scholarly journals A Cross Sectional Study on Risk Factors, Clinical Profile and Aetiology of Acute Pyelonephritis in a Tertiary Teaching Hospital in Kerala

2020 ◽  
Vol 7 (52) ◽  
pp. 3159-3165
Author(s):  
Mohammed Shafi P.K. ◽  
Rosh P
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Acute Kidney Injury ◽  
Urinary Tract ◽  
Teaching Hospital ◽  
Acute Pyelonephritis ◽  
Kidney Injury ◽  
Cross Sectional ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital

BACKGROUND Acute pyelonephritis (APN) is one of the most severe forms of urinary tract infections (UTI) with a higher incidence among females compared to males. Escherichia coli is the commonest causative organism isolated in 80 % of the cases in Kerala. Risk factors like structural or functional abnormalities of urogenital system, immunosuppression, comorbidities and virulence & resistance of microorganism play vital roles in predicting the prognosis. Our aim was to study the prevalence of various risk factors of acute pyelonephritis in adult patients, the clinical profile, aetiological agents and their sensitivity to antibiotics, and related complications on their usage. METHODS In a cross-sectional observational study, 100 adult patients with acute pyelonephritis admitted in a tertiary teaching hospital in Kerala were studied between January 2016 and January 2017. Detailed history and clinical examination were carried out. Complete haemogram, random blood sugar, renal function test, urine culture and sensitivity, and ultrasonogram of abdomen and pelvis were done. RESULTS The most common age group was 40 - 49 years with a male to female ratio of 2:3. Dysuria was observed in 82 % of patients followed by increased frequency of micturition in 65 % and vomiting in 42 %. Diabetes mellitus was observed in 55 % of patients and recurrent UTI in 44 %. Escherichia coli was found in 66 % of patients followed by Klebsiella in 23 %. Culture showed that 85 % of the bacteria were sensitive to piperacillin-tazobactam. 44 % of the patients did not respond to the empirical antibiotic, and the failure rate was higher among those empirically treated with ciprofloxacin. 41 % of the patients developed acute kidney injury, which necessitated haemodialysis in 23 %. 14 % of the patients developed septic shock and the mortality was 10 %. CONCLUSIONS Certain risk factors such as diabetes, hypertension, chronic kidney disease and indwelling catheters were associated with increased incidence of complications. Hence, in presence of such risk factors appropriate treatment and preventive measures should be initiated promptly. Among the pathogens, 85 % of the organisms were sensitive to piperacillin–tazobactam. Hence, piperacillintazobactam can be recommended as the first line empirical antibiotic. KEYWORDS Acute Pyelonephritis, Urinary Tract Infection, Acute Kidney Injury (AKI), and E. coli

scholarly journals COVID-19–induced acute kidney injury in critically ill patients: epidemiology, risk factors, and outcome

2021 ◽  
Vol 36 (4) ◽  
pp. 308-316
Author(s):  
Ahlem Trifi ◽  
Sami Abdellatif ◽  
Yosri Masseoudi ◽  
Asma Mehdi ◽  
Oussama Benjima ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Tissue Injury ◽  
Kidney Injury ◽  
Hematological Disorders ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital ◽  
Critical Patients ◽  
High Level ◽  
Stage 1

Background: The kidney represents a potential target for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Acute kidney injury (AKI) can occur through several mechanisms and includes intrinsic tissue injury by direct viral invasion. Clinical data about the clinical course of AKI are lacking. We aimed to investigate the proportion, risk factors, and prognosis of AKI in critical patients affected with coronavirus disease 2019 (COVID-19).Methods: A case/control study conducted in two intensive care units of a tertiary teaching hospital from September to December 2020.Results: Among 109 patients, 75 were male (69%), and the median age was 64 years (interquartile range [IQR], 57–71 years); 48 (44%) developed AKI within 4 days (IQR, 1–9). Of these 48 patients, 11 (23%), 9 (19%), and 28 (58%) were classified as stage 1, 2, and 3, respectively. Eight patients received renal replacement therapy. AKI patients were older and had more frequent sepsis, acute respiratory distress syndrome, and rhabdomyolysis; higher initial urea and creatinine; more marked inflammatory syndrome and hematological disorders; and required more frequent mechanical ventilation and vasopressors. An elevated level of D-dimers (odds ratio [OR], 12.83; 95% confidence interval [CI], 1.9–85) was an independent factor of AKI. Sepsis was near to significance (OR, 5.22; 95% CI, 0.94–28; P=0.058). Renal recovery was identified in three patients. AKI, hypoxemia with the ratio of the arterial partial pressure of oxygen and the inspiratory concentration of oxygen <70, and vasopressors were identified as mortality factors.Conclusions: AKI occurred in almost half the patients with critical COVID-19. A high level of D-dimers and sepsis contributed significantly to its development. AKI significantly worsened the prognosis in these patients.

scholarly journals The risk factors and outcome of early identified acute kidney injury among critically ill obstetric patients

2017 ◽  
Vol 6 (1) ◽  
pp. 11
Author(s):  
Amal Abd El-Hafez1 ◽  
Asmaa Mahjoub ◽  
Eman Ahmad
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Critical Care ◽  
Sofa Score ◽  
Postpartum Hemorrhage ◽  
Kidney Injury ◽  
Total Sample ◽  
Critical Care Nurses ◽  
Cross Sectional ◽  
Pregnancy And Postpartum

Background: Acute kidney injury (AKI) is one of the most challenging and serious complications of pregnancy and postpartum period that facing critical care nurses in Intensive Care Unit (ICU). Having a uniform standard for identifying and classifying AKI would enhance critical care nurses’ ability to recognize these patients and leading to better outcomes.Objective: This work aimed to explore the risk factors and outcome of early identified acute kidney injury of critically obstetric patients in Obstetric ICU. Design. A descriptive cross sectional research design was used in this study. Participants: A total sample of 338 women admitted to Obstetric ICU at Woman Health Hospital, Assiut City, Egypt. Method: Three tools were used.Tool I was developed by the researcher and included demographic and obstetric history, lab parameters, complications and outcomes arising from AKI. The Sequential Organ Failure Assessment (SOFA) score as tool II to determine the extent of a patient's organ function or rate of failure. Measurement of serum creatinine and urine output were used to early identify AKI stages according to Acute Kidney Injury Network (AKIN) Criteria (tool III). Results: The prevalence of AKI among obstetric patients admitted to obstetric ICU was 10.1%; of them 52.9% needed renal replacement therapy and the mortality rate was 29.4%. Postpartum hemorrhage was the most common cause of AKI and its prevalence was 41.2%. It was also found that 74.5% of AKI patients developed complications. Conclusion: AKI complicated 10.1% of total admitted women to the OICU in the studied period. Postpartum hemorrhage represents the most prevalent risk factors with a highly significant SOFA score compared to other risk factors as sever preeclampsia, eclampsia, HEELP & APH with acute fatty liver.

scholarly journals Classification of stillbirth by relative condition at death (Re Co De) at various trimesters of pregnancy: a rural tertiary teaching hospital based study

2017 ◽  
Vol 6 (8) ◽  
pp. 3550 ◽  
Author(s):  
V. Meera Rajagopal ◽  
Kalpana Betha ◽  
Satya Priya G.
Keyword(s):  
Risk Factors ◽  
Teaching Hospital ◽  
Rural Areas ◽  
Gestational Hypertension ◽  
Economic Status ◽  
Mode Of Delivery ◽  
Middle Income ◽  
Low Middle Income Countries ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital

Background: New global health figures show India to have the highest rates of stillbirth in the world. While maternal and under 5 child mortality rates have halved, stillbirth remains a neglected global endemic. To reduce stillbirths, the prevalence, risk factors and causes must be known. The aim of the present study is to know the prevalence and classify stillbirths by ReCoDe classification system at different trimesters of pregnancy.Methods: This was a retrospective study done between January 2013 to March 2017 at MediCiti Institute of Medical Sciences, a rural tertiary teaching hospital, Telangana, India. A total of 112 cases of stillbirths were included. Data was obtained on demographic variables, risk factors such as preeclampsia, etc. Data regarding mode of delivery, fetal asphyxia, were recorded.Results: Stillbirth rate was 12.1/1000 births. Fifty four percent of the women were unbooked. Preterm stillbirths were a majority (67%). The intra-partum still birth rate was low (15.1%) contrary to what is seen in low middle-income countries. Gestational hypertension/Pre-eclampsia, abruptio placenta, fetal growth restriction and oligohydramnios were the leading causes of stillbirths.Conclusions: Pregnant women from rural background with low socio-economic status are prone for stillbirths. As stillbirths were more among unbooked cases, the study highlights the importance of counselling, creating awareness in the rural areas regarding the importance of regular antenatal checkups. Identifying risk factors like pre-eclampsia, anemia etc., at early weeks will enable us to initiate appropriate strategies to improve pregnancy outcome.

scholarly journals Prevalence of gestational diabetes mellitus and perinatal outcome: a rural tertiary teaching hospital based study

2017 ◽  
Vol 6 (8) ◽  
pp. 3594 ◽  
Author(s):  
Ke Manga Reddy ◽  
Lakshmi Sailaja P. ◽  
Sahithi Balmuri ◽  
Avinash Jagarlamudi ◽  
Kalpana Betha
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Teaching Hospital ◽  
Perinatal Outcome ◽  
Oral Glucose ◽  
Increased Risk ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital

Background: Gestational diabetes mellitus is the commonest medical disorder in pregnancy. Women with GDM are at increased risk for adverse obstetric and perinatal outcome. Prevalence of GDM is known to vary widely depending on region of the country, dietary habits and socio-economic status. This study was undertaken to evaluate the prevalence of GDM and risk factors associated with it among women delivered in a rural tertiary teaching hospital in Telangana and further assess its impact on feto-maternal outcome.Methods: A retrospective study was conducted at Mediciti Institute of Medical Sciences on GDM cases delivered from May 2015 to April 2017. GDM was diagnosed using 2 step procedure of screening with glucose challenge test followed by confirmation with oral glucose tolerance test using Carpenter and Couston criteria. Demographic data and details about perinatal outcome were obtained from medical records and analyzed.Results: The prevalence was low (1.83%) compared to other studies. Majority of the women did not have risk factors. Preeclampsia is the commonest maternal complication seen (18%). Hypothyroidism is more often associated with GDM (15%). Caesarean section rate was high (62%). Though the NICU admission rate was high (76%), neonatal outcome was found to be satisfactory.Conclusions: The low prevalence of GDM seen highlights the importance of carrying out studies in different population groups of India to know the exact prevalence of GDM in the country. Pregnancies in women with GDM continue to be at increased risk of maternal and perinatal complications.

scholarly journals PREOPERATIVE RISK FACTORS FOR ACUTE KIDNEY INJURY AFTER LIVER TRANSPLANTATION: RESULTS FROM A CROSS-SECTIONAL STUDY IN NORTHEAST OF BRAZIL

2018 ◽  
Vol 55 (1) ◽  
pp. 18-22 ◽  
Author(s):  
Raimundo Martins GOMES JUNIOR ◽  
Lia Cavalcante CEZAR ◽  
Gdayllon Cavalcante MENESES ◽  
Geraldo Bezerra da SILVA JUNIOR ◽  
José Huygenes Parente GARCIA ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Acute Kidney Injury ◽  
Serum Albumin ◽  
Kidney Injury ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Preoperative Risk ◽  
Cross Sectional ◽  
Preoperative Risk Factors

ABSTRACT BACKGROUND: Acute kidney injury (AKI) is a common complication in the immediate postoperative period of patients undergoing liver transplantation. OBJECTIVE: The aim of this study was to evaluate preoperative risk factors for AKI after liver transplantation. METHODS: A cross-sectional study was conducted with adults submitted to orthotopic liver transplantation at a reference hospital in Fortaleza, Northeast of Brazil, from January to December 2016. Preoperative risk factors were evaluated for AKI development in the immediate postoperative period. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. RESULTS: A total of 40 patients were included in the study. AKI was found in 85% of patients in the first 24 hours after transplantation, most of them (40%) classified in KDIGO stage 1. Preoperative data indicate that serum albumin levels were lower in the KDIGO stage 3 group compared to the non-AKI group, as well as the hematocrit levels. Direct bilirubin (DB) was higher in the KDIGO stage 3 group compared to the group without AKI, as well as alkaline phosphatase (AP) and gamma-glutamiltransferase (GGT). In a logistic regression analysis independent risk factors for AKI were increase levels of AP, GGT and DB and decrease level of serum albumin. CONCLUSION: Low levels of serum albumin, and elevated levels of DB, AP and GGT in the preoperative period are risk factors for AKI development after liver transplantation.

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