scholarly journals Adequate fluid resuscitation decreases incidence of acute renal failure in burn patients

2019 ◽  
Vol 38 (2) ◽  
pp. 108
Author(s):  
Daniel Ardian Soeselo ◽  
Etheldreda Alexandria Stephanie Suparman
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Fluid Resuscitation ◽  
Burn Injury ◽  
Laboratory Data ◽  
Albumin Level ◽  
Burn Patients ◽  
Cross Sectional ◽  
Exact Test ◽  
Parkland Formula

BACKGROUND <br />Burns constitute a severe health problem in many countries. In Indonesia burns rank 4th of all trauma-related diseases and are a burden on the country’s health system. Adequate fluid resuscitation is the initial management of burns that determines the success of treatment. This study aimed to determine the relationship between adequate fluid resuscitation and incidence of acute renal failure in burn patients. <br /><br />METHODS<br />A retrospective study of cross-sectional design was conducted on 30 burn patients who came to the Emergency Unit (ER) from January 2015-December 2017. Medical records were reviewed to examine the data on fluid resuscitation according to the Parkland formula and the laboratory data. Acute renal failure was defined as a creatinine level of more than 2.1 mg/dL after 7 days. Hypoalbuminemia was defined as an albumin level of less than 3.4 g/dL. Fisher’s exact test was used to analyze the data.<br /><br />RESULTS<br />Twenty-two subjects received fluid resuscitation according to the Parkland formula and 8 did not. Twenty-five experienced complications such as acute renal failure (ARF) (13.3%), hypoalbuminemia (46.7%) and a combination of ARF and hypoalbuminemia (23.3%). One person died. Adequate fluid resuscitation was significantly associated with decrease incidence of ARF (p=0.015), but not significantly with hypoalbuminemia (p=0.214) and with mortality (p=0.267).<br /><br />CONCLUSION<br />Adequate fluid resuscitation decreased the incidence of ARF in burn patients. Consensus protocols for initial burn resuscitation and treatment are crucial to avoid the consequences of ARF after burn injury.

scholarly journals Predictors of Mortality in Patients with Acute Renal Failure

2006 ◽  
Vol 49 (3) ◽  
pp. 183-188 ◽  
Author(s):  
Mehmet Tugrul Sezer ◽  
Murat Demir ◽  
Gokhan Gungor ◽  
Altug Senol
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Prognostic Factors ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Laboratory Data ◽  
Albumin Level ◽  
Predictors Of Mortality ◽  
Apache Iii ◽  
Morbid Conditions

Mortality associated with acute renal failure (ARF) remains high despite of developments in therapy strategies and definition of different prognostic factors. Therefore, this study focused on to define new prognostic factors and especially regional characteristics of the ARF patients. One hundred fifteen ARF patients, diagnosed from November 1998 to May 2003, were included to this prospective and observational study. Clinical features, laboratory parameters, Acute Physiology and Chronic Health Evaluation (APACHE) III scores and co-morbid conditions of the patients were examined. Clinical and laboratory data, and APACHE III scores were recorded at the first nephrology consult day. Thirty of the patients (26%) died. APACHE III scores, presence and the total number of co-morbid conditions and serum albumin levels at the time of first nephrology consultation were found as independent predictors of mortality. There was a negative correlation between APACHE III scores and serum albumin levels. Not only increased APACHE III score and presence of co-morbid conditions but also low serum albumin level was found as the predictors of mortality. However, only serum albumin level is seen as modifiable prognostic factor among these parameters. Therefore, further studies are necessary to determine the causes of hypoalbuminemia in patients with ARF and the effect of it’s effective treatment on patients outcome.

Frequency of factors leading to acute renal failure in obstetric patients.

2021 ◽  
Vol 28 (05) ◽  
pp. 640-646
Author(s):  
Shaheena Zafar ◽  
Riffat Jaleeel ◽  
Kouser Karim Lodhani
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Serum Creatinine ◽  
Placental Abruption ◽  
Post Partum ◽  
Common Factor ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional

Objective: To determine the frequency of factors leading to acute renal failure in obstetric patients. Study Design: Cross Sectional study. Setting: Department of Obstetrics and Gynecology, Civil Hospital Karachi, Tertiary Care Hospital. Period: July 2015- Jan 2016. Material & Methods: Total 250 women during pregnancy and within 42 days after delivery who were diagnosed as ARF were included. Serum creatinine was done on admission and then after 24 hours of delievery. Those with urine output < 30ml / hour and serum creatinine > 1.5 mg / dl were recruited. All data was recorded on proforma. Results: The average age of the women was 29.36±5.87 years. Post-partum hemorrhage was the important and common factor i.e. 40.4%, followed by placental abruption 25.6%, Severe pre-eclampsia 18.4%, puerperal sepsis 8.4% and eclampsia 7.2%. Conclusion: Ante partum hemorrhage like placental abruption, eclampsia and preeclampsia, and postpartum hemorrhages’ are the major causes of obstetrical ARF. Good antenatal care and provision of universal health facility can prevent this dangerous condition. Though it is a treatable and curable complication, but if not diagnosed and treated timely, it can lead to significant maternal morbidity and mortality.

scholarly journals Frequency of acute renal failure in blackstone poisoning

2020 ◽  
Vol 27 (06) ◽  
pp. 1285-1290
Author(s):  
Ahmed Ali Kanhar ◽  
Waseem Raja Memon ◽  
Nasrullah Aamer ◽  
Bahkat Ali Sial ◽  
Abdul Aziz Sahito ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Urine Output ◽  
Low Cost ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Output Measurement

Objective: To determine the frequency of acute renal failure in patients presented with Blackstone poisoning in a tertiary care Hospital. Study Design: Cross sectional study. Setting: Medical wards and ICU at Peoples Medical College Hospital, Nawabshah. Period: September 2017 to March 2018. Material & Methods: All the patients of age 20 to 50 years having Paraphenylenediamine (PPD) poisoning (kala-patthar) during ≥6 hours after ingestion and either of gender were included. AKI was labelled as positive if either of any stage was present on the basses of urine output measurement for 24 hours through urine beg r urine output (UO) criteria. All the data was documented in self-made proforma. Results: The mean age for patients was 24.9±8.9 years, 46(19.08%) subjects were male and 195(80.91%) were female. 18(7.5%) study subjects had acute renal failure, out of them 6 study subjects had ARF of stage I, 5 patients had stage II and 7 study subjects had acute renal failure stage III. Conclusion: Acute renal injury is a common complication following PPD ingestion 7.5%. Paraphenylenediamine toxicity is a threat to the region of Asia and is evolving as a substitute to the poisoning of organophosphorus due to its easy accessibility and low cost.

scholarly journals Acute renal failure in children: outcome and prognostic factors

2016 ◽  
Vol 43 (6) ◽  
pp. 205
Author(s):  
Partini P Trihono ◽  
Ommy A Soesilo ◽  
Rulina Suradi
Keyword(s):  
Renal Failure ◽  
Logistic Regression ◽  
Acute Renal Failure ◽  
Prognostic Factors ◽  
Poor Prognosis ◽  
Laboratory Data ◽  
Bivariate Analysis ◽  
Female Ratio ◽  
Significant Relationships ◽  
The Mean

Background Acute renal failure (ARF) is an emergency conditionwith a high mortality rate despite the long-known dialysis and ad-vanced supportive care. Only few studies on prognostic factors ofARF in children are available in the literature, which are difficult tocompare to each other due to the different definitions of the ARFoutcome used.Objective To find out the clinical and laboratory characteristics ofchildren with acute renal failure and the prognostic factors affect-ing the outcome.Methods This observational prospective study was conducted onchildren with acute renal failure hospitalized in the Department ofChild Health, Cipto Mangunkusumo Hospital, between July andDecember 2001. Patients with acute on chronic renal failure wereexcluded. Clinical and laboratory data were taken at the time ofdiagnosis and the outcomes were noted after 2 weeks of observa-tion. We classified the outcome as cured, uncured, and dead. Ana-lytical study was done to find out the relationships among variousprognostic factors.Results Fifty-six children with ARF were recruited in this study.Male to female ratio was 1.3:1; the mean age was 4.4 year-old.The most frequent presenting symptom was dyspnea (34%), fol-lowed by oliguria (29%). The most frequent primary disease wasmalignancy (20%). Most of the patients had renal-type of ARF(73%). The outcomes were cure (71%), no cure (16%), and death(13%). Bivariate analysis and logistic regression revealed thatyounger age (OR=13.6; 95%CI 1.01;183.60) and the need for di-alysis (OR=10; 95%CI 1.53;65.97) had significant relationships withmortality or no cure.Conclusion We should be aware when finding ARF patientsless than 5 year-old and have the indications for dialysis, due tothe poor prognosis they might have

Dose-related effects of metformin on acid–base balance and renal function in patients with diabetes who develop acute renal failure: a cross-sectional study

2016 ◽  
Vol 53 (4) ◽  
pp. 551-558 ◽  
Author(s):  
David Cucchiari ◽  
Manuel Alfredo Podestà ◽  
Elisa Merizzoli ◽  
Albania Calvetta ◽  
Emanuela Morenghi ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Acid Base Balance ◽  
Acid Base ◽  
Cross Sectional ◽  
Patients With Diabetes ◽  
Base Balance

scholarly journals Congenital uronephropathy pattern in children

2001 ◽  
Vol 41 (5) ◽  
pp. 241
Author(s):  
Husein Alatas ◽  
Natalina Soesilawati ◽  
Bambang Madiyono
Keyword(s):  
Renal Failure ◽  
Urinary Tract Infection ◽  
Acute Renal Failure ◽  
Urinary Tract ◽  
Chronic Renal Failure ◽  
Tract Infection ◽  
Teaching Hospitals ◽  
Affecting Factors ◽  
Cross Sectional ◽  
Renal Hypoplasia

To obtain the basic data of congenital uronephropathy pattern and the affecting factors in children, we conducted a cross-sectional study at the Department of Child Health Cipto Mangunkusumo (CM) Hospital Jakarta from 1995 to 1999 and 9 teaching hospitals throughout Indonesia. During the study period 134 patients were obtained, 116 patients from the CM Hospital and 18 patients from other teaching hospitals. Most patients (48.8%) were below 1 year of age; male were affected more than female (2.4:1). The disorder was classified into two groups, i.e., congenital nephropathy and uropathy. There were 10 children with nephropathy, i.e., 4 with unilateral renal hypoplasia, 3 with polycystic kidney, and 3 with renal agenesis. In the uropathy group, 43 were with hypospadia, 22 with primary reflux vesicoureter, 18 with neurogenic bladder, and 17 with ureteropelvic junction obstruction. The complications found were urinary tract infection (71.2%), chronic renal failure (15.7%), hypertension (3.7%), and acute renal failure (1.5%). Consanguinity, familial disorders, maternal diseases, x-ray exposure and abortion efforts were found in a small proportion of patients. History of drug or herbs use in the first trimester of pregnancy was found in a large proportion of patients, mostly took analgesics (especially acetaminophen). In conclusion, uropathy disorders were much more common than congenital nephropathy. The most common complication was urinary tract infection, followed by chronic renal failure, hypertension, and acute renal failure.

Effect of Severe Hypoalbuminemia on Myelosuppression and Other Toxicities of High Dose Melphalan and Autologous Stem Cell Transplantation in AL Amyloidosis Patients

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5499-5499
Author(s):  
Shin Yin Lee ◽  
Robert Meehan ◽  
John Mark Sloan ◽  
Karen Quillen ◽  
Dina Brauneis ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Stem Cell ◽  
Serum Albumin ◽  
Albumin Level ◽  
Control Group ◽  
High Dose ◽  
Al Amyloidosis ◽  
Grade 3 ◽  
High Dose Melphalan

Abstract Background: High-dose melphalan with autologous peripheral blood stem cell transplantation (HDM/SCT) has been shown to extend survival as well as to induce hematologic and clinical responses in selected patients with light chain (AL) amyloidosis. The most frequent toxicities of HDM are profound myelosuppression and gastrointestinal (GI) side effects. Studies have shown that 80% of melphalan is bound to plasma proteins (60% albumin bound) with ~20% free. We hypothesized that AL amyloidosis patients with severe nephrotic syndrome and profound hypoalbuminemia might have greater free melphalan fraction and more treatment-related toxicity. Methods: Patients with AL amyloidosis treated with HDM/SCT between 2011 and 2014 with severe hypoalbuminemia (SH), defined as a pre-transplant serum albumin of ≤2g/dL, were studied retrospectively. The stem cell transplant database was queried for patient demographic information, pre-transplant albumin level, HDM dose, renal function, pre-transplant 24-hour urine protein level, time to neutrophil and platelet engraftment, and treatment-related complications. Patients with AL amyloidosis treated between 2011 and 2012 without severe hypoalbuminemia, defined as serum albumin level of > 2g/dL (WSH), served as a control group. Results: Of the 84 patients with AL amyloidosis treated with HDM/SCT in this 4 year period, 16 (19%) with SH were identified. 41 patients were identified in the control group (WSH). There was no difference in the proportion of patients with all non-hematologic grade 3 or 4 adverse events between the groups. All patients suffered from expected grade 4 myelosuppression. The only statistically different non-hematologic grade 4 toxicity in SH was acute renal failure requiring temporary hemodialysis (n=4/16, 25% SH vs n=2/41, 5% WSH; p=0.05), with 1 subject eventually needing long term dialysis. There were no grade 4 mucositis or GI toxicities in either groups. The only statistically different grade 3 non-hematologic toxicity was lightheadedness (n=3/16, 19% SH vs n=0/41, 0% WSH; p=0.02). Conclusion: These data suggest that patients with severe hypoalbuminemia do not have more prolonged myelosuppression or GI toxicities when treated with HDM/SCT compared to those with higher serum albumin levels in AL amyloidosis. Grade 4 renal toxicity with acute renal failure requiring temporary hemodialysis (p=0.05) and grade 3 lightheadedness (p=0.02) occurred more commonly in SH than WSH group. In this retrospective study, we did not measure free melphalan concentrations in the blood. However, these data suggest that patients with severe hypoalbuminemia do not require adjustment of melphalan dosing. Figure 1. Figure 1. Disclosures No relevant conflicts of interest to declare.

scholarly journals The effect of dietary intake of antioxidant micronutrients on burn wound healing: a study in a tertiary health institution in a developing country

2015 ◽  
Vol 3 ◽  
pp. 1-7 ◽  
Author(s):  
Mary Adjepong ◽  
Pius Agbenorku ◽  
Patricia Brown ◽  
Ibok Oduro
Keyword(s):  
Wound Healing ◽  
Vitamin C ◽  
Dietary Intake ◽  
Burn Injury ◽  
Dietary Assessment ◽  
Cross Sectional Study ◽  
Burn Patients ◽  
Burn Wound ◽  
Cross Sectional ◽  
Nutrient Analysis

Abstract Background Burn injury results in emotional stress affecting dietary intake and antioxidant micronutrient intake, which is known to have effects on recovery outcomes. The study aimed to assess dietary intake of antioxidant micronutrients and recovery outcomes of burn patients. Methods Questionnaires were administered to 40 burn patients at Komfo Anokye Teaching Hospital (Ghana) from January 1, 2014 to May 30, 2014. The data taken include anthropometric measurements and dietary assessment. Their nutrient intakes were assessed with the Nutrient Analysis Template. The average intakes were compared to the recommended daily allowance. Assessment of recovery was based on records of wound healing assessments and infection rates from the health practitioners. Results A cross-sectional study of 40 patients revealed an average total burn surface area (TBSA) of 31.4 %, where 70.0, 35.0, 75.0, 52.5, 12.5 and 32.5 % patients were deficient in vitamins A, C and E, zinc, copper and selenium, respectively and adequate amounts of vitamin C intake were related with significantly better wound healing progress. Positive wound healing outcomes were observed for patients with adequate vitamins A and E and zinc intake. Less infection presented among patients with adequate amount of vitamins A and C and zinc, but this was not observed for patients with adequate vitamin E, copper and selenium. Conclusions Most burn patients did not meet their dietary requirements for antioxidant micronutrients and this was due to meals not tailored to suit individual requirements. Adequacy of the antioxidants especially vitamin C resulted in positive wound healing outcomes. Hence, there is need for planned well-balanced meals of high vitamin C.

scholarly journals The Effect of Early Tangential Excision and Split Thickness Skin Graft in Reducing Length of Stay in Burns Patients in Jakarta Islamic Hospital Cempaka Putih

2021 ◽  
Vol 8 (1) ◽  
pp. 15-20
Author(s):  
Gammaditya Adhibarata Winarno ◽  
Aditya Wardhana ◽  
Sanjaya Faisal Tanjunga ◽  
A. S Augiani ◽  
An’umillah Arini Zidna
Keyword(s):  
Length Of Stay ◽  
Skin Graft ◽  
Burn Injury ◽  
Study Groups ◽  
Cross Sectional Study ◽  
Burn Injuries ◽  
Split Thickness Skin Graft ◽  
Burn Patients ◽  
Cross Sectional ◽  
Thickness Skin

Introduction: Early tangential excision (TE) and split-thickness skin graft (STSG) have increased the outcome in burn patients treated at specialized burn centers. This study was conducted to compare the length of stay (LOS) in burn patients undergoing early TE & STSG and delayed TE & STSG. Method: This is a retrospective cross-sectional study including 42 patients with varied burn degrees, and TBSA admitted to Jakarta Islamic Hospital Cempaka Putih (JIHCP) Burn Unit. Patients were assigned to two study groups, the early TE & STSG group including 32 patients and the delayed TE & STSG group including 10 patients. All data were collected from the medical record and compared between two study groups. Result: The mean of LOS in a group with early TE & STSG was shorter (9.81±6.41 days) than LOS in the delayed TE & STSG group (15.80±5.67 days). The data of LOS between these groups were compared using an independent T-test. The LOS in the early TE & STSG group was significantly shorter than the delayed TE & STSG group (p=0.012). Conclusion: In patients with burn injuries, early TE & STSG is associated with a shorter length of stay than the delayed TE & STSG. Our study indicates that early excision within five days after burn injury is optimal to reduce the length of stay in burn patients.

scholarly journals Ureteral Strangulation by Fibrosis: A Cold Case Report of Ormand's Disease

2011 ◽  
Vol 2011 ◽  
pp. 1-4
Author(s):  
Amarpreet Sandhu ◽  
Leslea Brickner ◽  
Mark Chen
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Retroperitoneal Fibrosis ◽  
Obstructive Uropathy ◽  
Laboratory Data ◽  
Signs And Symptoms ◽  
Final Diagnosis ◽  
Renal Ultrasound ◽  
Idiopathic Retroperitoneal Fibrosis ◽  
Acute And Chronic Inflammation

Retroperitoneal fibrosis or Ormand's disease is rare in incidence and clinically elusive to diagnosis until obstructive uropathy clinically manifests by the mechanism of ureteral fibrotic strangulation and acute renal failure. We encountered a 50-year-old woman with months of nonspecific abdominal pain and presented with signs and symptoms of acute renal failure. Laboratory data was significant for blood urea nitrogen 47 mg/dL and creatinine of 8.47 mg/dL. Renal ultrasound revealed bilateral hydronephrosis and an abdominal computed tomogram confirmed an abnormal soft tissue retroperitoneal confluence that encased the pelvic vessels. Urologic consultation was requested and bilateral ureteral stents were placed with relief of her obstructive uropathy. Five days after ureteral stenting her creatinine dropped to 1.64 mg/dL. One month later patient underwent ureterolysis with biopsy showing fibroblast proliferation consistent with acute and chronic inflammation. By ruling out infections and malignancy, the final diagnosis was made to be idiopathic retroperitoneal fibrosis.

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