scholarly journals A Deleterious Combination of Intravenous Drug Usage with HIV and Chronic Hepatitis Infection; How Renal Replacement Therapy Emanated?

2018 ◽  
Vol 3 (1) ◽  

Intravenous drug usage of substances like cocaine and heroin; encompasses a spectrum of generalized state of illness. A continuum insult which predispose patients to chronic viral illnesses, bacterial infections and subsequently end organ damage due to multiple factors. The renal structure is one of the target organs involved in this process, by which a majority of them will lately developed end stage renal disease and as a result renal replacement therapy. However, the spectrum of complications of this population is enormous starting with acquire infections like HIV, Hepatitis C, Hepatitis B, severe skin infections, pneumonias, cardiovascular diseases, endovascular complications as the well-known Lemierre’s syndrome, central nervous system infections, systemic complications like renal failure ending up in hemodialysis and most of them with a low expectancy of life. In our population 69 patients were randomly with a mean age of 44 years assign for investigation all of them known to have a poor social support in conjunction with intravenous drug usage of cocaine and heroin. All these patients were study using the electronic medical record system, several conditions were measure like HIV, Hepatitis B, Hepatitis C, Hypertension and Diabetes mellitus. Of the patients been study the admission diagnosis that lead to renal replacement therapy was recorded, and later in the process compared. Our population of 69 patients, 16 of them ended up in hemodialysis 23% (16/69), of this patients that had renal replacement therapy 4 of them had Hepatitis C 25% (4/16), Hepatitis B 19% (3/16), HIV 13% (2/16), Hypertension 6% (1/16) and Diabetes mellitus 6% (1/16) respectively. There were several precise findings that lead to hemodialysis in the population, with the majority been infected ulcers 25% (17/69), pneumonia 20% (14/69), upper gastrointestinal bleeding in 10 %(7/69) and symptomatic anemia 10% (7/69) respectively. All of this patient did not have good social support, none of them knew about the long-term consequences of renal failure and most of them did not had positive approach of stopping intravenous drug usage. As a whole, illicit intravenous drug usage is associated with a broad spectrum of diseases, all of them creating a rapid deleterious clinical picture; mostly debuting to medical assistance with infectious etiologies.

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Maria E. Jarut ◽  
Emma Sy. Moeis ◽  
Bradley J. Waleleng

Abstract: Chronic kidney disease (CKD) is a process with various etiology, resulting in a progressive descent in kidney function and generally end up with kidney failure that requires renal replacement therapy. One of the renal replacement therapy is hemodialysis. Subjects undergoing hemodialysis belong to the high-risk group for hepatitis B and hepatitis C. This study aimed to obtain the APRI scores in subjects CKD 5 HD with hepatitis B and hepatitis C. This was a retrospective observational descriptive study. This study was conducted from October to December 2014 in the medical record of Hemodialysis Unit Prof. Dr. R. D. Kandou Hospital Manado. The results showed that there were 64 subjects who met the inclusion criteria, consisted of 29 (45%) subjects with CKD 5 HD and hepatitis B and 35 (55%) subjects with CKD 5 HD and hepatitis C. Among subjects of CKD 5 HD with hepatitis B, there were 24 (37.50%) males and 5 (7.81%) females. Among subjects with CKD 5 HD and hepatitis C, there were 15 (23.43%) males and 20 (31.25%) females. Age range in subjects with CKD 5 HD and hepatitis B was 37-69 years, while in subjects with CKD 5 HD and hepatitis C was 33-65 years. The SGOT of the CKD 5 HD subjects with hepatitis B was 14-58 U/L while of the CKD 5 HD subjects with hepatitis C was 21-38 U/L. The platelet count in subjects with CKD 5 HD and hepatitis B was 78.103 /mm3 – 357.103/ mm3 while in CKD 5 HD subjects with hepatitis C was 54.103/mm3 – 417.103/mm3. Based on the SGOT and the platelet count, the final APRI scores for subjects with CKD 5 HD and hepatitis B was 0.004- 0.056 while the of CKD 5 HD subjects with hepatitis C was 0.005-0.177. The APRI scores in subjects with CKD 5 HD and hepatitis B and CKD 5 HD subjects with hepatitis C was < 0.5 which meant there was no fibrosis of the liver or fibrosis without septa. Conclusion: APRI scores were not significant to the degree of fibrosis in the early stages of either hepatitis B or hepatitis C. Keywords: CKD 5 HD, hepatitis B, hepatitis C, APRI score Abstrak: Penyakit ginjal kronik adalah suatu proses dengan etiologi beragam, mengakibatkan penurunan fungsi ginjal yang progresif dan umumnya berakhir dengan gagal ginjal yang memerlukan terapi pengganti ginjal. Salah satu terapi pengganti ginjal yaitu hemodialisis. Subyek yang menjalani hemodialisis merupakan kelompok risiko tinggi untuk virus hepatitis B dan hepatitis C. Penelitian ini bertujuan untuk mengetahui skor APRI pada subyek PGK 5 HD dengan hepatitis B dan hepatitis C. Jenis penelitian ini ialah observasional dengan rancangan deskriptif retrospektif. Penelitian ini dilaksanakan mulai Oktober sampai Desember 2014 di Bagian rekam medik Ilmu Penyakit Dalam Unit Hemodialisis RSUP Prof Dr. R. D. Kandou Manado. Hasil penelitian memperlihatkan dari 64 subyek yang memenuhi kriteria inklusi terdapat 29 (45%) subyek PGK 5 HD dengan hepatitis B dan 35 (55%) subyek PGK 5 HD dengan hepatitis C. Pada subyek PGK stadium 5 HD dengan hepatitis B, terdapat 24 laki-laki (37,50%) dan 5 perempuan (7,81%). Pada subyek PGK 5 HD dengan hepatitis C, terdapat 15 laki-laki (23,43%) dan 20 perempuan (31,25%). Rentang umur pada subyek PGK 5 HD dengan hepatitis B 37-69 tahun sedangkan rentang umur pada subyek PGK 5 HD dengan hepatitis C 33-65 tahun. Nilai SGOT subyek PGK 5 HD dengan hepatitis B 14-58 U/L sedangkan subyek PGK 5 HD dengan hepatitis C 21-38 U/L. Jumlah trombosit pada subyek PGK 5 HD dengan hepatitis B 78.103/mm3– 357.103/mm3sedangkan subyek PGK 5 HD dengan hepatitis C 54.103/mm3– 417.103/mm3. Berdasarkan nilai SGOT dan jumlah trombosit yang diperoleh maka hasil perhitungan skor APRI untuk subyek PGK 5 HD dengan hepatitis B 0,004-0,056 sedangkan pada subyek PGK 5 HD dengan hepatitis C 0,005-0,177. Skor APRI pada subyek PGK 5 HD dengan hepatitis B dan subyek PGK 5 HD dengan hepatitis C <0,5, yang menunjukkan tidak terdapat fibrosis pada hati atau terdapat fibrosis tanpa septa. Simpulan: Skor APRI tidak bermakna terhadap derajat fibrosis stadium awal baik pada hepatitis B ataupun heptitis C.Kata kunci: PGK 5 HD, hepatitis B, hepatitis C, skor APRI


Burns ◽  
2000 ◽  
Vol 26 (7) ◽  
pp. 638-643 ◽  
Author(s):  
Richard Tremblay ◽  
Jean Ethier ◽  
Serge Quérin ◽  
Vincent Béroniade ◽  
Pierre Falardeau ◽  
...  

2021 ◽  
Vol 57 (10) ◽  
pp. 1724-1725
Author(s):  
Rakesh K Pilania ◽  
Swati Dokania ◽  
Amber Kumar ◽  
Reyaz Ahmad ◽  
Shikha Malik ◽  
...  

2002 ◽  
Vol 30 (9) ◽  
pp. 2051-2058 ◽  
Author(s):  
Philipp G. H. Metnitz ◽  
Claus G. Krenn ◽  
Heinz Steltzer ◽  
Thomas Lang ◽  
Jürgen Ploder ◽  
...  

PEDIATRICS ◽  
1990 ◽  
Vol 85 (5) ◽  
pp. 819-823
Author(s):  
Nancy A. Bishof ◽  
Thomas R. Welch ◽  
C. Frederic Strife ◽  
Frederick C. Ryckman

Continuous arteriovenous hemofiltration is a form of renal replacement therapy whereby small molecular weight solutes and water are removed from the blood via convection, alleviating fluid overload and, to a degree, azotemia. It has been used in many adults and several children. However, in patients with multisystem organ dysfunction and acute renal failure, continuous arteriovenous hemofiltration alone may not be sufficient for control of azotemia; intermittent hemodialysis or peritoneal dialysis may be undesirable in such unstable patients. Recently, the technique of continuous arteriovenous hemodiafiltration has been used in many severely ill adults. We have used continuous arteriovenous hemodiafiltration in four patients at Children's Hospital Medical Center. Patient 1 suffered perinatal asphyxia and oliguria while on extracorporeal membrane oxygenation. Patients 2 and 4 both had Burkitt lymphoma and tumor lysis syndrome. Patient 3 had septic shock several months after a bone marrow transplant. All had acute renal failure and contraindications to hemodialysis or peritoneal dialysis. A blood pump was used in three of the four patients, while spontaneous arterial flow was adequate in one. Continuous arteriovenous hemodiafiltration was performed for varying lengths of time, from 11 hours to 7 days. No patient had worsening of cardiovascular status or required increased pressor support during continuous arteriovenous hemodiafiltration. The two survivors (patients 2 and 4) eventually recovered normal renal function. Continuous arteriovenous hemodiafiltration is a safe and effective means of renal replacement therapy in the critically ill child. It may be ideal for control of the metabolic and electrolyte abnormalities of the tumor lysis syndrome.


2001 ◽  
Vol 3 (2) ◽  
pp. 89-96 ◽  
Author(s):  
Bo-Ying CHOY ◽  
Yiu-Wing HO ◽  
Ka-Foon CHAU ◽  
Chi-Bon LEUNG ◽  
Wai-Kei TSANG ◽  
...  

2013 ◽  
Vol 2 (3) ◽  
pp. 116-119
Author(s):  
Vincenzo Morabito ◽  
Gilnardo Novelli ◽  
Rajiv Jalan

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