scholarly journals Rhabdomyolysis and acute kidney injury associated with thiocyclam hydrogen oxalate (Evisect) poisoning

2020 ◽  
Vol 8 ◽  
pp. 2050313X2095494
Author(s):  
Navaneethakrishnan Suganthan ◽  
Rasaiah Manmathan ◽  
Thirunavukarasu Kumanan
Keyword(s):  
Acute Kidney Injury ◽  
Supportive Care ◽  
Case Reports ◽  
Case Series ◽  
Kidney Injury ◽  
Uneventful Recovery ◽  
Molecular Formula ◽  
Human Toxicity ◽  
Brand Name ◽  
Cholinergic Syndrome

Thiocyclam hydrogen oxalate (Brand name: Evisect) is an insecticide with anti-cholinergic and cholinergic properties. Although there are few case reports and a case series of human toxicity of nereistoxin analogue insecticide such as cartap hydrochloride poisoning published in the literature, poisoning with thiocyclam hydrogen oxalate (Evisect), an another analogue of nereistoxin with its own molecular formula is only heard in animals, such as Nubian goats. Herein, we report a patient presented with rhabdomyolysis and acute kidney injury without significant symptoms of acute cholinergic syndrome following self-ingestion of thiocyclam hydrogen oxalate (Evisect) and he made an uneventful recovery with prompt supportive care.

Acute kidney injury following resuscitative aortic occlusion

2018 ◽  
Vol 2 (2) ◽  
Author(s):  
Guillaume Hoareau ◽  
Patrick A Cassiday ◽  
Ian J Stewart ◽  
Amy C Studer ◽  
Joseph J DuBose ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Ischemia Reperfusion Injury ◽  
Case Reports ◽  
Ischemia Reperfusion ◽  
Case Series ◽  
Kidney Injury ◽  
Aortic Occlusion ◽  
Trauma Patients ◽  
Creatinine Concentration ◽  
Factors Associated

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emergent technology for the treatment of non-compressible torso hemorrhage (NCTH). While aortic occlusion (AO) above the site of hemorrhage provides hemostasis and time for surgical intervention, ischemia-reperfusion injury to the kidneys is a known complication. We aimed to report the incidence and factors associated with acute kidney injury (AKI) following AO in patients with NCTH or in similar porcine models. Methods: We searched Pubmed (MEDLINE), Embase, Scopus, and ProQuest Dissertations & Theses from inception to July 2017. We included original studies of trauma patients with NCTH treated with REBOA, or similar porcine studies that included renal parameters, excluding case reports and case series. After duplicate removal, full texts of studies retrieved via the search strategy were evaluated by two authors. Renal parameters (e.g., creatinine concentration, urine output, histopathology) were extracted. Quality of the evidence and risk of bias were assessed. Results: Twelve out of 2,100 records were included (3 trauma patients, 9 porcine studies). While 1/3 human reports described AO in Zone 1, all swine publications reported Zone 1. All human studies reported renal damage. There were nonetheless inconsistencies in definitions used. Evidence of AKI was reported in 3/9 swine studies.  Conclusions: Consistent reporting of AKI incidence is lacking from human clinical studies of AO in NCTH trauma patients. While comorbidities in trauma patients may contribute to AKI, animal models support the association between AO and AKI. As REBOA is growing in popularity as a therapy for NCTH, further studies determining factors associated with the AKI are needed.

scholarly journals Granulomatous interstitial nephritis in a patient with SARS-CoV-2 infection

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Katarzyna Szajek ◽  
Marie-Elisabeth Kajdi ◽  
Valerie A. Luyckx ◽  
Thomas Hans Fehr ◽  
Ariana Gaspert ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Interstitial Nephritis ◽  
Kidney Biopsy ◽  
Kidney Diseases ◽  
Case Reports ◽  
Kidney Injury ◽  
Maculopapular Rash ◽  
Tubular Injury ◽  
Granulomatous Interstitial Nephritis ◽  
First Case

Abstract Background Acute kidney injury (AKI) associated with severe coronavirus disease 19 (COVID-19) is common and is a significant predictor of morbidity and mortality, especially when dialysis is required. Case reports and autopsy series have revealed that most patients with COVID-19 – associated acute kidney injury have evidence of acute tubular injury and necrosis - not unexpected in critically ill patients. Others have been found to have collapsing glomerulopathy, thrombotic microangiopathy and diverse underlying kidney diseases. A primary kidney pathology related to COVID-19 has not yet emerged. Thus far direct infection of the kidney, or its impact on clinical disease remains controversial. The management of AKI is currently supportive. Case Presentation The patient presented here was positive for SARS-CoV-2, had severe acute respiratory distress syndrome and multi-organ failure. Within days of admission to the intensive care unit he developed oliguric acute kidney failure requiring dialysis. Acute kidney injury developed in the setting of hemodynamic instability, sepsis and a maculopapular rash. Over the ensuing days the patient also developed transfusion-requiring severe hemolysis which was Coombs negative. Schistocytes were present on the peripheral smear. Given the broad differential diagnoses for acute kidney injury, a kidney biopsy was performed and revealed granulomatous tubulo-interstitial nephritis with some acute tubular injury. Based on the biopsy findings, a decision was taken to adjust medications and initiate corticosteroids for presumed medication-induced interstitial nephritis, hemolysis and maculo-papular rash. The kidney function and hemolysis improved over the subsequent days and the patient was discharged to a rehabilitation facility, no-longer required dialysis. Conclusions Acute kidney injury in patients with severe COVID-19 may have multiple causes. We present the first case of granulomatous interstitial nephritis in a patient with COVID-19. Drug-reactions may be more frequent than currently recognized in COVID-19 and are potentially reversible. The kidney biopsy findings in this case led to a change in therapy, which was associated with subsequent patient improvement. Kidney biopsy may therefore have significant value in pulling together a clinical diagnosis, and may impact outcome if a treatable cause is identified.

High Cut-Off Renal Replacement Therapy for Removal of Myoglobin in Severe Rhabdomyolysis and Acute Kidney Injury: A Case Series

Nephron ◽  
2013 ◽  
Vol 121 (3-4) ◽  
pp. c159-c164 ◽  
Author(s):  
Nils Heyne ◽  
Martina Guthoff ◽  
Julia Krieger ◽  
Michael Haap ◽  
Hans-Ulrich Häring
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Case Series ◽  
Kidney Injury

scholarly journals Hypercalcemia and acute kidney injury induced by eldecalcitol in patients with osteoporosis: a case series of 32 patients at a single facility

Renal Failure ◽  
2019 ◽  
Vol 41 (1) ◽  
pp. 88-97 ◽  
Author(s):  
Seishi Aihara ◽  
Shunsuke Yamada ◽  
Hideaki Oka ◽  
Taro Kamimura ◽  
Toshiaki Nakano ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Case Series ◽  
Kidney Injury ◽  
Single Facility

scholarly journals Acute kidney injury requiring dialysis in obstetric patients: management and clinical outcome in case series of 30 patients in a tertiary care centre

2017 ◽  
Vol 6 (7) ◽  
pp. 2997
Author(s):  
Molina U. Patel ◽  
Yuvraj Jadeja ◽  
Niket Patel ◽  
Nayana Patel ◽  
Smruti Vaishnav ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Tertiary Care ◽  
Case Series ◽  
Kidney Injury ◽  
Therapeutic Interventions ◽  
Risk Category ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Significant Difference ◽  
The Impact

Background: Acute Kidney Injury is a common medical problem affecting approximately 5% of all hospitalized and 30% of critically ill patients. The incidence in obstetric patients ranges from 1 in 2000 to 1 in 25000 pregnancies. In India till date, the impact of AKI on fetomaternal outcome and pertaining therapeutic interventions is only sparsely studied.Methods: It is a retrospective cross-sectional study. All obstetric patients with AKI on dialysis, admitted to Shree Krishna Hospital, a tertiary care hospital in Karamsad village in Gujarat from January 2013 to August 2015. Multivariate statistical analysis of clinical and laboratory parameters was performed using SPSS program to obtain the results.Results: The incidence of dialysis was 1.6%. HELLP syndrome and pre-eclampsia (80%) was found to be the most common etiology of AKI followed by Congestive cardiac failure (34.5%), hemorrhage and sepsis in 30% resp. All patients were admitted to ICU care. No significant difference was found between SAP II and SOFA monitoring system. Mechanical ventilation was done to support 53.3% and inotropic support was needed by 56.7% patients. According to the RIFLE criteria, majority of the patients fall under risk category followed by injury. 18% of the patients developed End Stage Renal Disease.Conclusions: In view of the multifaceted etiologies and complexity of management of AKI, a multi-disciplinary approach involving nephrologist, intensivists, obstetricians and neonatologists is extremely important.

scholarly journals Caffeine Overdose Complicated by Acute Kidney Injury despite Mild Creatine Kinase Elevation

2020 ◽  
Vol 3 (1) ◽  
pp. 12-16 ◽  
Author(s):  
Nao Koide ◽  
Nobuhiro Sato ◽  
Daisuke Kondo ◽  
Yasuo Hirose
Keyword(s):  
Emergency Department ◽  
Acute Kidney Injury ◽  
Creatine Kinase ◽  
Suicide Attempt ◽  
Case Reports ◽  
Kidney Injury ◽  
Elevated Creatine Kinase ◽  
Caffeine Overdose

Caffeine is a commonly used stimulant in our society. Prior case reports have described acute caffeine overdose resulting in rhabdomyolysis and acute kidney injury (AKI). We present the case of a 29-year-old man who presented to the emergency department after ingesting 20.1 g of caffeine in a suicide attempt and experienced AKI with only mildly elevated creatine kinase (CK). This case highlights the possibility that AKI can result from a caffeine overdose, even if the patient’s CK is only slightly elevated.

Eculizumab Modifies Outcomes in Adults with Atypical Hemolytic Uremic Syndrome with Acute Kidney Injury

2018 ◽  
Vol 48 (3) ◽  
pp. 225-233 ◽  
Author(s):  
Mercedes Cao ◽  
Bruna N. Leite ◽  
Tamara Ferreiro ◽  
María Calvo ◽  
Constantino Fernández ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Hemolytic Uremic Syndrome ◽  
Kidney Function ◽  
Case Reports ◽  
Atypical Hemolytic Uremic Syndrome ◽  
Kidney Injury ◽  
Complete Recovery ◽  
Genetic Abnormalities ◽  
Uremic Syndrome ◽  
Meta Analyses

Background: Atypical hemolytic uremic syndrome (aHUS) is a rare disease associated with congenital or acquired genetic abnormalities that result in uncontrolled complement activation, leading to thrombotic microangiopathy and kidney failure. Until recently, the only treatment was plasma exchange or plasma infusion (PE/PI), but 60% of patients died or had permanent kidney damage despite treatment. Eculizumab, a complement inhibitor, has shown promising results in aHUS. However, data are mainly extracted from case reports or studies of heterogeneous cohorts, and no direct comparison with PE/PI is available. Methods: An observational retrospective study of adult, dialysis-dependent aHUS patients with acute kidney injury (AKI) who were treated with either PE/PI alone or with second-line eculizumab in our center. We compared the effect of PE/PI and eculizumab on kidney function, hypertension, proteinuria, hematologic values, relapse, and death. Results: Thirty-one patients were included (females, 18; sporadic aHUS, 29; mean age, 46 ± 20 years). Twenty-six patients were treated with PE/PI alone, and 5 were deemed to be plasma-resistant and received eculizumab after stopping PE/PI. Among patients receiving eculizumab, 80% attained complete recovery of kidney function, 100% stopped dialysis, 20% had decreased proteinuria, and no patient relapsed (vs. 38.5, 50, 15.4, and 11.5%, respectively, of patients receiving only PE/PI). At 1-year of follow-up, no deaths had occurred in either group. Conclusion: Eculizumab shows greater efficacy than PE/PI alone for the treatment of adult aHUS patients with AKI. Prospective studies and meta-analyses are warranted to confirm our findings and set guidelines for treatment, monitoring, and maintenance.

scholarly journals Isolated rectal buttonhole tears in obstetrics: case series and review of the literature

2020 ◽  
Author(s):  
Joanna C. Roper ◽  
Ranee Thakar ◽  
Abdul H. Sultan
Keyword(s):  
Case Reports ◽  
Case Series ◽  
Operative Management ◽  
The Other ◽  
Uneventful Recovery ◽  
Repair Technique ◽  
Vaginal Deliveries ◽  
Colorectal Surgeon ◽  
Colorectal Surgeons ◽  
Repair Techniques

Abstract Introduction and hypothesis The management of isolated rectal buttonhole tears is not standardised and can be challenging in an acute obstetric setting. Our aim was to review the published literature and describe management and repair techniques in a case series. Methods A literature search was carried out. All results were screened and reviewed. Rectal buttonhole tears following vaginal delivery between April 2012 and January 2020 in our institution were identified. Repair technique and post-operative management were recorded. Results There were nine published case reports (four instrumental deliveries, two vaginal breech and three normal vaginal deliveries). Four case reports described a two-layer closure and five described a three-layer closure. Two cases were repaired in collaboration with colorectal surgeons. All nine cases made an uneventful recovery. We identified three patients with buttonhole tears all of whom had instrumental deliveries. A colorectal surgeon repaired the tear in two layers in one case, and an obstetrician performed the repair in the other two cases, one in three layers and the other in two layers. One patient had a de-functioning stoma at a later date due to a second breakdown of the recto-vaginal fistula repair. Conclusion Buttonhole tears are rare but techniques of repair vary. Most cases reviewed had an uneventful recovery after repair. We provide standardised steps for repair and management of isolated rectal buttonhole tears along with a video demonstrating the repair technique in an animal tissue (pig) model.

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