ◽  
pp. 100-106 ◽  
Author(s):  
Dao-Hai Cheng ◽  
Hua Lu ◽  
Tao-Tao Liu ◽  
Xiao-Qin Zou ◽  
Hui-Mei Pang
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Logistic Regression ◽  
Lymphoblastic Leukemia ◽  
Kidney Injury ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Baseline Serum ◽  
Childhood All ◽  
Dose Methotrexate

Aims: Although high-dose methotrexate (HDMTX) is an effective means for the treatment of acute lymphoblastic leukemia (ALL), the development of renal dysfunction remains a significant management challenge. This study aimed to identify the key factors in HDMTX-induced acute kidney injury (AKI) in childhood ALL. Methods: We retrospectively analyzed the clinical data in 1,329 courses of HDMTX treatment in 336 Chinese ALL children at the First Affiliated Hospital of Guangxi Medical University from September 2012 to November 2016. The clinical data were compared between the groups of children with development of AKI and those without. Risk factors were identified by multiple logistic regression analysis, and the diagnostic performance of plasma MTX concentration was evaluated by receiver operating characteristic (ROC) curve analysis. Results: AKI was observed in 88 patients (26.2%) and 104 courses (7.8%). Binary logistic regression revealed that age (OR 1.349; p = 0.005), first HDMTX course (OR 1.767; p = 0.013), MTX dose per body surface area (BSA; OR 1.944; p = 0.015), and baseline serum total protein (OR 0.929; p = 0.021) significantly correlated with AKI. The area under the ROC for 48-h plasma MTX concentration was 0.890 (95% CI 0.850–0.930), and sensitivity and specificity values of the cut-off value were 78.8 and 90.4%, respectively. Conclusion: Increasing age, higher MTX dose per BSA, lower baseline serum protein, and first HDMTX course were significant risk factors for developing HDMTX-induced AKI in childhood ALL. The threshold of 48-h MTX plasma concentration is valuable for the prediction of HDMTX-induced AKI.

scholarly journals MO359ASSOCIATIONS BETWEEN RENAL FUNCTION TRAJECTORIES AFTER 3 MONTHS ACUTE KIDNEY INJURY AND LONG-TERM RENAL OUTCOMES

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Chien-Ning Hsu ◽  
You-Lin Tain
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Kidney Injury ◽  
Chronic Dialysis ◽  
Dialysis Initiation ◽  
Renal Recovery ◽  
Post Discharge ◽  
Renal Function Recovery ◽  
Increased Risk ◽  
Function Recovery

Abstract Background and Aims Renal function recovery after acute kidney injury (AKI) is associated with patient outcomes. The study objectives were to assess the patterns of AKI recovery within 6 months following discharge for AKI and subsequent incidence of chronic dialysis. Method A retrospective cohort of 234,867 hospitalized adult patients was examined for AKI between January 1, 2010, and December 31, 2017 in the largest healthcare delivery system in Taiwan. Renal function recovery at 3- and 6-month post discharge, incident chronic kidney disease and chronic dialysis initiation were analyzed over 7 years of follow-up. Renal recovery was defined by < 1.5× baseline SCr (prior to the hospitalization). Independent associations between renal function recovery patterns and renal outcomes was assessed by Cox proportional hazard model controlling for potential confounders, and subdistribution hazard ratio (SHR) with [95% CI] was analysed for competing risk of early death. Results Among 3 months AKI survivors (n=24,132), 14.28% (n=3,430) did not recovery back to baseline, and 16% of recovery did not sustain. Three distinct renal function recovery continuums at 6 months post hospital discharge were: persistent non-recovery (10.18%), non-recovery (14.33%), and recovery (75.5%). Comparing to survivors without AKI (n=50,387), the impact of renal recovery continuum on chronic dialysis initiation varied by patient’s baseline renal disease (SHR was 2.82 [95%CI, 2.42-3.28] in CKD, and 0.8 [95%CI, 0.27-2.38] for non-CKD. Persistent non-recovery was significantly associated with a greater increased risk of chronic dialysis than non-recovery in any patients with AKI. Comparing to patients with sustained AKI recovery, risk of CKD onset increased 5-fold in persistent non-recovery and 3-fold risk in non-recovery. Conclusion The continuum of AKI recovery post 6 months is associated with increased risk of chronic dialysis, particularly in patients with baseline CKD. These study results suggested that patients ever with AKI should receive close renal function monitoring for post-discharge management.

scholarly journals Elevated Serum Ferritin Levels Are Predictive of Renal Function Recovery among Patients with Acute Kidney Injury

2019 ◽  
Vol 248 (2) ◽  
pp. 63-71 ◽  
Author(s):  
Zorica M. Dimitrijevic ◽  
Sonja S. Salinger-Martinovic ◽  
Radmilo J. Jankovic ◽  
Branka P. Mitic
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Serum Ferritin ◽  
Elevated Serum ◽  
Kidney Injury ◽  
Renal Function Recovery ◽  
Function Recovery

Risk factors for high‐dose methotrexate associated acute kidney injury in patients with hematological malignancies

2020 ◽  
Vol 38 (4) ◽  
pp. 584-588
Author(s):  
Irina Amitai ◽  
Uri Rozovski ◽  
Reem El‐Saleh ◽  
Shai Shimony ◽  
Daniel Shepshelovich ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Hematological Malignancies ◽  
Kidney Injury ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Dose Methotrexate
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