scholarly journals RENAL INVOLVEMENT IN ACUTE GASTROENTERITIS;

2012 ◽  
Vol 19 (06) ◽  
pp. 905-908
Author(s):  
MIRZA MUHAMMAD ILYAS BAIG ◽  
NAUMAN TARIF ◽  
FAWAD AHMAD RANDHAWA
Keyword(s):  
Renal Failure ◽  
Observational Study ◽  
Acute Gastroenteritis ◽  
Renal Involvement ◽  
Tertiary Care ◽  
Hypovolemic Shock ◽  
Renal Functions ◽  
Study Results ◽  
Male Patients

Objective: Acute renal failure is one of the important complications of acute gastroenteritis. Early intervention and proper fluidreplacement may lessen this risk. We conducted this observational study to see the renal involvement and its outcome in patients with acutegastroenteritis. Design: Observational study. Setting: This study was done in three different hospitals which are tertiary care and teachinghospitals. Period: May 2009 to September 2009. Material and Method: A total of 200 patients were included in this study who presented withacute gastroenteritis. All patients were assessed properly for their clinical examination and laboratory tests including renal functions,electrolytes and other routine tests were done and evaluated. These patients were treated either in Emergency department or indoordepartments. Only those patients were included in our study who met our inclusion criteria which was set before conducting study. Results: Atotal of 200 patients were included in our study, among them 160 were male patients and 40 were female patients. At presentation 32 (16%)patients had deranged renal functions, 18 (09%) patients had urea in range of 50-100mg/dL and creatinine in the range of 1.4-2.0mg/dL. 10(05%) patients had urea in range of 101-150mg/dL and creatinine 2.1-3.5mg/dL. 04 (02%) patients had urea in range of 151-200mg/dL andcreatinine 3.6-7.0mg/dL. 12 patients were received in hypovolemic shock at presentation. After one week of follow up most of these patientsimproved but 04 patients were deteriorated and put on renal replacement therapy. Patients who had their renal functions in normal range weredischarged from hospital and follow up of all these patients were continued for 6 months. It was observed that those patients which presentedlate had more chances of renal involvement. Conclusions: Early referral and timely management with fluids and antimicrobials may reducerisk of renal failure in patients with acute gastroenteritis.

Pediatric onset lupus nephritis in western India—is it different from the rest of the country?

Lupus ◽  
2021 ◽  
pp. 096120332110450
Author(s):  
Aliza Mittal ◽  
Harshita Bamnawat ◽  
Aasma Nalwa ◽  
Vikarn Vishwajeet ◽  
Prawin Kumar ◽  
...  
Keyword(s):  
Renal Failure ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Care Center ◽  
Renal Involvement ◽  
Tertiary Care ◽  
Neurological Involvement ◽  
Western India ◽  
Pediatric Systemic Lupus Erythematosus

Aim To determine the clinicopathological characteristics and outcomes of children diagnosed with lupus nephritis in a tertiary hospital in western Rajasthan and compare it with the data available from other parts of India. Material and methods: A retrospective review of children presenting to a tertiary care center in western Rajasthan, India, with a diagnosis of pediatric Systemic Lupus Erythematosus (p SLE), between July 2017 and July 2020 was done. Comparisons of pediatric lupus in western India to other parts of country were done. Results 19 children with SLE with Renal involvement were enrolled and followed up. The median age at presentation was 15 years (IQR-16–9.5) (73% females). 8/19 (42%) children presented with AKI, of which 62% children presented as rapidly progressive renal failure. Six (37.5%) patients required dialysis at presentation. 84.21% of children were evaluated with renal biopsy, 16 biopsies were done in 19 children, among which class II, III, and IV lupus nephritis were reported in 21%,42%, and 35% respectively(4 crescentic). Antiphospholipid antibodies were positive in 8/15(53%), children which is much higher than a reported incidence of 30% in other Indian studies. Ten patients (52%) had neurological involvement, with seizures being the most common form of presentation (60%). Seven patients (36%) developed hepatitis. We noted many uncommon presentations in the small group like Autoimmune Pancreatitis, Mononeuritis multiplex, and peripheral digital gangrene. Cyclophosphamide was used in 10 out of 19 patients for inducing remission with class 3 and 4 nephritis and MMF in 8 children. 55% patients attained remission (after completing induction), of which 4 relapsed during the follow up. Four patients were lost to follow-up. A total of 27% patients died and 10% patients developed end stage renal failure. It was seen that those who died had more cardiac and neurological involvement at presentation, higher grade of proteinuria, lower GFR, and need for dialysis at admission. Conclusion: We found a more severe form of clinical manifestation in pediatric SLE patients at the time of the first presentation in the form of severe renal and extrarenal manifestation compared to other parts of the country.

scholarly journals Assessment of Renal Functions in Infants with Acute Gastroenteritis and Dehydration

2020 ◽  
Vol 8 (2) ◽  
pp. 94-99
Author(s):  
sandeep S
Keyword(s):  
Renal Failure ◽  
Acute Gastroenteritis ◽  
Tertiary Care ◽  
Urinary Output ◽  
Electrolyte Imbalance ◽  
Fluid Loss ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Renal Functions ◽  
Fractional Excretion Of Sodium

Background: Acute gastroenteritis is a very common illness in neonates and infants and it is one of the important causes of morbidity and mortality in third world countries. Most of the complications are due to excessive fluid loss and electrolyte imbalance adversely affecting kidney functions. Renal failure is one of the critical causes of morbidity in these children. Aim: We in the present study tried to evaluate the renal functions in infants with acute gastroenteritis reporting to our tertiary care teaching Hospital. Methods: This cross-sectional prospective study was performed on n=100 infants with gastroenteritis admitted into the Emergency service room of Prathima Institute of Medical Sciences and Hospital, Naganoor, Karimnagar. The degree Dehydration was assessed both clinically and hematologically. Blood samples for estimation of leucocyte count, Urea, Creatinine, and electrolyte estimation were drawn initially on admission and subsequently, blood culture, urine culture, and radiologic procedures were undertaken whenever indicated. Result: There are 16 cases with Blood urea more than 84 mg, indicating 16% of renal failure in the total number of cases studied, taking blood urea more than 20 mg as the criterion. But considering urinary output there are 18 cases with urinary output less than 300 ml/1.73 M 2 /24-hours. All these cases show creatinine values of more than 1.5 mg%. The glomerular filtration rate is decreasing as the severity of dehydration is increasing and fractional excretion of Sodium is diminishing with an increase in the severity of dehydration. Conclusion: The biochemical parameters like serum creatinine, blood urea, the urinary volume must be routinely in all cases of dehydration along with urinary indices like FeNa and R.F.I to detect the early onset of acute tubular necrosis. Prompt administration of intravenous fluids in acute gastroenteritis will go a long way in minimizing the mortality and morbidity among the infants

scholarly journals Relationship between trajectories of post-stroke disability and self-rated health (NeuroAdapt): protocol for a prospective observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e049944
Author(s):  
Sarah K Schäfer ◽  
Robert Fleischmann ◽  
Bettina von Sarnowski ◽  
Dominic Bläsing ◽  
Agnes Flöel ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Functional Health ◽  
Care Hospital ◽  
Duration Of Symptoms ◽  
Post Stroke ◽  
Self Rated Health ◽  
Modifying Factors ◽  
Study Results

IntroductionStroke is the leading neurological cause of adult long-term disability in Europe. Even though functional consequences directly related to neurological impairment are well studied, post-stroke trajectories of functional health according to the International Classification of Functioning, Disability and Health are poorly understood. Particularly, no study investigated the relationship between post-stroke trajectories of activities of daily living (ADL) and self-rated health (SRH). However, such knowledge is of major importance to identify patients at risk of unfavourable courses. This prospective observational study aims to investigate trajectories of ADL and SRH, and their modifying factors in the course of the first year after stroke.Methods and analysisThe study will consecutively enrol 300 patients admitted to a tertiary care hospital with acute ischaemic stroke or transient ischaemic attack (TIA; Age, Blood Pressure, Clinical Features, Duration of symptoms, Diabetes score ≥3). Patient inclusion is planned from May 2021 to September 2022. All participants will complete an interview assessing ADL, SRH, mental health, views on ageing and resilience-related concepts. Participants will be interviewed face-to-face 1–5 days post-stroke/TIA in the hospital; and will be followed up after 6 weeks, 3 months, 6 months and 12 months via telephone. The 12-month follow-up will also include a neurological assessment. Primary endpoints are ADL operationalised by modified Rankin Scale scores and SRH. Secondary outcomes are further measures of ADL, functional health, physical activity, falls and fatigue. Views on ageing, social support, resilience-related concepts, affect, frailty, illness perceptions and loneliness will be examined as modifying factors. Analyses will investigate the bidirectional relationship between SRH and ADL using bivariate latent change score models.Ethics and disseminationThe study has been approved by the institutional review board of the University Medicine Greifswald (Ref. BB 237/20). The results will be disseminated through scientific publications, conferences and media. Moreover, study results and potential implications will be discussed with patient representatives.Trial registration numberNCT04704635.

scholarly journals Evaluation of Aetiology and Outcome of Acute Kidney Injury in a Tertiary Care Hospital of India- A Prospective Observational Study

2020 ◽  
Author(s):  
VS Gaurav Narayan ◽  
SG Ramya ◽  
Sonal Rajesh Kumar ◽  
SK Nellaiappa Ganesan
Keyword(s):  
Acute Kidney Injury ◽  
Intensive Care ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Rapid Decline ◽  
Care Hospital ◽  
Medical Intensive Care

Introduction: The Acute Kidney Injury (AKI) is a rapid decline in renal filtration function. The aetiological spectrum, prevalence of AKI and outcome is highly variable. This variation exists due to the difference in the criteria used, study population and demographic features. Huge differences are noted when AKI is compared in developing and developed countries. Hence, it is important to analyse the spectrum of AKI to facilitate earlier diagnosis and treatment which shall help in improving the outcome. Aim: To study the prevalence, aetiology and outcome of AKI in the medical intensive care. Materials and Methods: This was a prospective observational study conducted in a medical intensive care for 18 months where 1490 patients were screened and 403 patients were included as AKI by KDIGO criteria. History, examination, appropriate investigations and treatment details including dialysis were noted. The serum creatinine levels were obtained every day, to know the time of onset of AKI, at the time of death or discharge, and after one month for patients who turned up for follow-up. Patients were categorised based on outcome as survivors and nonsurvivors. Survivors were divided into as fully recovered and partially recovered and those who left the Intensive Care Unit (ICU) against medical advice were termed as lost to follow-up. Results: A total of 403 patients (27.04% of 1490) of medical intensive care admissions were found to have AKI. Sepsis was the most common cause of AKI. At the end of the month, 78.4% of AKI patients fully recovered, 1.2% partially recovered and the mortality was 14.9%. Mortality was higher in AKI associated with chronic medical conditions like cardiac failure, chronic liver disease and stroke. Conclusion: If treated early, AKI is mostly reversible. Regional differences in AKI should be studied extensively and local guidelines should be formulated by experts for prevention and early treatment, to improve the disease outcome.

scholarly journals Assessment of Dental Implants with Modified Calcium-Phosphate Surface in a Multicenter, Prospective, Non-Interventional Study: Results up to 50 Months of Follow-Up

2019 ◽  
Vol 10 (1) ◽  
pp. 5
Author(s):  
Carles Subirà-Pifarré ◽  
Cristina Masuet-Aumatell ◽  
Carlos Rodado Alonso ◽  
Ricardo Medina Madrid ◽  
Cosimo Galletti
Keyword(s):  
Clinical Practice ◽  
Survival Rate ◽  
Calcium Phosphate ◽  
Observational Study ◽  
Dental Implants ◽  
Daily Practice ◽  
High Rate ◽  
Osseointegrated Implants ◽  
Study Results

Prescription of implant treatments is very widespread at present, mainly due to the low rate of annual loss and, to date, few studies have assessed their survival in the routine clinical practice of dentistry. The purpose of this observational study was to evaluate the effectiveness of dental implants with a calcium-phosphate surface in the daily practice of dental clinics. A multicenter, prospective, non-interventional, observational study was performed, in which three experienced practitioners (one maxillofacial and two oral surgeons) inserted implants using standard external and internal hexagon connections in adult patients requiring ≥1 osseointegrated implants to replace missing teeth. Follow-up was performed for 24 months after implant loading. Two hundred and twelve subjects were included (51.5% men), with a mean age of 51.2 ± 11.90 years, in whom 544 implants were inserted. 87.2% of the patients received 1–4 implants. The preferred connection system was internal hexagon (73.5%). There were nine failures, with an interval survival rate (ISR) at 24 months of 100% and a cumulative survival rate (CSR) of 98.3%. In conclusion, implants with a modified calcium-phosphate surface are associated with a high rate of survival and may be considered a method of choice in clinical practice.

scholarly journals Clinical profile and renal complications among cases of malaria in children attending a tertiary care hospital of South India

2019 ◽  
Vol 6 (4) ◽  
pp. 1445
Author(s):  
Tenali Ravi Kumar ◽  
Sai Lakshmi Ananya Tenali
Keyword(s):  
Renal Failure ◽  
Vivax Malaria ◽  
Statistical Significance ◽  
Demographic Data ◽  
Renal Involvement ◽  
Tertiary Care ◽  
Clinical History ◽  
Clinical Profile ◽  
Care Hospital ◽  
Early Recovery

Background: Malaria is one of the major vectors borne disease globally responsible for 1 million deaths a year. Changing trends in the causative species and epidemiological distribution have identified icterus and renal involvement as an emerging complication associated with severe mortality in children. The objectives of this study were aimed to study the clinical profile of malaria cases admitted in a pediatric ward. The study also highlights the involvement of renal manifestations in the cases with regard to species distribution and associated complications in the study group.Methods: A prospective study for 14 months was conducted, and all positive cases of malaria admitted in paediatric unit were enrolled and socio demographic data, clinical history were collected, and biochemical investigations were performed and analyzed. SPSS software version 12 was used for analysis. Statistical significance was set at p ≤0.05.Results: About 278 subjects with 55.4% males, 44.6% females and with 5-10 years was most common age group. 102 cases of vivax malaria, 152 cases were falciparum and 24 were mixed cases. Cerebral malaria, hyperparasitemia was identified in 28 cases, DIC in 5.04% of cases. Renal involvement was observed in 38.16% of falciparum infections and 27.45% of vivax infections. 68 cases developed acute renal failure as a severe complication.Conclusions:  Renal involvement is more in falciparum and mixed infections than vivax malaria. Early diagnosis and prompt treatment help in early recovery of cases and halts to progression to renal failure. An urgent need for a biomarker for early identification of renal involvement in malaria before biochemical involvement is detected.

scholarly journals Gestational trophoblastic diseases: an observational study at a tertiary care teaching hospital in Jharkhand, India

2020 ◽  
Vol 9 (8) ◽  
pp. 3138
Author(s):  
Archana Kumari ◽  
Nikita Chauhan
Keyword(s):  
Observational Study ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
Molar Pregnancy ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Disease Spectrum ◽  
Trophoblastic Diseases ◽  
Gestational Trophoblastic Diseases

Background: Gestational Trophoblastic Diseases (GTD) encompass a wide spectrum of proliferative disorders of trophoblast tissue, which hold a good prognosis if diagnosed and treated on time. A close understanding of the disease spectrum is therefore needed to reduce morbidity and mortality.Methods: This is an observational study (both prospective and retrospective analysis) conducted in Rajendra Institute of Medical Sciences, a tertiary care teaching hospital in Ranchi, Jharkhand over a period of 2 years from 1st January 2017 to 31st December 2018.Results: A total of 162 cases of GTD were identified during the study period. Disease spectrum comprised of complete molar pregnancy in 146 (90.12%) and partial molar pregnancy in 7 (4.3%), GTN in 9 out of 162 cases (5.5%). Bleeding per vaginum preceded by amenorrhea was the most common symptom, observed in 95.4% of the cases. Uterine size was more than period of amenorrhea in almost 50% of the cases. Theca lutein cysts were found in 39.8% of the cases, hypertension in 21.5%, hyperthyroidism in 6.5% cases. Overall, there were nine (5.56%) cases of choriocarcinoma and six (3.7%) cases of Invasive mole. Remission rate in GTN was 86.7% with chemotherapy.Conclusions: Women complaining of vaginal bleeding in first half of pregnancy with uterine size more than period of amenorrhea must be evaluated for GTD by ultrasound and serum beta HCG. For cases of molar pregnancies, suction and evacuation remains the treatment of choice but need for regular follow-up and strict compliance to contraception during entire follow up has to be emphasized. Cases of GTN have excellent remission with chemotherapy.

scholarly journals Granulomatous nephritis: A rare presentation of juvenile-onset sarcoidosis

2021 ◽  
Author(s):  
Prashant Chotalia ◽  
Sapan Pandya ◽  
Puja Srivastava
Keyword(s):  
Renal Failure ◽  
Renal Involvement ◽  
Cervical Lymphadenopathy ◽  
Unknown Origin ◽  
Oral Prednisolone ◽  
Pulmonary Involvement ◽  
Juvenile Onset ◽  
Rare Presentation ◽  
Pyrexia Of Unknown Origin ◽  
Renal Functions

ABSTRACT Sarcoidosis is rare in children. Incidence and prevalence of sarcoidosis in India are not known. Renal involvement in childhood sarcoidosis is further rare with no clear data about prevalence. Here we report a case of a 13-year-old girl who presented with sarcoidosis with multi-system involvement including renal sarcoidosis. She initially presented with pyrexia of unknown origin and cervical lymphadenopathy – evaluation of which led to diagnosis of sarcoidosis. Later, after development of pulmonary involvement, she was treated with oral prednisolone and azathioprine. She again defaulted on medicines and later presented with renal failure and was diagnosed with a renal sarcoidosis. She was treated with oral prednisolone and mycophenolate mofetil with which she gradually improved with normal renal functions.

MO041STABILIZATION OF KIDNEY FUNCTION DECLINE AND CARDIOMYOPATHY IN MALE PATIENTS WITH CLASSIC FABRY DISEASE: A PRE- VS. POST-AGALSIDASE BETA TREATMENT FABRY REGISTRY ANALYSIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Alberto Ortiz ◽  
Michael Mauer ◽  
Elvira Ponce ◽  
Meng Yang ◽  
Badari Gudivada ◽  
...  
Keyword(s):  
Fabry Disease ◽  
Kidney Function ◽  
Renal Involvement ◽  
Left Ventricular ◽  
Post Treatment ◽  
Agalsidase Beta ◽  
Male Patients ◽  
Pre Treatment ◽  
Egfr Decline

Abstract Background and Aims Fabry disease (FD) is an X-linked lysosomal storage disorder caused by pathogenic GLA gene variants. Males with the classic (more severe) phenotype have markedly deficient or no α-galactosidase A activity and early, progressive accumulation of glycosphingolipids (e.g. globotriaosylceramide [GL-3] and deacylated GL-3 [lyso-GL-3]) in cells and body fluids. Particularly compromised are vascular endothelial and smooth muscle cells, most kidney cell types (particularly podocytes), cardiomyocytes and neural cells. Cellular injury triggers inflammatory responses leading to fibrosis with multisystem involvement. Symptoms associated with small fiber neuropathy (e.g. neuropathic pain) appear in childhood, typically followed in adulthood by chronic nephropathy (proteinuria, reduced glomerular filtration rate [GFR]) that may evolve to end-stage renal disease, and progressive cardiomyopathy with left ventricular hypertrophy and early demise. We compared kidney function and cardiomyopathy outcomes after enzyme replacement therapy with agalsidase beta with treatment-naive outcomes in male patients with the classic form of FD. Method The self-controlled comparison (piecewise mixed linear modelling) used Fabry Registry (NCT00196742) data from males with GLA variants associated with the classic FD phenotype (dbfgp.org/dbFgp/fabry/). The patients had received agalsidase beta (average dose of 0.9 − 1.1 mg/kg every 2 weeks) and had ≥2 pre- and ≥2 post-baseline assessments. Baseline was defined as up to 6 months after start of treatment. Follow-up spanned from 5 years pre-treatment (preTx) to 5 years post-treatment (postTx). Patients on dialysis or with a kidney transplant were excluded. Assessed were slopes of estimated GFR (eGFR, CKDEPI equation), ultrasound derived interventricular septum thickness (IVSTd) and left ventricular posterior wall thickness (LVPWTd) during the preTx and postTx periods. Data were stratified by low renal involvement (LRI, ratios [g/g] urine protein-to-creatinine ≤0.5 or albumin-to-creatinine ≤0.3) and high renal involvement (HRI, ratios [g/g] >0.5 or >0.3, respectively). Ages at start of treatment (ageTx) and follow-up durations are expressed as medians. Results Compared with 1.1-year preTx data, eGFR decline was similar during 4.1-year postTx follow-up in 254 males, ageTx 30.8 years. eGFR slopes (preTx vs. postTx) were -2.22 vs. -2.66 ml/min/1.73 m2/year (Ppre-post difference=0.24). The changing patterns among the 165 LRI males, ageTx 25.4 years (slopes preTx vs. postTx: -1.73 vs. -1.92 ml/min/1.73 m2/year; Ppre-post difference=0.66), and the 68 HRI males, ageTx 38.2 years (slopes: -2.93 vs. -4.31 ml/min/1.73 m2/year; Ppre-post difference=0.04), were statistically different (Pinteraction<0.01). IVSTd remained stable among 73 males, ageTx 34.2 years, during 1.0-year preTx (slope=+0.02 mm/year, P0>0.05) and 4.1-year postTx follow-up (slopes=-0.02 mm/year, P0>0.05) (Ppre-post difference=0.83), where a P0 <0.05 indicates that the slope is significantly different from zero. LVPWTd increased preTx (slope=+0.33 mm/year, P0=0.01) but stabilized during postTx follow-up (slope=-0.09 mm/year, P0>0.05) in 87 males, ageTx 35.1 years (Ppre-post difference<0.01). Overall, patients with LRI had more stable cardiac ultrasound indices throughout follow-up. Conclusion In males with classic FD, treatment with agalsidase beta appeared to stabilize eGFR decline in LRI males. Overall, IVSTd remained stable throughout follow-up and LVPWTd, increasing during pre-treatment follow-up, stabilized post-treatment. Funding: Fabry Registry, abstract: Sanofi Genzyme.

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