scholarly journals Double Whammy: Pigment Nephropathy and Warfarin-related Nephropathy As Aetiology for Acute Kidney Injury in a Patient With Mechanical Heart Valves

2019 ◽  
Vol 12 (1) ◽  
pp. 41-44 ◽  
Author(s):  
Arvind Conjeevaram ◽  
Priyangani Lohia ◽  
Ravishankar GS ◽  
Mahesha Vankalakunti
Keyword(s):  
Acute Kidney Injury ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Oral Anticoagulation ◽  
Heart Valves ◽  
Kidney Injury ◽  
Mechanical Heart Valves ◽  
Biopsy Diagnosis ◽  
Sheer Stress ◽  
Pigment Nephropathy

It is well known that patients with mechanical heart valves may develop sheer stress related hemolysis and consequent pigment related nephropathy. Warfarin Related Nephropathy (WRN) is a relatively new entity and defined as Acute Kidney Injury (AKI) in the setting of an INR of > 3.0 excluding other obvious etiologies. A biopsy diagnosis of WRN is conducted when red blood cell casts are noted filling and blocking the tubules; additionally, glomerular hemorrhage may be observed. We describe a patient with mechanical heart valves on oral anticoagulation who developed both pigment nephropathy and WRN causing AKI.

Acute Kidney Injury During Warfarin Therapy Associated With Obstructive Tubular Red Blood Cell Casts: A Report of 9 Cases

2009 ◽  
Vol 54 (6) ◽  
pp. 1121-1126 ◽  
Author(s):  
Sergey V. Brodsky ◽  
Anjali Satoskar ◽  
Jun Chen ◽  
Gyongyi Nadasdy ◽  
Jeremiah W. Eagen ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Warfarin Therapy ◽  
Kidney Injury

scholarly journals The Association between Red Blood Cell Distribution Width and Mortality in Critically Ill Patients with Acute Kidney Injury

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Benji Wang ◽  
Huaya Lu ◽  
Yuqiang Gong ◽  
Binyu Ying ◽  
Bihuan Cheng
Keyword(s):  
Acute Kidney Injury ◽  
Blood Cell ◽  
Critically Ill ◽  
Red Blood Cell ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Cell Distribution ◽  
Distribution Width ◽  
The Impact ◽  
Red Blood Cell Distribution

Background. Several investigators have sought risk factors for mortality in acute kidney injury (AKI). However, no epidemiological studies have investigated the impact of red blood cell distribution width (RDW) on prognosis for critically ill patients with AKI. The aim of this study was to investigate the association of RDW with mortality in these patients. Methods. We analyzed data from the MIMIC-III. RDW was measured upon ICU admission. The association between RDW and mortality of AKI was determined using a multivariate logistic regression and was expressed as the adjusted odds ratio with associated 95% confidence interval (CI). We also conducted subgroup analyses to determine the consistency of this association. Results. A total of 14,078 critically ill patients with AKI were eligible for this analysis. In multivariate analysis, adjusted for age and gender and compared with the reference group (RDW 11.1-13.4%) related to hospital mortality, the adjusted ORs (95% CIs) for RDW levels 13.5-14.3%, 14.4-15.6%, and 15.7-21.2% were 1.22 (1.05, 1.43), 1.56 (1.35, 1.81), and 2.66 (2.31, 3.06), respectively. After adjusting for confounding factors, with high RDW linked to an increase in mortality (RDW 15.7-21.2% versus 11.1-13.4%: OR, 1.57; 95% CI, 1.22 to 2.01; P trend <0.0001). A similar trend was observed for 30-day mortality. Conclusions. RDW appeared to be an independent prognostic marker in critically ill patients with AKI and higher RDW was associated with increased risk of mortality in these patients.

A retrospective analysis of the effect of blood transfusion on cerebral oximetry entropy and acute kidney injury

Perfusion ◽  
2016 ◽  
Vol 32 (1) ◽  
pp. 35-43 ◽  
Author(s):  
Milo Engoren ◽  
Russell R. Brown ◽  
Anna Dubovoy
Keyword(s):  
Acute Kidney Injury ◽  
Blood Transfusion ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Cerebral Oxygenation ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Cerebral Oximetry ◽  
Red Blood Cell Transfusion ◽  
Care Hospital

Purpose: Acute anemia is associated with both cerebral dysfunction and acute kidney injury and is often treated with red blood cell transfusion. We sought to determine if blood transfusion changed the cerebral oximetry entropy, a measure of the complexity or irregularity of the oximetry values, and if this change was associated with subsequent acute kidney injury. Methods: This was a retrospective, case-control study of patients undergoing cardiac surgery with cardiopulmonary bypass at a tertiary care hospital, comparing those who received a red blood cell transfusion to those who did not. Acute kidney injury was defined as a perioperative increase in serum creatinine by ⩾26.4 μmol/L or by ⩾50% increase. Entropy was measured using approximate entropy, sample entropy, forbidden word entropy and basescale4 entropy in 500-point sets. Results: Forty-four transfused patients were matched to 88 randomly selected non-transfused patients. All measures of entropy had small changes in the transfused group, but increased in the non-transfused group (p<0.05, for all comparisons). Thirty-five of 132 patients (27%) suffered acute kidney injury. Based on preoperative factors, patients who suffered kidney injury were similar to those who did not, including baseline cerebral oximetry levels. After analysis with hierarchical logistic regression, the change in basescale4 entropy (odds ratio = 1.609, 95% confidence interval = 1.057–2.450, p = 0.027) and the interaction between basescale entropy and transfusion were significantly associated with subsequent development of acute kidney injury. Conclusions: The transfusion of red blood cells was associated with a smaller rise in entropy values compared to non-transfused patients, suggesting a change in the regulation of cerebral oxygenation, and these changes in cerebral oxygenation are also associated with acute kidney injury.

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