scholarly journals Renal replacement therapy-requiring acute kidney injury due to tubulointerstitial nephritis and uveitis syndrome: case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
B. Marahrens ◽  
K. Amann ◽  
K. Asmus ◽  
S. Erfurt ◽  
D. Patschan
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Kidney Function ◽  
Tubulointerstitial Nephritis ◽  
Kidney Injury ◽  
Rare Type ◽  
Case Presentation ◽  
New Onset

Abstract Background Acute kidney injury is a major challenge for today’s healthcare systems around the globe. Renal replacement therapy has been shown to be beneficial in acute kidney injury, but treatment highly depends on the cause of the acute kidney injury. One less common cause is tubulointerstitial nephritis, which comes in different entities. A very rare type of tubulointerstitial nephritis is tubulointerstitial nephritis and uveitis syndrome, in which the patient presents with additional uveitis. Case presentation A 19-year-old caucasian male presented with mild dyspnea, lack of appetite, weight loss, and moderate itchiness. Lab results showed an acute kidney injury with marked increase of serum creatinine. The patient was started on prednisolone immediately after admission. As the patient in this case showed symptoms of uremia on admission, we decided to establish renal replacement therapy, which is unusual in tubulointerstitial nephritis and uveitis syndrome. During his course of dialysis, the patient developed symptoms of sepsis probably due to a catheter-related infection requiring intensive care and antibiotic treatment, which had to be terminated early as the patient developed a rash. Intensified immunosuppression, combined with antibiotics, significantly resolved excretory kidney dysfunction. Conclusions Since both the primary inflammatory process and the secondary infectious complication significantly impaired excretory kidney function, kidney function of younger individuals with new-onset anterior uveitis should be monitored over time and during follow-up.

scholarly journals Hematuria Is Associated with More Severe Acute Tubulointerstitial Nephritis

2020 ◽  
Vol 9 (7) ◽  
pp. 2135
Author(s):  
Raquel Esteras ◽  
Jonathan G. Fox ◽  
Colin C. Geddes ◽  
Bruce Mackinnon ◽  
Alberto Ortiz ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Tubulointerstitial Nephritis ◽  
Kidney Injury ◽  
Common Cause ◽  
Acute Tubulointerstitial Nephritis ◽  
Acute Dialysis

Acute tubulointerstitial nephritis (ATIN) is a common cause of acute kidney injury. Although haematuria is a risk factor for the development of renal disease, no previous study has analyzed the significance of haematuria in ATIN. Retrospective, observational analysis of 110 patients with biopsy-proven ATIN was conducted. Results: Haematuria was present in 66 (60%) ATIN patients. A higher percentage of ATIN patients with haematuria had proteinuria than patients without haematuria (89.4% vs. 59.1%, p = 0.001) with significantly higher levels of proteinuria (median (interquartile range) protein:creatinine ratio 902.70 (513–1492) vs. 341.00 (177–734) mg/g, p <0.001). Moreover, those patients with more haematuria intensity had a higher urinary protein:creatinine ratio (1352.65 (665–2292) vs. 849.60 (562–1155) mg/g, p = 0.02). Those patients with higher proteinuria were more likely to need renal replacement therapy (22.7 vs. 0%, p = 0.03) and to suffer relapse (4 vs. 0%, p = 0.03). At the end of follow up, haematuric ATIN patients had higher serum creatinine levels (3.19 ± 2.91 vs. 1.91 ± 1.17 mg/dL, p = 0.007), and a trend towards a higher need for acute dialysis (7 vs. 1%, p = 0.09) and renal replacement therapy (12.1 vs. 2.3%, p = 0.12). Haematuria is common in ATIN and it is associated with worse renal function outcomes.

scholarly journals Long-Term Outcome After Renal Replacement Therapy in Severe Burns

2020 ◽  
Vol 41 (4) ◽  
pp. 866-870
Author(s):  
Ilmari Rakkolainen ◽  
Kukka-Maaria Mustonen ◽  
Jyrki Vuola
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Burn Injury ◽  
Kidney Injury ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Discharged Patients

Abstract Acute kidney injury is a common sequela after major burn injury, but only a small proportion of patients need renal replacement therapy. In the majority of patients, need for renal replacement therapy subsides before discharge from the burn center but limited literature exists on long-term outcomes. A few studies report an increased risk for chronic renal failure after burn injury. We investigated the long-term outcome of severely burned patients receiving renal replacement therapy during acute burn injury treatment. Data on 68 severely burned patients who received renal replacement therapy in Helsinki Burn Centre between November 1988 and December 2015 were collected retrospectively. Thirty-two patients survived and remained for follow-up after the primary hospital stay until December 31, 2016. About 56.3% of discharged patients were alive at the end of follow-up. In 81.3% of discharged patients, need for renal replacement therapy subsided before discharge. Two patients received renal replacement therapy for longer than 3 months; however, need for renal replacement therapy subsided in both patients. One patient required dialysis several years later on after the need for renal replacement therapy had subsided. This study showed that long-term need for renal replacement therapy is rare after severe burn injury. In the vast majority of patients, need for renal replacement therapy subsided before discharge from primary care. Acute kidney injury in association with burns is a potential but small risk factor for later worsening of kidney function in fragile individuals.

New-onset atrial fibrillation in patients with acute kidney injury on continuous renal replacement therapy

2021 ◽  
Vol 62 ◽  
pp. 157-163
Author(s):  
Khaled Shawwa ◽  
Panagiotis Kompotiatis ◽  
Shane A. Bobart ◽  
Kristin C. Mara ◽  
Brandon M. Wiley ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Onset Atrial Fibrillation ◽  
New Onset

Malignancy-associated kidney disease

2016 ◽  
Vol 6 (1) ◽  
pp. 0-0
Author(s):  
K Kozłowska ◽  
J. Małyszko
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Nephrotic Syndrome ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Tubulointerstitial Nephritis ◽  
Kidney Diseases ◽  
Kidney Injury ◽  
Electrolyte Abnormalities

Malignancy or its treatment affect kidney in several ways. The most common are acute kidney injury and chronic kidney disease. Other form of kidney diseases can also be present such as nephrotic syndrome, tubulointerstitial nephritis, thrombotic microangipathy etc. In addition, electrolyte abnormalities such as hypercalcemia, hyponatremia and hypernatremia, hypokalemia and hyperkalemia, and hypomagnesemia. are observed. Treatment of malignancy associated kidney disease is usually symptomatic. Cessation of the offending agent or other supportive measures if needed i.e. renal replacement therapy are also implemented.

Efficacy of Three Renal Replacement Therapy Modalities for the Treatment of Acute Kidney Injury Caused by Wasp Sting

2021 ◽  
pp. 1-11
Author(s):  
Fugang Li ◽  
Li Liu ◽  
Dezheng Chen ◽  
Yong Zhang ◽  
Mingli Wang ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Therapeutic Effects ◽  
Wasp Sting ◽  
Laboratory Results ◽  
Better Than

<b><i>Background/Aim:</i></b> This study mainly aimed to explore the therapeutic effects of 3 renal replacement therapy (RRT) modalities on acute kidney injury (AKI) caused by wasp stings. <b><i>Methods:</i></b> A retrospective study from September 2016 to December 2019 was conducted. Thirty-one patients with AKIs caused by wasp sting were selected and divided into 3 groups according to the initial RRT modality received, namely, (1) the intermittent hemodialysis combined with hemoperfusion (IHD + HP) group, (2) the continuous veno-venous hemodiafiltration (CVVHDF) group, and (3) the CVVHDF combined with HP (CVVHDF + HP) group. The laboratory results were measured and analyzed before treatment on the 3rd, 7th, and 14th days of treatment. The renal function outcomes and survival of the patients were investigated at 3 months follow-up. <b><i>Results:</i></b> The laboratory results of enzyme measures and inflammatory indicators in wasp sting patients increased significantly in the early stage and 3 RRT modalities were effective in reducing these indicators. In addition, continuous RRT modality (CVVHDF and CVVHDF + HP) showed better clearance of myoglobin than IHD + HP. The serum creatinine levels of patients in the 3 groups did not recover to baseline within 14 days after beginning treatment. Nevertheless, the CVVHDF + HP group was better than the CVVHDF group, and CVVHDF was better than the IHD + HP group on the 3rd day. The interleukin (IL)-6 and IL-10 levels in CVVHDF + HP and IHD + HP groups were obviously lower than those in the CVVHDF group on the 3rd day. In the follow-up study, the recovery rate of renal function in CVVHDF and CVVHDF + HP groups was significantly better than that in the IHD + HP group. <b><i>Conclusion:</i></b> Early RRT was effective in the treatment of patients with A KI caused by wasp sting. CVVHDF + HP and CVVHDF modalities were better than the IHD + HP group in venom clearance and renal function recovery.

scholarly journals SO020NEPHROLOGY INTERVENTION IN PATIENTS AWAITING CARDIAC SURGERY: A RANDOMISED CONTROLLED TRIAL

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Sergi Codina ◽  
Ana Coloma ◽  
Fabrizio Sbraga ◽  
Enric Boza ◽  
Jose Maria Vazquez-Reveron ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Controlled Trial ◽  
Kidney Injury ◽  
Categorical Variables

Abstract Background and Aims Acute kidney injury (AKI) is a frequent complication after cardiac surgery. Its incidence ranges from 19 to 44% depending on the study and which definition is used. There are some well-known risk factors associated with AKI, including baseline patient characteristics (age and comorbidities), need of perioperative blood transfusion or presence of previous chronic kidney disease. We wanted to evaluate if a nephrologist management and control of potential risk factors of renal disease can be used to prevent AKI, thereby minimizing the risk of need RRT, reducing costs and improving survival in these patients. It will be the first study focused on this intervention. The aim of this study is to assess if a nephrology intervention before cardiac surgery can reduce the postoperative incidence of AKI. Method Unicentric prospective randomized controlled trial of 298 participants from 2015 to 2019. The inclusion criteria was patients undergoing scheduled cardiac surgery of &gt; 18 years old. The exclusion criteria was a requirement for renal replacement therapy before surgery. Clinical Research Ethics Committee of Bellvitge has approved the study before initiation. All patients have given written informed consent. We have done an intention-to-treat analysis, continuous variables have been compared between groups using Student's t test and categorical variables using X2. Results Nephrology intervention before surgery, included a preoperative study done minimum 1 month before the surgery to optimize the patient’ s overall condition by optimization of hydration state, remove or minimize dose of drugs that potentially deteriorate kidney function and correct metabolic disorders. No differences in the characteristics of the patients between groups was found (Table 1). The number of patients with AKI were 49 without differences between groups (0.112), with most of them presenting a stage 1 AKI, only 3 patients present a stage 3 AKI, but none of them required renal replacement therapy (Table 2). We found 1.3% of mortality (1 participant in the intervention group and 3 in control group). Data at 1 year follow-up (n= 144) showed low incidence of kidney disease (creatinine in intervention arm 91.87±30.79μmol/L and in control arm 87.08±23.58, p=0.292) without differences in albuminuria. Conclusion In summary, we did not find any difference in acute kidney injury and death when a nephrology intervention is done to cardiac surgery patients, probably it would be necessary to increase the sample size to make conclusions. The results at 1 year follow-up showed no kidney disease in these patients.

scholarly journals MP241RISK FACTORS FOR RENAL REPLACEMENT THERAPY AND MORTALITY IN ACUTE KIDNEY INJURY INPATIENTS AT HOSPITAL CIVIL DE GUADALAJARA, MEXICO: 2 YEARS FOLLOW UP

2016 ◽  
Vol 31 (suppl_1) ◽  
pp. i420-i421
Author(s):  
Daniel Murillo ◽  
Monica Jimenez ◽  
Jonathan Iniguez ◽  
Guillermo Garcia ◽  
Karina Renoirte
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Kidney Injury

scholarly journals Continuous Renal Replacement Therapy: A Review

2021 ◽  
Vol 1 (2) ◽  
pp. 63-77
Author(s):  
Mujahidin ◽  
Yasir Teuku ◽  
Dzaky. A. N
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Organ Failure ◽  
Kidney Function ◽  
Human Body ◽  
Kidney Injury ◽  
Hemodynamic Stability

Kidney is an important organ to maintain hemodynamic stability inside the human body. In patient with acute kidney injury (AKI) there was a decreased kidney function that could interfere hemodynamic stability which can lead to multi organ failure even death. Around 5-10% patients with AKI required renal replacement therapy (RRT) to support their decreased renal function. Continuous renal replacement therapy (CRRT) is one of RRT modality that commonly used for patients with AKI who are hemodynamically unstable or in critically ill conditions.CRRT could divided into 4 mode, slow continuous ultrafiltration (SCUF), continuous veno-venous hemofiltration (CVVH), continuous veno-venous hemodialysis (CVVHD) and continuous veno-venous hemodialfiltration (CVVHDF). CRRT used based on renal and nonrenal indication. Several studies are still trying to prove nonrenal indication of RRT, to ascertain whether CRRT could be used as therapy effectively. Therefore the indication, the mechanism and the comparison of renal replacement therapy are very important to be understood.

scholarly journals Continuous Renal Replacement Therapy: A Review

2020 ◽  
Vol 1 (2) ◽  
pp. 63-77
Author(s):  
Muja Hidin ◽  
Yasir Teuku ◽  
Dzaky.A.N
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Organ Failure ◽  
Kidney Function ◽  
Human Body ◽  
Kidney Injury ◽  
Hemodynamic Stability

ABSTRACT Kidney is an important organ to maintain hemodynamic stability inside the human body. In patient with acute kidney injury (AKI) there was a decreased kidney function that could interfere hemodynamic stability which can lead to multi organ failure even death. Around 5-10% patients with AKI required renal replacement therapy (RRT) to support their decreased renal function. Continuous renal replacement therapy (CRRT) is one of RRT modality that commonly used for patients with AKI who are hemodynamically unstable or in critically ill conditions. CRRT could divided into 4 mode, slow continuous ultrafiltration (SCUF), continuous veno-venous hemofiltration (CVVH), continuous veno-venous hemodialysis (CVVHD) and continuous veno-venous hemodialfiltration (CVVHDF). CRRT used based on renal and nonrenal indication. Several studies are still trying to prove nonrenal indication of RRT, to ascertain whether CRRT could be used as therapy effectively. Therefore the indication, the mechanism and the comparison of renal replacement therapy are very important to be understood.

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