scholarly journals Hiding in Plain Sight: A Case of Perinephric Abscess Diagnosed by POCUS

POCUS Journal ◽  
2020 ◽  
Vol 5 (2) ◽  
pp. 33-34
Author(s):  
David Haughey, MD ◽  
Tai Truong, MD
Keyword(s):  
Acute Kidney Injury ◽  
Renal Mass ◽  
Obstructive Uropathy ◽  
Hospital Medicine ◽  
Kidney Injury ◽  
Educational Interventions ◽  
Renal Pathology ◽  
Perinephric Abscess

An 87 year old male with obstructive uropathy was initially diagnosed with acute kidney injury (AKI), a new renal mass and hydronephrosis. When transferred to a facility with a hospital medicine POCUS program, the renal mass was correctly identified as a perinephric abscess, which was percutaneously drained leading to resolution of AKI and the underlying infection. Renal POCUS is readily taught via brief educational interventions and empowers providers to identify common (hydronephrosis) and uncommon (perinephric abscess) renal pathology at the bedside. 

Utilization of Renal Ultrasound for Predicting Obstructive Uropathy in ICU Patients With Acute Kidney Injury

CHEST Journal ◽  
2014 ◽  
Vol 146 (4) ◽  
pp. 223A ◽  
Author(s):  
Syed Amin ◽  
Reejis Stephen ◽  
David Morris ◽  
David Kaufman
Keyword(s):  
Acute Kidney Injury ◽  
Obstructive Uropathy ◽  
Kidney Injury ◽  
Renal Ultrasound ◽  
Icu Patients

scholarly journals Effects on renal outcome of concomitant acute pyelonephritis, acute kidney injury and obstruction duration in obstructive uropathy by urolithiasis: a retrospective cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e030438
Author(s):  
Eung Hyun Lee ◽  
Su-Hyun Kim ◽  
Jung-ho Shin ◽  
Sung Bin Park ◽  
Byung Hoon Chi ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Acute Pyelonephritis ◽  
Retrospective Cohort ◽  
Obstructive Uropathy ◽  
Kidney Injury ◽  
Renal Outcome ◽  
Factors Affecting

ObjectiveObstruction release from urolithiasis can be delayed with a lack of suggested time for preventing the deterioration of renal function. The objective of this study was to investigate the effect of obstruction duration, concomitant acute kidney injury (AKI) or acute pyelonephritis (APN) during the obstruction on the prognosis of renal function.DesignRetrospective cohort study.Setting and participants1607 patients from a urolithiasis-related obstructive uropathy cohort, between January 2005 and December 2015.Outcome measuresEstimated glomerular filtration rate (eGFR) decrease ≥30% and/or end-stage renal disease (ESRD), and eGFR decrease ≥50% and/or ESRD, according to obstruction duration, AKI and APN accompanied by obstructive uropathy.ResultsWhen the prognosis was divided by obstruction duration quartile, the longer the obstruction duration the higher the probability of eGFR reduction >50% (p=0.02). In patients with concomitant APN or severe AKI during hospitalisation with obstructive uropathy, an eGFR decrease of >30% and >50% occurred more frequently, compared with others (p<0.001). When we adjusted for sex, age, hypertension, diabetes mellitus, APN, AKI grades and obstruction release >7 days for multivariate analysis, we found that concomitant APN (HR 3.495, 95% CI 1.942 to 6.289, p<0.001), concomitant AKI (HR 3.284, 95% CI 1.354 to 7.965, p=0.009 for AKI stage II; HR 6.425, 95% CI 2.599 to 15.881, p<0.001 for AKI stage III) and an obstruction duration >7 days (HR 1.854, 95% CI 1.095 to 3.140, p=0.001) were independently associated with an eGFR decrease >50%. Tree analysis also showed that AKI grade 3, APN and an obstruction duration >7 days were the most important factors affecting renal outcome.ConclusionsIn patients with urolithiasis-related obstructive uropathy, concomitant APN was strongly associated with deterioration of renal function after obstruction release. The elapsed time to release the obstruction also affected renal function.

scholarly journals Overflow diarrhea and acute kidney injury as a presentation of fecal impaction that led to obstructive uropathy

2021 ◽  
Vol 11 (3) ◽  
pp. 71-74
Author(s):  
Dhara Dave
Keyword(s):  
Acute Kidney Injury ◽  
Case Report ◽  
Elderly Population ◽  
Early Recognition ◽  
Case Reports ◽  
Obstructive Uropathy ◽  
Kidney Injury ◽  
The Elderly ◽  
Fecal Impaction ◽  
Elderly Male

Fecal impaction is a known complication of chronic constipation and is particularly bothersome in the elderly population. Common complications of fecal impaction include hemorrhoids, megacolon, overflow diarrhea, and obstructive uropathy among others. Many case reports have been reported with fecal impaction and obstructive uropathy though none have reported overflow diarrhea as a presentation. In this case report, we present an elderly male who came in with overflow diarrhea and acute kidney injury that resulted from fecal impaction that caused obstructive uropathy. He was managed with catharsis and early recognition of the condition led to a good outcome. Recognition and management of fecal impaction can be challenging especially in patients who present with diarrhea. We, therefore, outline and discuss the importance of recognition of overflow diarrhea as a complication of fecal impaction and the management of such patients.

scholarly journals Outcome of Acute Kidney Injury in Sudanese Children — An Experience from a Sub-Saharan African Unit

2014 ◽  
Vol 34 (5) ◽  
pp. 526-533 ◽  
Author(s):  
Mohamed Abdelraheem ◽  
El-Tigani Ali ◽  
Rania Osman ◽  
Rashid Ellidir ◽  
Amna Bushara ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Developing Countries ◽  
Obstructive Uropathy ◽  
Pediatric Nephrology ◽  
Age Groups ◽  
Kidney Injury ◽  
Admission Rate ◽  
Morbidity And Mortality ◽  
University Hospital ◽  
Acute Glomerulonephritis

BackgroundAcute Kidney Injury (AKI) is an important cause of morbidity and mortality in developing countries. Although continuous renal replacement therapy is gaining more popularity worldwide, peritoneal dialysis (PD) in children remains an appropriate therapy for AKI in children for all age groups including neonates.MethodologyWe retrospectively reviewed all children who have been admitted with AKI at the pediatric nephrology unit, Soba University Hospital, Khartoum, during the period from January 2005 to December 2011.ResultsOver 7 years we recorded 659 children of whom 362 (54.9%) were male. The spectrum of age was variable with the majority being neonates, 178 (27.1%). The average patient admission rate was 94 patients per year, with an estimated incidence of 9.8 patients/million population/year. Common causes of AKI were sepsis 202 (30.8%), acute glomerulonephritis 75 (11.5%) and obstructive uropathy due to stones 56 (8.5%). The most common dialysis modality used was PD, 343 (52.4%), and peritonitis was reported in 53 (15.4%) patients. Recovery from AKI was achieved in 450 (68.9%) children, 37 (5.7%) went into chronic kidney disease (CKD), 33 (5.1%) referred to the pediatric surgery and 194 (29.7%) died.ConclusionIn the setting of developing countries where AKI is a common cause of morbidity and mortality, reasonably equipped renal units with adequately trained medical staff may save many lives. International funding programs for communicable diseases and charity organizations should include AKI management in their programs. Acute PD remains the treatment modality of choice for AKI in developing countries.

scholarly journals Correlation of serum magnesium levels with renal parameters in patients with acute kidney injury

2020 ◽  
Vol 8 (10) ◽  
pp. 3698
Author(s):  
Raveendra K. R. ◽  
Avinash H. R. ◽  
Nitish Ashok Gurav
Keyword(s):  
Diabetes Mellitus ◽  
Acute Kidney Injury ◽  
Obstructive Uropathy ◽  
Serum Magnesium ◽  
Kidney Injury ◽  
Drug Induced ◽  
Cross Sectional ◽  
Electrolyte Disturbance ◽  
Electrolyte Disturbances ◽  
Patients With Diabetes

Background: Acute kidney injury is a common problem with various causes and consequences like electrolyte disturbances in the form of hypocalcaemia, hypokalemia, hyperkalemia depending on the phase. Hypomagnesaemia is one of the most common electrolyte disturbance found in hospitalized patients especially in the critically ill patients. Prevalence of hypomagnesemia varies from 11 to 65% in different studies. Hence, we decided to conduct a study to evaluate correlation of serum magnesium levels in AKI.Methods: A cross-sectional, hospital based time bound study was conducted between November 2016 and August 2018 with a sample of 100 patients aged 18-65 years and who had AKI were included and patients with diabetes mellitus, multi-organ dysfunction, obstructive uropathy and drug induced AKI were excluded from study. The decrease in magnesium <1.7 mg/L was defined as hypomagnesaemia. AKI was defined as per AKIN criteria. Day 1, day 3 and day 6 magnesium levels were measured.Results: Prevalence of hypomagnesaemia was 53%, 30% and 36% on day 1, day 3 and day 6 respectively. It was observed that there was a positive correlation between serum magnesium, and serum creatinine. Normomagnsemia and hypermagnesemia on day 1, 3 and 6 were significantly associated with recovery of AKI (p<0.001).Conclusions: The prevalence of hypomagnesemia was significantly higher in AKI patients and normal magnesium and hypermagnesium on day 1, 3 and day 6 was associated with recovery than non-recovery. Hypomagnesemia was associated more with non-recovery then recovery.

scholarly journals Impact of acute kidney injury on long-term adverse outcomes in obstructive uropathy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jihyun Yang ◽  
Bong Gyun Sun ◽  
Hyeon-Jin Min ◽  
Young-Bin Son ◽  
Tae Bum Kim ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Clinical Characteristics ◽  
Obstructive Uropathy ◽  
Kidney Injury ◽  
Progression Rate ◽  
Long Term Outcomes ◽  
Malignant Obstruction ◽  
The Impact

AbstractObstructive uropathy is known to be associated with acute kidney injury (AKI). This study aimed to investigate the etiologies, clinical characteristics, consequences and also assess the impact of AKI on long-term outcomes. This multicenter, retrospective study of 1683 patients with obstructive uropathy who underwent percutaneous nephrostomy (PCN) analyzed clinical characteristics, outcomes including progression to end-stage kidney disease (ESKD), overall mortality, and the impact of AKI on long-term outcomes. Obstructive uropathy in adults was most commonly caused by malignancy, urolithiasis, and other causes. AKI was present in 78% of the patients and was independently associated with preexisting chronic kidney disease (CKD). Short-term recovery was achieved in 56.78% after the relief of obstruction. ESKD progression rate was 4.4% in urolithiasis and 6.8% in other causes and older age, preexisting CKD, and stage 3 AKI were independent factors of progression. The mortality rate (34%) was highly attributed to malignant obstruction (52%) stage 3 AKI was also an independent predictor of mortality in non-malignant obstruction. AKI is a frequent complication of adult obstructive uropathy. AKI negatively affects long-term kidney outcomes and survival in non-malignant obstructions. A better understanding of the epidemiology and prognostic factors is needed for adult obstructive uropathy.

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