scholarly journals Intra-abdominal Hypertension as a Cause of Oliguric Acute Kidney Injury in a Patient with Chronic Lymphocytic Leukemia

2020 ◽  
Vol 31 (5) ◽  
pp. 1140
Author(s):  
Dimitris Xydakis ◽  
Ergini Antonaki ◽  
Anna Boula ◽  
Emilia Stavroulaki ◽  
Aristea Hatzivasili ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Chronic Lymphocytic Leukemia ◽  
Kidney Injury ◽  
Lymphocytic Leukemia ◽  
Abdominal Hypertension

scholarly journals Chronic lymphocytic leukemia; an incidental finding in a COVID-19 patient.

2021 ◽  
Author(s):  
Shazaf Masood Sidhu ◽  
Fabiha Ghulam Muhammad ◽  
Ainan Arshad
Keyword(s):  
Acute Kidney Injury ◽  
Chronic Lymphocytic Leukemia ◽  
Incidental Finding ◽  
Tumor Lysis Syndrome ◽  
Kidney Injury ◽  
Functional Class ◽  
Lymphocytic Leukemia ◽  
Shortness Of Breath ◽  
Tumor Lysis ◽  
History Of

Abstract We report a case of 57 years old male, with no prior comorbids functional class I, presented with a history of fever for one week along with shortness of breath and cough for 5 days. Upon workup his baseline CBC reported bicytopenia along with marked lymphocytosis which raised the suspicion and to confirm the diagnosis, his acute leukemia comprehensive panel was done which reported an incidental finding of Chronic lymphocytic leukemia along with concomitant COVID PCR positive. This patient also presented with Tumor Lysis Syndrome and Acute kidney Injury.

scholarly journals New insights in prevention and treatment of sepsis-induced acute kidney injury

2013 ◽  
Vol 1 (1) ◽  
pp. 23-27
Author(s):  
Patrick M. Honore ◽  
Rita Jacobs ◽  
Olivier Joannes-Boyau ◽  
Willem Boer ◽  
Elisabeth De Waele ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Lactate Clearance ◽  
Trauma Patients ◽  
Abdominal Hypertension ◽  
Prevention And Treatment ◽  
Ringer’S Lactate ◽  
Important Challenge ◽  
Crystalloid Solutions ◽  
Renal Doppler

AbstractSepsis-induced acute kidney injury (SAKI) remains an important challenge for intensive care unit clinicians. We reviewed current available evidence regarding prevention and treatment of SAKI thereby incorporating some major recent advances and developments. Prevention includes early and ample administration of “balanced” crystalloid solutions such as Ringer’s lactate. For monitoring of renal function during resuscitation, lactate clearance rate is preferred above ScvO2or renal Doppler. Aiming at high central venous pressures seems to be deleterious in light of the novel “kidney afterload” concept. Noradrenaline is the vasopressor of choice for preventing SAKI. Intra-abdominal hypertension, a potent trigger of acute kidney injury in postoperative and trauma patients, should not be neglected in sepsis. Renal replacement therapy (RRT) must be started early in fluid-overloaded patients refractory to diuretics. Continuous RRT (CRRT) is the preferred modality in hemodynamically unstable SAKI but its use in more stable SAKI is increasing. In the absence of hypervolemia, diuretics should be avoided. Antimicrobial dosing during CRRT needs to be thoroughly reconsidered to assure adequate infection control.

scholarly journals Acute kidney injury and intra-abdominal hypertension in burn patients in intensive care

2018 ◽  
Vol 30 (1) ◽  
Author(s):  
Thalita Bento Talizin ◽  
Meiry Sayuri Tsuda ◽  
Marcos Toshiyuki Tanita ◽  
Ivanil Aparecida Moro Kauss ◽  
Josiane Festti ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Intensive Care ◽  
Kidney Injury ◽  
Burn Patients ◽  
Abdominal Hypertension

Point-of-Care Echocardiography Unveils Misclassification of Acute Kidney Injury as Hepatorenal Syndrome

2019 ◽  
Vol 50 (3) ◽  
pp. 204-211 ◽  
Author(s):  
Juan Carlos Q. Velez ◽  
Bradley Petkovich ◽  
Nithin Karakala ◽  
J. Terrill Huggins
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Function ◽  
Volume Expansion ◽  
Hepatorenal Syndrome ◽  
Point Of Care ◽  
Kidney Injury ◽  
Volume Status ◽  
Early Improvement ◽  
Abdominal Hypertension ◽  
The Mean

Introduction: Fulfillment of the diagnostic criteria for ­hepatorenal syndrome type 1 (HRS-1) requires prior failure of 2 days of intravenous volume expansion and/or diuretic withdrawal. However, no parameter of volume status is used to guide the need for volume expansion in patients with suspected HRS-1. We hypothesized that point-of-care echocardiography (POCE) may better characterize the volume status in patients with acute kidney injury (AKI) and cirrhosis to ascertain or disprove the diagnosis of HRS-1. Methods: A pilot observational study was conducted to determine the clinical utility of POCE-based examination of inferior vena cava diameter (IVCD) and collapsibility index (IVCCI) to assess intravascular volume status in patients with cirrhosis and AKI who had been deemed adequately volume-repleted and thereby assigned a clinical diagnosis of HRS-1. Early improvement in kidney function was defined as ≥20% decrease in serum creatinine (sCr) at 48–72 h. Results: A total of 53 patients were included. The mean sCr at the time of volume assessment was 3.2 ± 1.5 mg/dL, and the mean Model for End-Stage Liver Disease score was 29 ± 8. Fifteen (23%) patients had an IVCD <1.3 cm and IVCCI >40% and were reclassified as fluid-depleted, 11 (21%) had an IVCD >2 cm and IVCCI <40% and were reclassified as fluid-expanded, and 8 (15%) had and IVCD <1.3 cm and IVCCI <40% and were reclassified as having intra-abdominal hypertension (IAH). Twelve (23%) patients exhibited early improvement in kidney function following a POCE-guided therapeutic maneuver, that is, volume expansion, diuresis, or paracentesis for those deemed fluid-depleted, fluid-expanded or having IAH, respectively. Conclusion: POCE-based assessment of volume status in cirrhotic individuals with AKI reveals marked heterogeneity. Unguided volume expansion in these patients may lead to premature or delayed diagnosis of HRS-1.

scholarly journals Neglected obstetric haemorrhage leading to acute kidney injury

2017 ◽  
Vol 6 (11) ◽  
pp. 5177
Author(s):  
Pallavi Verma ◽  
Pavitra Manu Dogra ◽  
Shivendra Kumar Sinha ◽  
Ramesh Kaushik ◽  
Davinder Bhardwaj
Keyword(s):  
Acute Kidney Injury ◽  
Fluid Management ◽  
Kidney Injury ◽  
Young Female ◽  
High Morbidity ◽  
Daily Hemodialysis ◽  
Aggressive Management ◽  
Obstetric Haemorrhage ◽  
Abdominal Hypertension ◽  
Intraperitoneal Bleeding

Pregnancy related acute kidney injury takes substantial share of acute kidney injury (AKI) in India, with obstetrical haemorrhage having high morbidity and mortality. A young female had neglected obstetric haemorrhage (unrecognized intrauterine and massive intraperitoneal bleeding post caesarean, due to uterine trauma and atony) and dangerous intra-abdominal hypertension with exsanguination eventually leading to shock, multifactorial AKI, metabolic acidosis, and hyperkalemia. Intensive and aggressive management with subtotal hysterectomy, inotropes, fluid management, mechanical ventilation, tracheostomy, and hemodialysis changed the outcome. Despite odds against, neglected obstetric haemorrhage with complicated AKI, was managed successfully by emergency hysterectomy, aggressive intervention for AKI with intensive fluid, ventilatory management and daily hemodialysis. Timely identification and aggressive management of this condition and complications is pivotal in preventing complications, morbidity, and maternal mortality. 

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