Averrhoa bilimbi ingestion and acute kidney injury: A case series

Averrhoa bilimbi (Irumban puli) is commonly used in South India for variety of household preparations and also as a remedy for hypertension, diabetes and dyslipidemia. The fruit has very high oxalate content which, when consumed in large quantities, forms calcium oxalate crystals in the renal tubules. These crystals get adhered to the tubular cells and cause cell necrosis resulting in acute kidney injury. We describe a series of 4 such cases who presented to us in acute renal failure after consumption of Averrhoa bilimbi in excess. 3 out of 4 patients required hemodialysis. There was recovery of renal function at the end of 2-6 weeks.

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Acute Kidney Injury Following Ingestion of Averrhoa bilimbi Juice

Bangladesh Critical Care Journal ◽

10.3329/bccj.v3i2.25115 ◽

2015 ◽

Vol 3 (2) ◽

pp. 71-73 ◽

Cited By ~ 1

Author(s):

Md Mostarshid Billah ◽

Md Anisur Rahman ◽

Muhammad Abdur Rahim ◽

Ayesha Tabassum Swarna ◽

Palash Mitra ◽

...

Keyword(s):

Acute Kidney Injury ◽

Renal Function ◽

High Risk ◽

Kidney Injury ◽

Renal Tubules ◽

Fasting State ◽

Calcium Oxalate Crystals ◽

The Family ◽

History Of ◽

Very High

Bilimbi/belembu fruit belongs to the family of Oxalidacae, species Averrhoa bilimbi. Freshly prepared concentrated juice of bilimbi has very high oxalic acid content and consumption carries a high risk of developing acute kidney injury (AKI) by deposition of calcium oxalate crystals in renal tubules. AKI due to Averrhoa bilimbi juice injestion is very rare. We report the case history of a 60-year-old hypertensive, dyslipidemic patient, with normal renal function, who ingested around 600ml of juice in fasting state for treating dyslipidemia. The patient developed AKI and required three sessions of hemodialysis. Her renal function returned to normal after five weeks.Bangladesh Crit Care J September 2015; 3 (2): 71-73

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Inhibition of HDAC6 protects against rhabdomyolysis-induced acute kidney injury

AJP Renal Physiology ◽

10.1152/ajprenal.00546.2016 ◽

2017 ◽

Vol 312 (3) ◽

pp. F502-F515 ◽

Cited By ~ 31

Author(s):

Yingfeng Shi ◽

Liuqing Xu ◽

Jinhua Tang ◽

Lu Fang ◽

Shuchen Ma ◽

...

Keyword(s):

Acute Kidney Injury ◽

Therapeutic Potential ◽

Apoptotic Cell ◽

Kidney Injury ◽

Acute Injury ◽

Tubular Damage ◽

Renal Tubules ◽

Tubular Cells ◽

Renal Tubular Cells ◽

Renal Tubular

Histone deacetylase 6 (HDAC6) inhibition has been reported to protect against ischemic stroke and prolong survival after sepsis in animal models. However, it remains unknown whether HDAC6 inhibition offers a renoprotective effect after acute kidney injury (AKI). In this study, we examined the effect of tubastatin A (TA), a highly selective inhibitor of HDAC6, on AKI in a murine model of glycerol (GL) injection-induced rhabdomyolysis. Following GL injection, the mice developed severe acute tubular injury as indicated by renal dysfunction; expression of neutrophil gelatinase-associated lipocalin (NGAL), an injury marker of renal tubules; and an increase of TdT-mediated dUTP nick-end labeling (TUNEL)-positive tubular cells. These changes were companied by increased HDAC6 expression in the cytoplasm of renal tubular cells. Administration of TA significantly reduced serum creatinine and blood urea nitrogen levels as well as attenuated renal tubular damage in injured kidneys. HDAC6 inhibition also resulted in decreased expression of NGAL, reduced apoptotic cell, and inactivated caspase-3 in the kidney after acute injury. Moreover, injury to the kidney increased phosphorylation of nuclear factor (NF)-κB and expression of multiple cytokines/chemokines including tumor necrotic factor-α and interleukin-6 and monocyte chemoattractant protein-1, as well as macrophage infiltration. Treatment with TA attenuated all those responses. Finally, HDAC6 inhibition reduced the level of oxidative stress by suppressing malondialdehyde (MDA) and preserving expression of superoxide dismutase (SOD) in the injured kidney. Collectively, these data indicate that HDAC6 contributes to the pathogenesis of rhabdomyolysis-induced AKI and suggest that HDAC6 inhibitors have therapeutic potential for AKI treatment.

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SARS-CoV-2 Causes Acute Kidney Injury by Directly Infecting Renal Tubules

Frontiers in Cell and Developmental Biology ◽

10.3389/fcell.2021.664868 ◽

2021 ◽

Vol 9 ◽

Author(s):

Zhaohui Chen ◽

Junyi Hu ◽

Lilong Liu ◽

Rong Chen ◽

Miao Wang ◽

...

Keyword(s):

Acute Kidney Injury ◽

Cohort Analysis ◽

Kidney Injury ◽

Human Kidney ◽

Cell Types ◽

Progressive Increase ◽

Renal Tubules ◽

Spike Gene ◽

Tubular Cells ◽

Renal Tubular Cells

Acute kidney injury (AKI) is one of the most prevalent complications among hospitalized coronavirus disease 2019 (COVID-19) patients. Here, we aim to investigate the causes, risk factors, and outcomes of AKI in COVID-19 patients. We found that angiotensin-converting enzyme II (ACE2) and transmembrane protease serine 2 (TMPRSS2) were mainly expressed by different cell types in the human kidney. However, in autopsy kidney samples, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleoprotein was detected in ACE2+ or TMPRSS2+ renal tubular cells, whereas the RNAscope® Assay targeting the SARS-CoV-2 Spike gene was positive mainly in the distal tubular cells and seldom in the proximal tubular cells. In addition, the TMPRSS2 and kidney injury marker protein levels were significantly higher in the SARS-CoV-2-infected renal distal tubular cells, indicating that SARS-CoV-2-mediated AKI mainly occurred in the renal distal tubular cells. Subsequently, a cohort analysis of 722 patients with COVID-19 demonstrated that AKI was significantly related to more serious disease stages and poor prognosis of COVID-19 patients. The progressive increase of blood urea nitrogen (BUN) level during the course of COVID-19 suggests that the patient’s condition is aggravated. These results will greatly increase the current understanding of SARS-CoV-2 infection.

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Association between positive end-expiratory pressure and central venous pressure towards acute kidney injury in COVID-19 acute respiratory distress syndrome: A case series

10.26226/morressier.5fa2cf404d4e91fe5c54b840 ◽

2020 ◽

Author(s):

Marilaeta Cindryani

Keyword(s):

Acute Kidney Injury ◽

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Venous Pressure ◽

Case Series ◽

Kidney Injury ◽

Positive End Expiratory Pressure ◽

Central Venous

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Faculty Opinions recommendation of Sestrin-2 and BNIP3 regulate autophagy and mitophagy in renal tubular cells in acute kidney injury.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718012810.793481005 ◽

2013 ◽

Author(s):

Kenneth Hallows ◽

Mohammad Al-bataineh

Keyword(s):

Acute Kidney Injury ◽

Kidney Injury ◽

Tubular Cells ◽

Renal Tubular Cells ◽

Renal Tubular

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ACUTE KIDNEY INJURY IN ELDERLY PATIENTS

Wiadomości Lekarskie ◽

10.36740/wlek201908109 ◽

2019 ◽

Vol 72 (8) ◽

pp. 1466-1472

Author(s):

Grażyna Kobus ◽

Jolanta Małyszko ◽

Hanna Bachórzewska-Gajewska

Keyword(s):

Acute Kidney Injury ◽

Renal Failure ◽

Acute Renal Failure ◽

Elderly Patients ◽

Older Patients ◽

Age Groups ◽

Kidney Injury ◽

The Elderly ◽

Younger Patients ◽

Common Cause

Introduction: In the elderly, impairment of kidney function occurs. Renal diseases overlap with anatomic and functional changes related to age-related involutionary processes. Mortality among patients with acute renal injury is approximately 50%, despite advances in treatment and diagnosis of AKI. The aim: To assess the incidence of acute kidney injury in elderly patients and to analyze the causes of acute renal failure depending on age. Materials and methods: A retrospective analysis included medical documentation of patients hospitalized in the Nephrology Clinic during the 6-month period. During this period 452 patients were hospitalized in the clinic. A group of 77 patients with acute renal failure as a reason for hospitalization was included in the study. Results: The prerenal form was the most common cause of AKI in both age groups. In both age groups, the most common cause was dehydration; in the group of patients up to 65 years of age, dehydration was 29.17%; in the group of people over 65 years - 43.39%. Renal replacement therapy in patients with AKI was used in 14.29% of patients. In the group of patients up to 65 years of age hemodialysis was 16.67% and above 65 years of age. -13.21% of patients. The average creatinine level in the group of younger patients at admission was 5.16 ± 3.71 mg / dl, in the group of older patients 3.14 ± 1.63 mg / dl. The size of glomerular filtration GFR in the group of younger patients at admission was 21.14 ± 19.54 ml / min, in the group of older patients 23.34 ± 13.33 ml / min. Conclusions: The main cause of acute kidney injury regardless of the age group was dehydration. Due to the high percentage of AKI in the elderly, this group requires more preventive action, not only in the hospital but also at home.

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Lupus cystitis: unusual cause of renal failure in systemic lupus erythematosus

BMJ Case Reports ◽

10.1136/bcr-2019-233446 ◽

2019 ◽

Vol 12 (12) ◽

pp. e233446

Author(s):

Kevin John ◽

Krupa Varughese ◽

Ranil Johann Boaz ◽

Tarun George

Keyword(s):

Systemic Lupus Erythematosus ◽

Acute Kidney Injury ◽

Renal Failure ◽

Renal Function ◽

Lupus Erythematosus ◽

Kidney Injury ◽

Systemic Lupus ◽

Uncommon Presentation ◽

Acute Dyspnoea ◽

Chronic Fever

A 42-year-old woman presented with chronic fever, abdominal pain, intermittent loose stools and dysuria for 3 months. She had recently developed acute dyspnoea with acute kidney injury. She was found to have a contracted, thick-walled bladder with bilateral hydroureteronephrosis. She underwent bilateral percutaneous nephrostomies, following which her renal function recovered. She satisfied the clinical and immunological features of the Systemic Lupus International Collaborating Clinics criteria for systemic lupus erythematosus (SLE). She was initiated on immunosuppression. Lupus cystitis with a contracted bladder is an uncommon presentation of SLE.

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Acute kidney injury and nephrotic syndrome associated with eltrombopag therapy in chronic idiopathic thrombocytopenic purpura

BMJ Case Reports ◽

10.1136/bcr-2020-241462 ◽

2021 ◽

Vol 14 (4) ◽

pp. e241462

Author(s):

Suchi Anindita Ghosh ◽

Jean Patrick ◽

Kyaw Zin Maw

Keyword(s):

Acute Kidney Injury ◽

Renal Failure ◽

Nephrotic Syndrome ◽

Idiopathic Thrombocytopenic Purpura ◽

Kidney Injury ◽

High Dose ◽

Chronic Idiopathic Thrombocytopenic Purpura ◽

Thrombocytopenic Purpura ◽

Antibody Screen ◽

Auto Antibody

A 77-year-old man was admitted with severe acute kidney injury and nephrotic syndrome. He was started on eltrombopag for chronic idiopathic thrombocytopenic purpura 6 weeks earlier. An ultrasound of the kidneys was normal and an auto-antibody screen was negative. The use of the Naranjo adverse drug reaction probability scale indicated a probable relationship (score of 5) between the patient’s development of acute renal failure and eltrombopag therapy. Literature review identified only one other case of nephrotic syndrome and acute kidney injury associated with eltrombopag therapy in which a kidney biopsy revealed focal segmental glomerulosclerosis. Due to the challenges faced during the prevailing SARS-CoV-2 pandemic and persistent low platelet counts a renal biopsy was not undertaken. On stopping eltrombopag, the patients renal function stabilised and he successfully went into remission following treatment with high dose corticosteroids and diuretics. This report of a serious case of reversible renal failure and nephrotic syndrome after treatment with eltrombopag may serve to inform clinicians about the possible severe renal adverse effects of eltrombopag before its commencement for future use.

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