Herbal and dietary supplements related to diarrhea and acute kidney injury: a case report

2017 ◽  
Vol 14 (1) ◽  
Author(s):  
Suphamat Wanitsriphinyo ◽  
Mayuree Tangkiatkumjai
Keyword(s):  
Acute Kidney Injury ◽  
Case Report ◽  
Herbal Medicine ◽  
Serum Creatinine ◽  
Dietary Supplements ◽  
Kidney Function ◽  
Health Care Providers ◽  
Kidney Injury ◽  
Fluid Replacement ◽  
Care Providers

AbstractBackgroundThere is very little evidence relating to the association of herbal medicine with diarrhea and the development of acute kidney injury (AKI). This study reports a case of diarrhea-induced AKI, possibly related to an individual ingesting copious amounts of homemade mixed fruit and herb puree.Case presentationA 45-year-old Thai man with diabetes had diarrhea for 2 days, as a result of taking high amounts of a puree made up of eight mixed fruits and herbs over a 3-day period. He developed dehydration and stage 2 AKI, with a doubling of his serum creatinine. He had been receiving enalapril, as a prescribed medication, over one year. After he stopped taking both the puree and enalapril, and received fluid replacement therapy, within a week his serum creatinine had gradually decreased. The combination of puree, enalapril and AKI may also have induced hyperkalemia in this patient. Furthermore, the patient developed hyperphosphatemia due to his worsening kidney function, exacerbated by regularly taking some dietary supplements containing high levels of phosphate. His serum levels of potassium and phosphate returned to normal within a week, once the patient stopped both the puree and all dietary supplements, and had begun receiving treatment for hyperkalemia.ResultsThe mixed fruit and herb puree taken by this man may have led to his diarrhea due to its effect; particularly if the patient was taking a high concentration of such a drink. Both the puree and enalapril are likely to attenuate the progression of kidney function. The causal relationship between the puree and AKI was probable (5 scores) assessed by the modified Naranjo algorithm. This is the first case report, as far as the authors are aware, relating the drinking of a mixed fruit and herbal puree to diarrhea and AKI in a patient with diabetes.ConclusionsThis case can alert health care providers to the possibility that herbal medicine could induce diarrhea and develop acute kidney injury.

scholarly journals Clinical features of acute kidney injury in Coronavirus disease 2019—A case report with review of literature

2020 ◽  
Author(s):  
Hai Yuan ◽  
Xiaohan Lu ◽  
E Guo ◽  
Fengqi Hu ◽  
Zhao Gao
Keyword(s):  
Acute Kidney Injury ◽  
Case Report ◽  
Kidney Function ◽  
Kidney Injury ◽  
Hubei Province ◽  
Review Of Literature ◽  
Case Presentation ◽  
High Incidence ◽  
Careful Management ◽  
High Incidence Area

Abstract Background: In December 2019, an outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurred in Wuhan, Hubei province, China. We surveyed 91 patients who were diagnosis as coronavirus disease 2019 (COVID-19) in Xiangyang, Hubei province. And we found the incident of acute kidney injury (AKI) was 3.29% (3/91), which was higher than in the whole country but similar in Hubei province.Case presentation: We describe a case of 58-year-old man who was diagnosis as AKI stage 3 and non-oliguria AKI in the SARS-CoV-2 infection. After antiviral and other supporting treatment, his kidney function improved and he was transferred to normal ward.Conclusions: This case illustrated that careful management and strict monitoring of kidney function should be employed in COVID-19 patients especially in high incidence area of COVID-19.

scholarly journals Contrast Induced Acute Kidney Injury and its Impact on Mid-Term Kidney Function, Cardiovascular Events and Mortality

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Werner Ribitsch ◽  
Joerg H. Horina ◽  
Franz Quehenberger ◽  
Alexander R. Rosenkranz ◽  
Gernot Schilcher
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Kidney Function ◽  
Cardiovascular Events ◽  
Negative Impact ◽  
Kidney Injury ◽  
Long Term Effects ◽  
Record System ◽  
Medical Record System ◽  
Risk Patients

AbstractThe existence and clinical relevance of contrast induced acute kidney injury (CI-AKI) is still heavily debated and angiographic procedures are often withheld in fear of CI-AKI, especially in CKD-patients. We investigated the incidence of CI-AKI in cardiovascular high risk patients undergoing intra-arterial angiography and its impact on mid-term kidney function, cardiovascular events and mortality. We conducted a prospective observational trial on patients undergoing planned intra-arterial angiographic procedures. All subjects received standardized intravenous hydration prior to contrast application. CI-AKI was defined according to a ≥25% increase of creatinine from baseline to either 24hrs or 48hrs after angiography. Plasma creatinine and eGFR were recorded from the institutional medical record system one and three months after hospital discharge. Patients were followed up for two years to investigate the long term effects of CI-AKI on cardiovascular events and mortality. We studied 706 (317 female) patients with a mean eGFR of 52.0 ± 15 ml·min−1·1.73 m−2. The incidence of CI-AKI was 10.2% (72 patients). In 94 (13.3%) patients serum creatinine decreased ≥25% either 24 or 48 hours after angiography. Patients with CI-AKI had a lower creatinine and a higher eGFR at baseline, but no other independent predictors of CI-AKI could be identified. Kidney function was not different between both groups one and three months after discharge. After a two year follow up the overall incidence of cardiovascular events was 56.5% in the CI-AKI group and 58.8% in the Non CI-AKI group (p = 0.8), the incidence of myocardial infarctions, however, was higher in CI-AKI-patients. Overall survival was also not different between patients with CI-AKI (88.6%) and without CI-AKI (84.7%, p = 0.48). The occurrence of CI-AKI did not have any negative impact on mid-term kidney function, the incidence of cardiovascular events and mortality. Considerable fluctuations of serum creatinine interfere with the presumed diagnosis of CI-AKI. Necessary angiographic procedures should not be withheld in fear of CI-AKI.

scholarly journals Biomarkers for Early Diagnosis of Acute Kidney Injury

2019 ◽  
Vol 1 (1) ◽  
Keyword(s):  
Acute Kidney Injury ◽  
Early Diagnosis ◽  
Serum Creatinine ◽  
Kidney Function ◽  
Kidney Injury ◽  
Diagnostic Tools ◽  
Specific Intervention ◽  
Targeted Intervention ◽  
Targeted Interventions ◽  
Life Threatening

Acute kidney injury (AKI) is a common and potentially life-threatening conditionassociated with morbidity and mortality. Currently, the standard diagnostic tools for the detection of AKI are monitoring of urinary output and serum creatinine (sCr), both of which are markers of kidney function but not kidney injury. Novel AKI biomarkers have made significant contributions to our understanding of the molecular under pinnings of AKI, they could also have use as molecular phenotyping tools that facilitate the identification of patients who could benefit from a specific intervention, even a biomarker-targeted intervention and they were proved to be useful in facilitating early diagnosis, guiding targeted interventions and monitoring the disease progression and resolution.

scholarly journals Acute Kidney Injury after ingestion of Star fruit juice in patients with previous history of acute kidney injury: Two case reports

2017 ◽  
Vol 7 (1) ◽  
pp. 33-35
Author(s):  
Sayed Fazlul Islam ◽  
KBM Hadizzaman ◽  
Syed Mahbub Morshed ◽  
Md Omar Faroque ◽  
AH Hamid Ahmed ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Case Report ◽  
Serum Creatinine ◽  
Case Reports ◽  
Previous History ◽  
Kidney Injury ◽  
Normal Serum ◽  
Tubular Necrosis ◽  
Mild Degree ◽  
Star Fruit

Acute kidney injury can occur due to various reasons. In this case report two cases of acute kidney injury (AKI) were reported after ingestion of 250 ml of starfruit juice presented. In both cases features of nephrotoxicity and neurotoxicity were found and there was mild to moderate rise in serum creatinine. Routine and microscopic examination of urine showed mild degree of proteinuria, no other active urinary sediment was found except calcium oxalate crystals. Renal biopsy was done in both cases which showed features of acute tubular necrosis. These two patients were treated symptomatically and discharged with normal serum creatinine. There is no case report of acute kidney injury due to star fruit ingestion in Bangladesh. Star fruit is very popular, cheap and easily available. But its nephrotoxic effect is not known to general population. These two case reports might be a first time message to the nation.J Shaheed Suhrawardy Med Coll, 2015; 7(1):33-35

MO389PREDICTORS OF COMMUNITY-ACQUIRED ACUTE KIDNEY INJURY IN PATIENTS WITH ACUTE CARDIAC DISEASES

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Marina Efremovtseva ◽  
Svetlana Avdoshina ◽  
Maria Markova ◽  
Zhanna Kobalava
Keyword(s):  
Blood Pressure ◽  
Risk Assessment ◽  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Hospital Mortality ◽  
Kidney Function ◽  
Kidney Injury ◽  
Assessment Scale ◽  
Cardiac Diseases ◽  
L 14

Abstract Background and Aims Acute kidney injury (AKI) is a common and serious problem associated with poor prognosis. The aim of the study was to reveal the prevalence and predictors of community-acquired AKI in patients with acute cardiac diseases. Method 566 patients (278 with acute decompensated heart failure (ADHF), 288 with non-ST-elevation acute coronary syndrome (NSTE-ACS), 46% male, 71±11 years (M±SD), smokers 26%, arterial hypertension 91%, previous myocardial infarction (MI) 45%, diabetes mellitus (DM) 28%, atrial fibrillation 35%, chronic kidney disease (CKD) 46%, previous hospitalization with ADHF 36%, ejection fraction (EF) <35% 15%, blood pressure (BP) 142±30/83±16 mmHg) were examined. AKI was diagnosed according 2012 KDIGO Guidelines. Community-acquired AKI was identified in patients with elevated serum creatinine levels on admission, which decreased during hospitalization. Results: Incidence of AKI in all patients, patients with ADHF and NSTE-ACS was 40, 43.5 and 37.2%. In-hospital mortality in patients with AKI was higher than in those with stable kidney function (14.9 vs 3.6%, p<0.001). Community-acquired AKI was present in 18% of patients (20.5 and 15.6% in ADHF and NSTE-ACS respectively), in-hospital mortality was 16.7% (10.5 and 24.4% respectively). The risk assessment scale for community-acquired AKI was developed based on independent predictors of AKI, using binary logistic regression and ROC analysis (AUC 0.860, 95% CI 0.821-0.898). Independent variables included in the model, and the corresponding points (pts) are listed below: clinical and demographic characteristics (male gender - 6 pts, alcohol abuse - 7 pts, DM - 1 pt), present on admission (MI - 5 pts, AHF/ADHF - 9 pts, systolic BP <120 - 10 pts, <110 - 15 pts, <90 mmHg - 27 pts; state of kidney function on admission: serum creatinine >98 and >128 mkmol/L - 14 and 22 pts, GFRCKD-EPI <45 and <15 ml/min/1.73 m2 - 7 and 14 pts; glucose level >7 mmol/L - 4 pts), outpatient intake of ACE inhibitors - 4 pts, absence of spironolactone in outpatient therapy - 1 pt. Diagnostically significant risk score for predicting AKI was >30 pts, the risk prediction model showed sensitivity 89%, specificity 66%. Conclusion Community-acquired AKI is common in patients in acute cardiovascular events, is associated with high mortality, and often is underdiagnosed. Usage of risk assessment scale in clinical practice may help to detect patients with high-risk of AKI on admission. Baseline kidney function and blood pressure level are main predictors of AKI in patients admitted with acute cardiac diseases.

scholarly journals Service evaluation of the implementation of a digitally-enabled care pathway for the recognition and management of acute kidney injury

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1033 ◽  
Author(s):  
Alistair Connell ◽  
Hugh Montgomery ◽  
Stephen Morris ◽  
Claire Nightingale ◽  
Sarah Stanley ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Kidney Function ◽  
Health Research ◽  
Care Pathway ◽  
Kidney Injury ◽  
Service Evaluation ◽  
Care Quality ◽  
Evaluation Team ◽  
Response Team

Acute Kidney Injury (AKI), an abrupt deterioration in kidney function, is defined by changes in urine output or serum creatinine. AKI is common (affecting up to 20% of acute hospital admissions in the United Kingdom), associated with significant morbidity and mortality, and expensive (excess costs to the National Health Service in England alone may exceed £1 billion per year). NHS England has mandated the implementation of an automated algorithm to detect AKI based on changes in serum creatinine, and to alert clinicians. It is uncertain, however, whether ‘alerting’ alone improves care quality. We have thus developed a digitally-enabled care pathway as a clinical service to inpatients in the Royal Free Hospital (RFH), a large London hospital. This pathway incorporates a mobile software application - the “Streams-AKI” app, developed by DeepMind Health - that applies the NHS AKI algorithm to routinely collected serum creatinine data in hospital inpatients. Streams-AKI alerts clinicians to potential AKI cases, furnishing them with a trend view of kidney function alongside other relevant data, in real-time, on a mobile device. A clinical response team comprising nephrologists and critical care nurses responds to these AKI alerts by reviewing individual patients and administering interventions according to existing clinical practice guidelines. We propose a mixed methods service evaluation of the implementation of this care pathway. This evaluation will assess how the care pathway meets the health and care needs of service users (RFH inpatients), in terms of clinical outcome, processes of care, and NHS costs. It will also seek to assess acceptance of the pathway by members of the response team and wider hospital community. All analyses will be undertaken by the service evaluation team from UCL (Department of Applied Health Research) and St George’s, University of London (Population Health Research Institute).

scholarly journals Contrast‐Induced Acute Kidney Injury in Patients Undergoing TAVI Compared With Coronary Interventions

2020 ◽  
Vol 9 (16) ◽  
Author(s):  
Gabriele Venturi ◽  
Michele Pighi ◽  
Gabriele Pesarini ◽  
Valeria Ferrero ◽  
Mattia Lunardi ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Aortic Valve ◽  
Serum Creatinine ◽  
Contrast Medium ◽  
Kidney Function ◽  
Kidney Injury ◽  
Serum Creatinine Concentration ◽  
Creatinine Concentration ◽  
Emergency Procedures ◽  
The Impact

Background Differences in the impact of contrast medium on the development of contrast‐induced acute kidney injury (CI‐AKI) in patients undergoing transcatheter aortic valve implantation (TAVI) or a coronary angiography/percutaneous coronary intervention (CA/PCI) have not been previously investigated. Methods and Results Patients treated with TAVI or elective CA/PCI were retrospectively analyzed in terms of baseline and procedural characteristics, including preprocedural and postprocedural kidney function. CI‐AKI was defined as a relative increase in serum creatinine concentration of at least 0.3 mg/dL within 72 hours of contrast‐medium administration compared with baseline. The incidence of CI‐AKI in the TAVI versus CA/PCI group was compared. After the exclusion of patients in dialysis and emergency procedures, 977 patients were analyzed; there were 489 patients who had undergone TAVI (50.1%) and 488 patients who had undergone CA/PCI (49.9%). Patients treated by TAVI were older, presenting a higher rate of anemia and chronic kidney disease ( P <0.001 for all comparisons). Consistently, they also had a significantly lower glomerular filtration rate and higher serum creatinine concentration ( P <0.001 for all). However, the occurrence of CI‐AKI was significantly lower in these patients compared with patients treated by a CA/PCI (6.7% versus 14.5%, P <0.001). At multivariate analysis, the TAVI procedure had an independent protective effect on CI‐AKI incidence among total population (odds ratio, 0.334; 95% CI, 0.193–0.579; P <0.001). This observation was confirmed after propensity score matching among 360 patients (180 by TAVI and 180 by CA/PCI; P =0.002). Conclusions CI‐AKI occurred less frequently in patients undergoing TAVI than in patients undergoing a CA/PCI, despite a worse‐risk profile. The impact of contrast administration on kidney function in patients who had undergone TAVI may be better tolerated because of the hemodynamic changes following aortic valve replacement.

Delayed seizure-like activity following analytically confirmed use of previously unreported synthetic cannabinoid analogues

2014 ◽  
Vol 34 (5) ◽  
pp. 557-560 ◽  
Author(s):  
LJ Schep ◽  
RJ Slaughter ◽  
S Hudson ◽  
R Place ◽  
M Watts
Keyword(s):  
Health Care ◽  
Acute Kidney Injury ◽  
Adverse Effects ◽  
Blood Sample ◽  
Health Care Providers ◽  
Synthetic Cannabinoids ◽  
Kidney Injury ◽  
Synthetic Cannabinoid ◽  
Care Providers ◽  
Low Concentrations

Synthetic cannabinoid use has become widespread, leading to increased burdens on health care providers. Symptoms range from agitation and psychosis to seizures and acute kidney injury. We report a case where a patient was assessed and treated twice within 12 h for seizures following synthetic cannabinoid intoxication. Blood sample determinations showed low concentrations of analogues not previously reported, some of which are legal. Clinicians should be aware that synthetic cannabinoids may cause an array of severe health consequences. Given the ever evolving structure of available analogues, clinicians must also be prepared for other unexpected adverse effects.

scholarly journals Acyclovir Nephrotoxicity: A Case Report Highlighting the Importance of Prevention, Detection, and Treatment of Acyclovir-Induced Nephropathy

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Raymond Fleischer ◽  
Michael Johnson
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Case Report ◽  
Serum Creatinine ◽  
Clinical Manifestation ◽  
Kidney Injury ◽  
Rapid Rise ◽  
Acyclovir Therapy

Acute kidney injury is an unfortunate complication of acyclovir therapy secondary to crystal-induced nephropathy. It is characterized by a decrease in renal function that develops within 24–48 hours of acyclovir administration indicated by a rapid rise in the serum creatinine. Failure to quickly realize this as an etiology of acute kidney injury can lead to excessive morbidity to the patient. The case described in this vignette is an example of the clinical manifestation of acyclovir crystal obstructive nephrotoxicity. We will briefly discuss the pathophysiology, diagnosis, prevention, and management of patients that present with acyclovir nephrotoxicity.

scholarly journals Service evaluation of the implementation of a digitally-enabled care pathway for the recognition and management of acute kidney injury

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1033 ◽  
Author(s):  
Alistair Connell ◽  
Hugh Montgomery ◽  
Stephen Morris ◽  
Claire Nightingale ◽  
Sarah Stanley ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Kidney Function ◽  
Health Research ◽  
Care Pathway ◽  
Kidney Injury ◽  
Service Evaluation ◽  
Care Quality ◽  
Evaluation Team ◽  
Response Team

Acute Kidney Injury (AKI), an abrupt deterioration in kidney function, is defined by changes in urine output or serum creatinine. AKI is common (affecting up to 20% of acute hospital admissions in the United Kingdom), associated with significant morbidity and mortality, and expensive (excess costs to the National Health Service in England alone may exceed £1 billion per year). NHS England has mandated the implementation of an automated algorithm to detect AKI based on changes in serum creatinine, and to alert clinicians. It is uncertain, however, whether ‘alerting’ alone improves care quality. We have thus developed a digitally-enabled care pathway as a clinical service to inpatients in the Royal Free Hospital (RFH), a large London hospital. This pathway incorporates a mobile software application - the “Streams-AKI” app, developed by DeepMind Health - that applies the NHS AKI algorithm to routinely collected serum creatinine data in hospital inpatients. Streams-AKI alerts clinicians to potential AKI cases, furnishing them with a trend view of kidney function alongside other relevant data, in real-time, on a mobile device. A clinical response team comprising nephrologists and critical care nurses responds to these AKI alerts by reviewing individual patients and administering interventions according to existing clinical practice guidelines. We propose a mixed methods service evaluation of the implementation of this care pathway. This evaluation will assess how the care pathway meets the health and care needs of service users (RFH inpatients), in terms of clinical outcome, processes of care, and NHS costs. It will also seek to assess acceptance of the pathway by members of the response team and wider hospital community. All analyses will be undertaken by the service evaluation team from UCL (Department of Applied Health Research) and St George’s, University of London (Population Health Research Institute).

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