scholarly journals Acute Renal Failure in a Tertiary Care Center in Nepal

2005 ◽  
Vol 44 (158) ◽  
Author(s):  
Sudha Khakurel ◽  
P R Satyal ◽  
R K Agrawal ◽  
P K Chhetri ◽  
R Hada
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Bacillary Dysentery ◽  
Care Center ◽  
Tertiary Care ◽  
Acute Interstitial Nephritis ◽  
Female Age ◽  
Tubular Necrosis ◽  
Common Causes ◽  
Urate Nephropathy

From July 1998 to July 1999, 45 cases of acute renal failure were treated at Bir Hospital, Kathmandu. Outof which 24 were male and 21 were female. Age ranged from 11 months to 84 years with mean age being 35years and 9 cases were below 10 years.Four cases with pre-renal azotaemia and twenty five cases of acute tubular necrosis (ATN) accounted for64% of all cases. These were due to gastroenteritis 10, sepsis 6, post surgical 1, trauma 1 and obstreticalcomplications 5. Multiple hornet stings were responsible for acute renal failure in 3 cases, acute urate nephropathy in 1 case and miscellaneous causes in 2 cases.Glomerulonephritis / vasculitis accounted for 17.7%, acute interstitial nephritis 4.4%, haemotytic uraemicsyndrome (HUS) 6.6%, and post renal azotaemia in 6.6% of all cases. Mean serum creatinine was 8 mg/dl,mean blood urea 190 mg/dl. Eight cases were treated only conservatively, eighteen received haemodialysis,fourteen received peritoneal dialysis, three received both and two refused for dialysis. Average duration ofhospital stay was 13.6 days. Out of the forty-five cases twenty-nine recovered normal renal function, tenexpired, two recovered partially, two progressed to chronic renal failure and two left against medical advice.Overall mortality was 22.2%.Common causes of acute renal failure in our setting were gastroenteritis (22%) and sepsis (20%). HUS wasexclusively seen in children following bacillary dysentery. Multiple hornet stings is an important cause ofacute renal failure in our country.

SULPHINPYRAZONE (SP) AS A CAUSE OF ACUTE RENAL FAILURE (ARF): A REVIEW

1987 ◽  
Author(s):  
J Boelaert ◽  
P Lijnen ◽  
R Daneels ◽  
M Schurgers ◽  
A Amery
Keyword(s):  
Renal Failure ◽  
Interstitial Nephritis ◽  
Acute Interstitial Nephritis ◽  
Progressive Increase ◽  
Prostaglandin Synthesis ◽  
Acute Ischaemia ◽  
Acute Dialysis ◽  
Tubular Necrosis ◽  
Renal Histology ◽  
Urate Nephropathy

A total of 41 patients (all but one since 1980, 10 from our own group) have been reported with ARF due to SP. Their mean age was 58 years. 84 % of them received SP for coronary or cerebrovascular disease. Signs of pre-existing renal disease were absent in 91%of cases. Daily dosage of SP was < 400 mg in 21 %, 600 mg in 21 % and 800 mg in 58 % of the cases. ARF appeared within the first day of R/ with SP in31 % of cases(median delay of 4 days). Oliguria was present in 41 % and lumbar or abdominal pain in 26 %. Urinalysis showed uric acid crystals in 13 %. Serum creatinine peaked at a mean of 7.2 mg%. Extrarenal signs (fever, rash) were rare (10 %). 3 patients (8 %) died; renal function recovered in the others, acute dialysis being needed in 6 cases (15 %). Renal histology (11 cases) showed either no lesions (2), minimal tubulo-interstitial lesions (3), discrete interstitial infiltration (2), acute interstitial nephritis (3) or acute tubular necrosis (1).SP can cause ARF by 3 mechanisms which are not mutually exclusive : acute urate nephropathy, acute (immunological) interstitial nephritis or acute ischaemia due to inhibition of the renal synthesis of kallikrein-kinin and/or vasodilatory prostaglandins. We suggest that the latter mechanism is the most prevalent. The effect of SP on the renal prostaglandin synthesis is not settled; thurinary excretion of kallikrein is significantly depressed by SPIn conclusion : since 1980, R/ with SP is a frequent cause of ARF Practically: 1) the indications for sp should be taken with care; 2) a progressive increase in the dosage of SP may decreses the incidence of ARF.

scholarly journals Etiological Spectrum of Pregnancy-Related Acute Renal Failure among Females at a Tertiary Care Hospital

2019 ◽  
Vol 8 (1) ◽  
pp. 13-17
Author(s):  
Syed Muhammad Muzaffar Hussain ◽  
Khalid Mahmood Nasir ◽  
Qazi Adil Inam ◽  
Khalid Mahmud Khan
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
General Population ◽  
Drug Toxicity ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Tubular Necrosis ◽  
Etiological Spectrum ◽  
In Pregnancy

Background: Acute renal failure in pregnancy can be induced by any of the disorders leading to renal failure in the general population, such as acute tubular necrosis due to infection, glomerulonephritis related to lupus, or drug toxicity. There are, however, pregnancy complications characteristic of each trimester that can result in renal failure. The objective of this study was to determine the frequency of various causes of pregnancy-related acute renal failure among females presenting to a tertiary care hospital.

Acute Renal Failure Amongst Children in a Tropical Environment

1987 ◽  
Vol 10 (2) ◽  
pp. 97-101 ◽  
Author(s):  
K.S. Chugh ◽  
A. Narang ◽  
L. Kumar ◽  
V. Sakhuja ◽  
V. Narayanan Unni ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Rural Areas ◽  
Acute Interstitial Nephritis ◽  
Acute Glomerulonephritis ◽  
Drug Induced ◽  
Tubular Necrosis ◽  
Renal Histology ◽  
Endocapillary Proliferative Glomerulonephritis ◽  
Glucose 6 Phosphate Dehydrogenase

The pathogenetic factors leading to acute renal failure (ARF) in 223 children between the ages of 20 days and 14 years were studied. Diarrhoeal diseases were responsible for ARF in 49.8%, acute glomerulonephritis in 34.1%, drug induced intravascular hemolysis in glucose -6-phosphate dehydrogenase deficiency in 4.5%, snake bite in 4%, hemolytic uremic syndrome in 2.2%, and miscellaneous causes in 5.4%. Dialysis was instituted in 178 children and the others were treated conservatively. Renal histology in 39 out of 76 children who presented with an acute nephritic illness revealed acute endocapillary proliferative glomerulonephritis in 27 and crescentic glomerulonephritis in 12. The histology in 79 out of 147 remaining patients showed acute tubular necrosis in 64, acute cortical necrosis in 13, and acute interstitial nephritis in 2. Overall mortality was 27.4%. This high incidence of ARF due to infective diarrhoeas and dysentery reflects poor socio-economic and hygienic conditions, inadequate facilities in rural areas, delays in seeking medical advice, and lack of knowledge about fluid and electrolyte therapy amongst the staff.

scholarly journals Asian wasp envenomation and acute renal failure: a report of two cases

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Rabindra Das ◽  
Keka Mukherjee
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Hypersensitivity Reaction ◽  
Interstitial Nephritis ◽  
Hepatic Dysfunction ◽  
Acute Interstitial Nephritis ◽  
Unusual Complication ◽  
Tubular Necrosis ◽  
Wasp Stings ◽  
Vespa Affinis

Acute renal failure is an unusual complication of wasp stings. We report two cases of renal failure after multiple wasp stings (Vespa affinis). Both patients had evidence of intravascular haemolysis, hepatic dysfunction, oligo-anuria and azotaemia and required dialysis. The first patient had severe hemolysis, rhabdomyolysis, pigment and venom nephropathy and died on the 8th day in hospital. The second patient, who recovered completely in 3 weeks time with steroid and antihistaminic therapy, had interstitial nephritis. Although acute renal failure after wasp stings is typically caused by acute tubular necrosis (ATN) in the setting of haemolysis or rhabdomyolysis, in some patients, acute renal failure may result from a direct nephrotoxic effect or acute interstitial nephritis from a hypersensitivity reaction.

scholarly journals Acute renal failure in children in a tertiary care center

2013 ◽  
Vol 24 (2) ◽  
pp. 413 ◽  
Author(s):  
Mukta Mantan ◽  
Sukesh Upare ◽  
GulshanRai Sethi ◽  
Malobika Bhattacharya ◽  
Dhulika Dhingra
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center

Frequency of factors leading to acute renal failure in obstetric patients.

2021 ◽  
Vol 28 (05) ◽  
pp. 640-646
Author(s):  
Shaheena Zafar ◽  
Riffat Jaleeel ◽  
Kouser Karim Lodhani
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Serum Creatinine ◽  
Placental Abruption ◽  
Post Partum ◽  
Common Factor ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional

Objective: To determine the frequency of factors leading to acute renal failure in obstetric patients. Study Design: Cross Sectional study. Setting: Department of Obstetrics and Gynecology, Civil Hospital Karachi, Tertiary Care Hospital. Period: July 2015- Jan 2016. Material & Methods: Total 250 women during pregnancy and within 42 days after delivery who were diagnosed as ARF were included. Serum creatinine was done on admission and then after 24 hours of delievery. Those with urine output < 30ml / hour and serum creatinine > 1.5 mg / dl were recruited. All data was recorded on proforma. Results: The average age of the women was 29.36±5.87 years. Post-partum hemorrhage was the important and common factor i.e. 40.4%, followed by placental abruption 25.6%, Severe pre-eclampsia 18.4%, puerperal sepsis 8.4% and eclampsia 7.2%. Conclusion: Ante partum hemorrhage like placental abruption, eclampsia and preeclampsia, and postpartum hemorrhages’ are the major causes of obstetrical ARF. Good antenatal care and provision of universal health facility can prevent this dangerous condition. Though it is a treatable and curable complication, but if not diagnosed and treated timely, it can lead to significant maternal morbidity and mortality.

scholarly journals Renal involvement in human rabies: clinical manifestations and autopsy findings of nine cases from northeast of Brazil

2005 ◽  
Vol 47 (6) ◽  
pp. 315-320 ◽  
Author(s):  
Elizabeth De Francesco Daher ◽  
Geraldo Bezerra da Silva Júnior ◽  
Marúsia Thomaz Ferreira ◽  
Fernando Antonio de Sousa Barros ◽  
Tiago Magalhães Gurgel ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Renal Involvement ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Hemodynamic Instability ◽  
Human Rabies ◽  
Tubular Necrosis ◽  
Post Mortem Findings ◽  
Histopathologic Findings

A retrospective study was conducted in nine patients with rabies admitted to a hospital of Fortaleza, Brazil. Autopsy was performed in all cases. The ages ranged from three to 81 years and six were males. They all were bitten by dogs. The time between the accident and the hospital admission ranged from 20 to 120 days (mean 45 ± 34 days). The time until death ranged from one to nine days (mean 3.3 ± 5.5 days). The signs and symptoms presented were fever, hydrophobia, aerophobia, agitation, disorientation, dyspnea, sialorrhea, vomiting, oliguria, sore throat, pain and hypoesthesia in the site of the bite, headache, syncope, cough, hematemesis, mydriasis, hematuria, constipation, cervical pain and priapism. In three out of six patients, there was evidence of acute renal failure, defined as serum creatinine > 1.4 mg/dL. The post-mortem findings in the kidneys were mild to moderate glomerular congestion and mild to intense peritubular capillary congestion. Acute tubular necrosis was seen in only two cases. This study shows some evidence of renal involvement in rabies. Histopathologic findings are nonspecific, so hemodynamic instability, caused by autonomic dysfunction, hydrophobia and dehydration must be responsible for acute renal failure in rabies.

scholarly journals An evaluation of antioxidant effects on recovery from postischemic acute renal failure.

1994 ◽  
Vol 4 (8) ◽  
pp. 1588-1597
Author(s):  
R A Zager ◽  
S M Fuerstenberg ◽  
P H Baehr ◽  
D Myerson ◽  
B Torok-Storb
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Dna Fragmentation ◽  
Proliferating Cell Nuclear Antigen ◽  
Antigen Expression ◽  
Nuclear Antigen ◽  
Terminal Deoxynucleotidyl Transferase ◽  
Tubular Necrosis ◽  
Proliferating Cell

Xanthine oxidase (XO) activity and hydroxyl radical (.OH) formation are widely proposed mediators of renal reperfusion injury, potentially altering the severity of, and recovery from, postischemic acute renal failure. The goal of this study was to ascertain whether combination XO inhibitor (oxypurinol) and .OH scavenger (Na benzoate) therapy, given at the time of renal ischemia, alters the extent of: (1) tubular necrosis and filtration failure; (2) DNA fragmentation/apoptosis (assessed in situ by terminal deoxynucleotidyl transferase reactivity); (3) early tubular regenerative responses (proliferating cell nuclear antigen expression; (3H)thymidine incorporation); and (4) the rate and/or degree of functional and morphologic repair. The effects of XO inhibition, .OH scavengers, and "catalytic" iron (FeSO4) on human proximal tubular cell proliferation in vitro were also assessed with a newly established cell line (HK-2). Male Sprague-Dawley rats were subjected to 35 min of bilateral renal arterial occlusion with or without oxypurinol/benzoate therapy. These agents did not alter the extent of tubular necrosis or filtration failure, proliferating cell nuclear antigen expression or thymidine incorporation, or the rate/extent of renal functional/morphologic repair. DNA fragmentation did not precede tubular necrosis, and it was unaffected by antioxidant therapy. By 5 days postischemia, both treatment groups demonstrated regenerating epithelial fronds that protruded into the lumina. These structures contained terminal deoxynucleotidyl transferase-reactive, but morphologically intact, cells, suggesting the presence of apoptosis. Oxypurinol and .OH scavengers (benzoate; dimethylthiourea) suppressed in vitro tubular cell proliferation; conversely, catalytic Fe had a growth-stimulatory effect. These results suggest that: (1) XO inhibition/.OH scavenger therapy has no discernible net effect on postischemic acute renal failure; (2) DNA fragmentation does not precede tubular necrosis, suggesting that it is not a primary mediator of ischemic cell death; and (3) antioxidants can be antiproliferative for human tubular cells, possibly mitigating their potential beneficial effects.

scholarly journals Frequency of acute renal failure in blackstone poisoning

2020 ◽  
Vol 27 (06) ◽  
pp. 1285-1290
Author(s):  
Ahmed Ali Kanhar ◽  
Waseem Raja Memon ◽  
Nasrullah Aamer ◽  
Bahkat Ali Sial ◽  
Abdul Aziz Sahito ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Urine Output ◽  
Low Cost ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Output Measurement

Objective: To determine the frequency of acute renal failure in patients presented with Blackstone poisoning in a tertiary care Hospital. Study Design: Cross sectional study. Setting: Medical wards and ICU at Peoples Medical College Hospital, Nawabshah. Period: September 2017 to March 2018. Material & Methods: All the patients of age 20 to 50 years having Paraphenylenediamine (PPD) poisoning (kala-patthar) during ≥6 hours after ingestion and either of gender were included. AKI was labelled as positive if either of any stage was present on the basses of urine output measurement for 24 hours through urine beg r urine output (UO) criteria. All the data was documented in self-made proforma. Results: The mean age for patients was 24.9±8.9 years, 46(19.08%) subjects were male and 195(80.91%) were female. 18(7.5%) study subjects had acute renal failure, out of them 6 study subjects had ARF of stage I, 5 patients had stage II and 7 study subjects had acute renal failure stage III. Conclusion: Acute renal injury is a common complication following PPD ingestion 7.5%. Paraphenylenediamine toxicity is a threat to the region of Asia and is evolving as a substitute to the poisoning of organophosphorus due to its easy accessibility and low cost.

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