Cardiovascular Emergency Surgery After Acute Renal Failure: A Case Report

ABSTRACT We describe the case of a 68-year-old patient who was admitted to the trauma unit with anisocoria after pre-hospital resuscitation upon loss of consciousness. An intracranial bleeding was ruled out. The patient was admitted to the cardiology ward with the initial diagnosis of a syncope due to myocarditis, as myocardial necrosis markers were slightly elevated. The suspicion of an acute aortic dissection (AAD) was raised when the patient developed kidney failure and a progressive aortic regurgitation. He underwent emergency surgery for an acute type A AAD. Renal function recovered completely and, fortunately, the patient was discharged 10 days later.

Download Full-text

Ascites, a New Cause for Bilateral Hydronephrosis: Case Report

The Scientific World JOURNAL ◽

10.1100/tsw.2009.112 ◽

2009 ◽

Vol 9 ◽

pp. 1035-1039 ◽

Cited By ~ 1

Author(s):

Deepika Jain ◽

Smrita Dorairajan ◽

Madhukar Misra

Keyword(s):

Renal Failure ◽

Renal Function ◽

Acute Renal Failure ◽

Liver Cirrhosis ◽

Case Report ◽

Abdominal Ultrasound ◽

Back Pressure ◽

Alcoholic Liver Cirrhosis ◽

Bilateral Hydronephrosis ◽

History Of

Bilateral hydronephrosis secondary to urinary obstruction leads to a buildup of back pressure in the urinary tract and may lead to impairment of renal function. We present a case of a 57-year-old male with a history of alcoholic liver cirrhosis, who presented with tense ascites and acute renal failure. Bilateral hydronephrosis was seen on abdominal ultrasound. Multiple large-volume paracenteses resulted in resolution of hydronephrosis and prompt improvement in renal function.

Download Full-text

Acute Renal Failure and Jaundice without Methemoglobinemia in a Patient with Phenazopyridine Overdose: Case Report and Review of the Literature

Case Reports in Nephrology ◽

10.1155/2014/845372 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3

Author(s):

Ian Holmes ◽

Nathaniel Berman ◽

Vinicius Domingues

Keyword(s):

United States ◽

Renal Failure ◽

Renal Function ◽

Acute Renal Failure ◽

Case Report ◽

Hemolytic Anemia ◽

Normal Renal Function ◽

Urine Output ◽

The United States ◽

Review Of The Literature

Phenazopyridine is a commonly used urinary analgesic available throughout the United States. Ingestion of large quantities can lead to methemoglobinemia, hemolytic anemia, jaundice, and acute renal failure. We report a case of a 78-year-old male with previously normal renal function who developed acute renal failure and jaundice without methemoglobinemia or hyperbilirubinemia after taking nearly 8 g of phenazopyridine over the course of 4 days. Initially presenting with oliguria, the urine output began to increase by day 2 of his admission, and the creatinine peaked 11 days after he began taking phenazopyridine, and he was discharged safely soon after. To our knowledge, this is the first such case of renal failure and jaundice without methemoglobinemia or hemolytic anemia in an adult patient with normal renal function.

Download Full-text

Aortic dissection and stroke associated with COVID-19: case report

10.5327/1516-3180.242 ◽

2021 ◽

Author(s):

Amanda Xavier Darella ◽

Stefany Elias ◽

Gladys Lentz Martins

Keyword(s):

Case Report ◽

Aortic Dissection ◽

Acute Aortic Dissection ◽

Rna Virus ◽

Myocardial Necrosis ◽

Middle Layer ◽

The Body ◽

Lower Limbs ◽

Acute Type ◽

Upper Limbs

Case Report A 58-year-old man, previously healthy, presented with headache, myalgia, retrosternal chest pain associated with paresthesia and paresis in upper limbs and lower limbs of acute onset. He denies fever, cough, dyspnea, or contact with patients with COVID-19. There was a difference in blood pressure and pulse in the upper limbs. No particularities in the neurological examination were noted. The electrocardiogram and enzymes of myocardial necrosis did not show abnormalities. PCR for SARS-CoV-2 was positive. Chest computed angiotomography showed acute type IA aortic dissection. The patient underwent cardiac surgery, without complications. After 48 hours of the procedure, the patient progresses with a lower level of consciousness, left hemiplegia, and anisocoria. The brain computed tomography showed extensive ischemic injury in the right middle cerebral artery territory. The patient underwent decompression craniectomy. The patient was discharged from the hospital, maintaining hemiplegia on the left side of the body. Discussion SARS-CoV-2 is a RNA virus responsible for the current COVID-191 pandemic. Moderate to severe forms of the disease may present with acute respiratory distress syndrome (ARDS), myocarditis, and thrombotic events such as pulmonary venous thromboembolism and ischemic stroke2. There are few reports in the literature about acute aortic dissection in patients with COVID-193,4. Acute aortic dissection is characterized by rupture of the intimal layer of the vessel with exposure of the middle layer and cystic necrosis and formation of a false lumen5. The mechanisms associated with thromboembolic phenomena in SARSCoV-2 infection remain poorly elucidated in the literature. This case report highlights a patient with severe complications of COVID-19, with the viral trigger being a possible contributor to the condition of acute aortic dissection and stroke.

Download Full-text

Acute Renal Failure and Thrombocytopenia To a 36-Year -Old Woman: Case Report

International Journal of Clinical Case Reports and Reviews ◽

10.31579/2690-4861/068 ◽

2020 ◽

Vol 4 (3) ◽

pp. 01-06

Author(s):

Marilena Stoian

Keyword(s):

Renal Failure ◽

Acute Renal Failure ◽

Case Report ◽

Lupus Anticoagulant ◽

Severe Heart Failure ◽

Central Nervous System Involvement ◽

Anticardiolipin Antibody ◽

Myocardial Necrosis ◽

Antiphospholipid Antibody ◽

Antiphospholipid Antibody Syndrome

Background: Antiphospholipid syndrome (APS) is an acquired, immune-mediated thrombophilia occurring alone (primary APS, PAPS) or in association with other autoimmune diseases, mainly systemic lupus erythematous (SLE), (secondary APS), characterized by recurrent venous or arterial thrombosis and /or pregnancy morbidity in association with antiphospholipid antibodies (aPL) and/or lupus anticoagulant (LA). Case report: A 36-year-old woman was admitted to the hospital because of acute renal failure and thrombocytopenia. This woman presented with an acute illness characterized by a prodrome of respiratory symptoms and fever that were unresponsive to antibiotic therapy, followed by the progressive involvement of multiple organs. There was enzymatic and functional evidence of myocardial necrosis leading to intermittent, severe heart failure, as well as acute renal failure requiring dialysis, laboratory evidence of pancreatic injury, pulmonary infiltrates with respiratory failure, and central nervous system involvement, with confusion. After a renal biopsy was detected a perinephric hematoma and thrombocytopenia. The laboratory criteria for the diagnosis of the antiphospholipid-antibody syndrome are an elevated value for IgG anticardiolipin antibody, a positive test for lupus anticoagulant, and an elevated value for IgM anticardiolipin antibody. Conclusions: This patient has the antiphospholipid antibody syndrome, with an acute thrombotic angiopathy that caused ischemic damage in the myocardium, pancreas, kidneys and lungs. The renal interstitial inflammation is more severe than that expected from the ischemic injury alone and many reflect either a hypersensitivity drug reaction or in view of the dry Sjogren’s syndrome.

Download Full-text

Suspected Nafcillin-Induced Interstitial Nephritis

Annals of Pharmacotherapy ◽

10.1177/106002809302700206 ◽

1993 ◽

Vol 27 (2) ◽

pp. 170-173 ◽

Cited By ~ 63

Author(s):

Sudip Roy Guharoy ◽

Sheila Kar ◽

James Mcgalliard

Keyword(s):

Renal Failure ◽

Renal Function ◽

Acute Renal Failure ◽

Case Report ◽

Literature Review ◽

Renal Impairment ◽

Interstitial Nephritis ◽

Acute Interstitial Nephritis ◽

Staphylococcal Pneumonia ◽

Allergic Manifestations

Objective To present a case of nafcillin-induced interstitial nephritis. Methodology Case report and literature review. Setting Hospital. Results Three days following initiation of nafcillin therapy for staphylococcal pneumonia, an 80-year-old woman developed allergic manifestations and progressive renal impairment suggestive of acute allergic interstitial nephritis. These manifestations were completely reversed within 96 hours of cessation of nafcillin therapy. Conclusions In the clinical setting of acute renal failure in a patient on nafcillin therapy, acute interstitial nephritis should be considered. Prompt cessation of nafcillin therapy has generally been associated with reversal of symptoms and an improvement in renal function.

Download Full-text

Bilateral acute renal infarction treated by endovascular therapy: A case report and literature review

International Journal of Case Reports ◽

10.28933/ijcr-2021-07-2105 ◽

2021 ◽

pp. 236

Author(s):

◽

Keyword(s):

Renal Failure ◽

Renal Function ◽

Acute Renal Failure ◽

Case Report ◽

Literature Review ◽

Endovascular Therapy ◽

Rare Case ◽

Renal Outcome ◽

Renal Infarction ◽

Catheter Directed Thrombolysis

Renal infarction is a rare emergency and the estimated incidence is extremely low according to the literature. In addition, simultaneous bilateral renal infarction was only about 20% in these rare cases. Herein we reported a case of acute renal failure related to bilateral renal infarction and successfully treated by endovascular therapy including angioplasty and catheter-directed thrombolysis. His renal function also significantly improved after the intervention. This rare case reminds physician that early endovascular therapy might improve renal function and result in better renal outcome for patients with simultaneous bilateral renal infarction.

Download Full-text

Plasma D Dimer: A Useful Marker of Fibrin Breakdown in Renal Failure

Thrombosis and Haemostasis ◽

10.1055/s-0038-1646627 ◽

1989 ◽

Vol 61 (03) ◽

pp. 522-525 ◽

Cited By ~ 32

Author(s):

M P Gordge ◽

R W Faint ◽

P B Rylance ◽

H Ireland ◽

D A Lane ◽

...

Keyword(s):

Renal Failure ◽

Renal Function ◽

Acute Renal Failure ◽

Monoclonal Antibodies ◽

Diabetic Nephropathy ◽

Renal Disease ◽

Plasma Concentrations ◽

Significant Negative Correlation ◽

Healthy Controls ◽

D Dimer

SummaryD dimer and other large fragments produced during the breakdown of crosslinked fibrin may be measured by enzyme immunoassay using monoclonal antibodies. In 91 patients with renal disease and varying degrees of renal dysfunction, plasma D dimer showed no correlation with renal function, whereas FgE antigen, a fibrinogen derivative which is known to be cleared in part by the kidney, showed a significant negative correlation with creatinine clearance. Plasma concentrations of D dimer were, however, increased in patients with chronic renal failure (244 ± 3l ng/ml) (mean ± SEM) and diabetic nephropathy (308 ± 74 ng/ml), when compared with healthy controls (96 ± 13 ng/ml), and grossly elevated in patients with acute renal failure (2,451 ± 1,007 ng/ml). The results indicate an increase in fibrin formation and lysis, and not simply reduced elimination of D dimer by the kidneys, and are further evidence of activated coagulation in renal disease. D dimer appears to be a useful marker of fibrin breakdown in renal failure.

Download Full-text

Effect of Curcuma longa and Galega orientalis on renal function in rats with experimental diabetes mellitus and acute renal failure

ZHurnal «Patologicheskaia fiziologiia i eksperimental`naia terapiia» ◽

10.25557/0031-2991.2019.04.88-95 ◽

2019 ◽

pp. 88-95

Author(s):

Р.И. Айзман ◽

А.П. Козлова ◽

Е.И. Гордеева ◽

М.С. Головин ◽

Г.А. Корощенко ◽

...

Keyword(s):

Diabetes Mellitus ◽

Renal Failure ◽

Renal Function ◽

Acute Renal Failure ◽

Experimental Diabetes ◽

Curcuma Longa ◽

Diabetic Rats ◽

Standard Diet ◽

Experimental Diabetes Mellitus ◽

Galega Orientalis

Цель - исследование влияния куркумы длинной и галеги восточной на осмо- и ионорегулирующую функции почек крыс при аллоксан-индуцированном сахарном диабете и острой почечной недостаточности в эксперименте. Методика. Эксперименты выполнены на самцах крыс Wistar (n=70) с моделью сахарного диабета (1-я серия) и острой почечной недостаточности (2-я серия). В обеих сериях животные были поделены на 3 группы: крыс 1-й группы содержали на стандартном корме, крысам остальных групп в корм добавляли куркуму (2-я группа) или галегу (3-я группа) (2% от массы корма). На 7-е сут эксперимента проводили исследование диуретической и ионоуретической функций почек натощак и после 5% водной нагрузки. Концентрацию ионов в моче и плазме определяли методом пламенной фотометрии; осмотическую концентрацию биологических жидкостей - методом криоскопии; биохимические показатели крови - колориметрическим методом. Результаты. У животных с сахарным диабетом фоновый диурез, а также экскреция натрия и калия были статистически значимо выше, чем у контрольных животных. При острой почечной недостаточности наблюдался более низкий уровень диуреза и ионоуреза, особенно после водной нагрузки. Прием куркумы и галеги вызывал улучшение осмо- и ионорегулирующей функции почек у крыс с сахарным диабетом, и практически не влиял на эти функции почек при острой почечной недостаточности. Заключение. При сахарном диабете оба фитопрепарата вызывали понижение концентрации глюкозы, креатинина, мочевины и улучшение ионно-осмотических показателей плазмы крови, при этом эффект куркумы был выражен отчетливее. При острой почечной недостаточности эти фитопрепараты не давали описанного эффекта. Aim. To study effects of the phytomedicines, Curcuma longa and Galega orientalis, on osmosis- and ion-regulating renal functions in rats with experimental diabetes mellitus (DM) and acute renal failure (ARF). Methods. Experiments were performed in two series on Wistar male rats (n=70) with modeled diabetes mellitus (series 1) and acute renal failure (series 2). In each series, the animals were divided into 3 groups, 1) rats of group 1 receiving a standard diet; 2) rats of groups 2 and 3 receiving a standard diet supplemented with turmeric or galega (2% of food weight), respectively. On the 7th day of the experiment, the diuretic and ionuretic renal function was studied in fasting state and after 5% water loading. Concentrations of ions in urine and plasma were determined by flame photometry; osmotic concentrations of biological fluids were measured by cryoscopy; blood biochemical parameters were measured by colorimetry. Results. In diabetic rats, background diuresis and sodium and potassium excretion were significantly higher than in the control animals. In rats with acute renal failure, diuresis and ionuresis were significantly lower, particularly after the water loading. Turmeric and galega supplementation improved the osmotic and ion-regulating renal function in diabetic rats and left practically unchanged these functions in rats with acute renal failure. Conclusion. In rats with diabetes mellitus, both herbal remedies reduced concentrations of glucose, creatinine, and urea and improved ion-osmotic parameters of blood plasma with a more pronounced effect of turmeric. In acute renal failure, these phytomedicines did not produce the described effects.

Download Full-text