scholarly journals MATERNAL OUTCOMES OF PREGNANCY-RELATED ACUTE KIDNEY INJURY

2021 ◽  
Vol 71 (6) ◽  
pp. 2057-60
Author(s):  
Irfan Khattak ◽  
Samina Naseem Khattak ◽  
Ayesha Imran ◽  
Khawar Kamal ◽  
Umairah Yaqoob
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Previous History ◽  
Kidney Injury ◽  
Cross Sectional Study ◽  
Military Hospital ◽  
Maternal Outcomes ◽  
Recent Past ◽  
Cross Sectional ◽  
History Of

Objective: To determine the frequency of Pregnancy-related acute kidney injury in the Pakistani population and its effect on maternal health. Study Design: Cross-sectional study. Place and Duration of the Study: Department of Nephrology and Obstetrics and Gynecology, Combined Military Hospital Kharian, from Jan 2018 to Dec 2020. Methodology: All pregnant women with normal renal functions at the time of enrolment in the study and no previous history of any kidney disease or renal procedure in the recent past (at least 3 months) before conception were included in our study at Combined Military Hospital Kharian. All participants had serum creatinine tested at enrolment and were inquired specifically about any history of renal disease or any renal procedure in the recent past (at least 3 months old). Results: Mean maternal age in the study was 29 ± 7.67 years however it ranged from 16-41 years. Around a quarter of acute kidney injury cases occurred in the first and second trimesters combined, with 26 (12%) and 24 (11%) cases in the first and second trimesters, respectively. Thirty percent of acute kidney injury cases were diagnosed in the third trimester. A substantial number 58 (27%) of cases developed azotemia which persisted beyond three months and developed chronic kidney disease of various stages. Regarding maternal outcomes, 166 (77%) mothers recovered completely. However, 43 (20%) patients had some degree pf azotemia, a few cases required permanent renal replacement therapy. Conclusion: Acute kidney injury is a common problem in our community leading to suboptimal maternal outcomes..............

scholarly journals MO406ACUTE KIDNEY INJURY AND RENAL REPLACEMENT THERAPY IN HOSPITALIZED PATIENTS: A CROSS SECTIONAL STUDY FROM IRAN

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Zohreh Rostami ◽  
Sepehr Shafei ◽  
Eghlim Nemati ◽  
Behzad Einollahi ◽  
Afsaneh Rostami
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Previous History ◽  
Kidney Injury ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Icu Admission ◽  
History Of

Abstract Background and Aims Acute kidney injury is an important finding in COVID-19 patients that can even result in renal replacement therapy. AKI complicates COVID-19 management by making volume management and administering agents with renal clearance challenging tasks. Various reasons have been proposed for the development of acute kidney injury in COVID-19 patients, including multi-organ failure and pre-renal causes, drug toxicity, tubular injury, and invasion of proximal tube podocytes by SARS-CoV-2. Although the development of AKI is not uncommon in COVID-19 patients, several inconsistencies in the literature exist regarding incidence rate and risk factors of acute kidney injury among hospitalized patients. This can be attributed to ethnical variations and methodological differences of studies. Herein we report AKI incidence in hospitalized COVID-19 patients in Baqiyatallah Hospital in Iran and investigate associate factors that can lead to AKI and renal replacement therapy in COVID-19 patients. Method In this cross-sectional study, we investigated medical records and laboratory data of hospitalized COVID-19 patients in Baqiyatallah Hospital in Tehran, Iran, from September 2020 until the end of November. COVID-19 infection was confirmed using polymerase chain reaction (PCR), and only patients with Positive PCR for COVID-19 were included. Furthermore, patients with missing data and unknown past medical history were excluded from this study, and a total of 459 patients were selected. The KDIGO criteria for acute kidney injury were used for evaluating kidney injury in COVID-19 patients. ICU admission and dialysis were according to the Ministry of Health and Medical Education on ICU admission and renal replacement therapy in COVID-19 patients. Results Of 459 patients with the criteria who were admitted to the hospital (244 male, 213 female, with an average age of 59.57 with SD 14.3), 75 patients (16%) developed acute kidney injury in the course of the disease. The mortality rate in patients with AKI (44%) was significantly higher than other patients (9%). The development of the AKI was significantly associated with the risk of ICU admission and the severe forms of the disease. Furthermore, it was observed that the patients who developed AKI was significantly older and male gender, diabetes (DM), Hypertension (HTN), and Previous history of Chronic kidney disease(CKD) was also significantly associated with developing AKI in COVID-19 patients. Chronic heart failure and ischemic heart disease increased the odds of developing AKI, but it was not significant enough to come up with a conclusion. It was observed that from 75 patients who developed AKI, 22 patients (29%) required renal replacement therapy. Of 22 patients who need dialysis, 14 patients did not survive (mortality rate=63%). The previous history of kidney disease increases the risk of dialysis due to AKI, while no significant association was found between age, gender, DM, HTN, and heart disease with the need for dialysis. Conclusion Results of our study indicate that acute kidney injury can be a major obstacle in managing COVID-19 patients. Patients with older age, previous history of CKD, HTN, and DM should be admitted to the hospital and monitored closely to prevent unfortunate outcomes of this disease.

scholarly journals P0614URINARY EXOSOMAL MICRORNA-21 AS A MARKER OF SCRUB TYPHUS-ASSOCIATED ACUTE KIDNEY INJURY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
In O Sun ◽  
Kwang Young Lee ◽  
A Young Cho
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Scrub Typhus ◽  
Area Under The Curve ◽  
Kidney Injury ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Total Leukocyte Count ◽  
Cross Sectional ◽  
Exosomal Mirna

Abstract Background and Aims Urinary microRNA (miRNA)-21 is reported to be a biomarker for detection of acute kidney injury (AKI). Analysis of urinary exsome may serve as a novel diagnostic approach in kidney disease. The aim of this study is to investigate the clinical significance of urinary exosomal miRNA-21 for AKI in patients with scrub typhus. Method In a cross-sectional study, we collected 138 urine samples at the time of admission from 145 patients with scrub typhus. For 25 patients with scrub typhus-associated AKI and 25 age, sex-matched scrub typhus patient without AKI, we measured miRNA-21 in urinary exosomal fraction and compared diagnostic value in predictiong AKI. Results Compared with patients in the non-AKI group, patients in the AKI group were more likely to have one or more comorbidity such as diabetes (50% vs. 5%, P<0.01) and chronic kidney disease (8% vs. 0%, P<0.01). Total leukocyte count were higher in patients with AKI than in those without AKI (10.40 × 103/ mL vs. 6.40 × 103/mL, P<0.01). The levels of urinary miRNA-21 were higher in the AKI group than in the non-AKI group. Urinary exosomal miRNA-21 levels correlated directly with serum neutrophil gelatinase-associated lipocalin values and total leukocyte counts and inversely with estimated glomerular filtration rate. The receiver operator characteristics curve analysis for urinary exosomal miRNA-21 showed good discriminative power for the diagnosis of scrub typhus-associated AKI, with area under the curve value of 0.907. Conclusion Urinary exosomal miRNA-21 could be a surrogate markers for the diagnosis of scrub typhus–associated AKI.

Malaria among migrants in a university hospital in Colombia during 2018: A case series

2020 ◽  
pp. 004947552098130
Author(s):  
Fabián R Carreño-Almánzar ◽  
Adán Coronado-Galán ◽  
Sonia A Cala-Gómez ◽  
Agustín Vega-Vera
Keyword(s):  
Latin American ◽  
Previous History ◽  
Case Series ◽  
Cross Sectional Study ◽  
Imported Malaria ◽  
University Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
History Of ◽  
Clinical Profiles

Imported malaria has increased in Colombia since 2015 and has been attributed to migrants coming from Venezuela. We present a series of malaria cases, nested in a retrospective cross-sectional study between 2017 and 2018, aimed at calculating the prevalence of medical diseases among immigrants in a University Hospital in Colombia. Among 154 immigrants admitted for medical causes between 2017 and 2018, 8 were diagnosed with malaria, all due to Plasmodium vivax. Of these, seven had uncomplicated malaria, five had a previous history of malaria, one was critically ill, but none died. We highlight that, similar to other case series of imported malaria, Latin American migrants were young, with similar clinical profiles, having a low proportion of severe cases, and P. vivax was the most frequent cause.

MO376CLINICAL OUTCOMES OF ACUTE KIDNEY INJURY FOLLOWING SNAKE BITE INJURIES

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Weerakit Naweera ◽  
Thapat Wannarong
Keyword(s):  
Acute Kidney Injury ◽  
Logistic Regression ◽  
Kidney Injury ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Renal Recovery ◽  
Binary Logistic Regression Analysis ◽  
Cross Sectional ◽  
Hospital Arrival ◽  
Russell’S Viper

Abstract Background and Aims Snakebite is a common animal bite injury in tropical countries. Acute kidney injury (AKI) is an important complication in snakebite patients. This study aimed to comprehensively investigate the clinical profiles and outcomes of patients following hematotoxin-related snakebite associated with kidney impairment. Method We conducted a hospital-based, cross-sectional study of 238 patients with hematotoxin-related snakebite injuries. Data were retrieved from the King Narai Hospital Registry from October 2014 to August 2020. The prevalence of complications associated with snakebite injuries, including acute kidney injury (AKI) and its severity, was determined. Univariate and Multivariate predictors of AKI diagnosis were evaluated using binary logistic regression analysis Results A total of 238 patients, with 63.4% men, median (IQR) age 49.8 (39-61) years and median duration from injury to a hospital arrival of 1 hour (0.5-2) hours, were injured by Green pit viper (85.7%), Russell’s viper (12.6%) and Malayan pit viper (1.7%). AKI mostly occurred in Russell’s viper group 66.7%. An AKI was reported in thirty (12.6%, 95% CI: 8.7 % - 17.5%) patients, with the severity of 66.7% stage one, 6.7% stage two, 26.6% stage three by KDIGO classifications, and 13.3% requiring hemodialysis. Complete renal recovery was seen in twenty-two patients (73.3%), while partial renal recovery was 23.3%. Other complications included 84.4 % limb cellulitis, 4.6% significantly bleeding, 2.5% hypotension, 25.6% prolonged venous clotting time (VCT), 46.7% prolonged prothrombin time (PT), and 14.3% prolonged partial thromboplastin time (PTT). Of total patients, 60.1% were treated with anti-venom. Mortality was relatively low (0.4%). In multivariable logistic regression analyses, AKI was significantly associated with time to hospital arrival more than 3 hours (p = 0.04), Russell’s viper bitten (p = 0.01), clinical bleeding (p = 0.01), and prolonged PT (p < 0.01). Conclusion The prevalence of AKI in patients bitten by hematotoxin snakes was 12.6%, mostly from Russell’s viper. Factors associated with AKI outcomes were time to hospital arrival more than 3 hours, Russell’s viper bitten, clinical bleeding, and prolonged PT. Besides, one-fourth of AKI patients turned to chronic kidney disease.

scholarly journals Prevalence of Acute Kidney Injury in Patients with Liver Cirrhosis

2020 ◽  
Vol 58 (228) ◽  
Author(s):  
Pukar Thapa ◽  
Sudhamshu KC ◽  
Achyut Bikram Hamal ◽  
Dilip Sharma ◽  
Sandip Khadka ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Liver Cirrhosis ◽  
Hospital Stay ◽  
Hepatorenal Syndrome ◽  
Kidney Injury ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Tubular Necrosis ◽  
Advanced Liver Cirrhosis ◽  
Life Threatening

Introduction: Acute kidney injury is a common and life-threatening event in patients with liver cirrhosis occurring in approximately 20-50% of hospitalized patients of liver cirrhosis. Pre-renal acute kidney injury, the hepatorenal syndrome type of acute kidney injury and acute tubular necrosis represent the common causes. The aim of this study was to study the profile of acute kidney injury in patients with liver cirrhosis. Methods: Consecutive patients of liver cirrhosis admitted in Liver unit of Bir Hospital were studied to see the presence of acute kidney injury in this hospital based descriptive cross-sectional study. Clinical and laboratory parameters along with various clinical outcome were compared between different groups categorized by the severity of liver disease and renal dysfunction. Results: Out of 302 liver cirrhosis patients, 56 (18.5%) had acute kidney injury among which 23 (46%) were found to have pre-renal acute kidney injury, 15 (30%) with hepatorenal syndrome– acute kidney injury and 12 (24%) with intrinsic renal disease. Patients with higher stages of acute kidney injury had longer duration of hospital stay and hepatorenal syndrome-acute kidney injury was seen in patients with higher grade of ascites and with hyponatremia. Conclusions: Acute kidney injury is a common occurrence in patients with advanced liver cirrhosis with pre-renal acute kidney injury being the commonest cause. Median hospital stay is directly affected by the severity of acute kidney injury and hepatorenal syndrome–acute kidney injury was seen in patients with higher grade of ascites and hyponatremia. Early identification of patients at high risk for acute kidney injury may help to reduce mortality and contain costs.  

scholarly journals Profile of Herpes Zoster Patients with Co-morbidities: Cross-sectional Observation at a Tertiary Level Hospital in Dhaka

2021 ◽  
Vol 16 (2) ◽  
pp. 40-43
Author(s):  
Md Shirajul Islam Khan ◽  
Hossain Md Emran ◽  
ATM Rezaul Karim
Keyword(s):  
Herpes Zoster ◽  
Secondary Infection ◽  
Study Finding ◽  
Cross Sectional Study ◽  
Military Hospital ◽  
Morbid Condition ◽  
Cross Sectional ◽  
Ulcer Disease ◽  
History Of ◽  
Irritable Bowel

Introduction: Herpes zoster (HZ) is characterized by an extremely painful vesicular rash, which may be complicated by secondary infection and post-herpetic neuralgia. To date, multiple risk factors associated with HZ have been established, including endocrine diseases, immunosuppressive conditions, cancers, and other chronic medical conditions. Objectives: To assess the profile of herpes zoster associated with co-morbid condition. Methods and Materials: This cross sectional study was conducted among purposively selected 130 HZ patients in the department of Dermatology and Venereology, Combined Military Hospital (CMH) Dhaka from January 2017 to December 2018. Data were collected through face to face interview using pretested semi-structured questionnaire. Results: Out of 130 patients, majority of the patients were male (69.2%) and mean age was 53.5±9.8 years and majority gave the history of chicken pox 60% and common site of involvement were chest (right and left) 33.1% and 48.5%, upper back (right and left) 30.8% and 43.1% and upper right arm 33.1%. About 66.9% patients gave the history of having co-morbid condition like Diabetes 30.8%, Stroke 9.2%, Hypertension 2.3%, Myocardial infarction 3.8%, Peptic ulcer disease 10.0%, Malignancy 2.3%, Tuberculosis 2.3% and Irritable bowel syndrome 2.3%. Conclusion: Based on our study finding, we can conclude that herpes zoster is a disease that is associated with other co-morbid conditions. If herpes zoster is an early manifestation of undiagnosed co-morbid condition, patients should undergo testing for undiagnosed disease when they present with herpes zoster. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 40-43

scholarly journals Preventing acute kidney injury in high-risk patients by temporarily discontinuing medication – an observational study in general practice

2019 ◽  
Author(s):  
Suzanne J Faber ◽  
Nynke Scherpbier ◽  
Hans Peters ◽  
Annemarie Uijen
Keyword(s):  
Heart Failure ◽  
Acute Kidney Injury ◽  
High Risk ◽  
Kidney Injury ◽  
Cross Sectional Study ◽  
Fluid Loss ◽  
Cross Sectional ◽  
High Risk Patients ◽  
Risk Patients ◽  
Raas Inhibitors

Abstract Background Elderly, patients with chronic kidney disease (CKD) and patients with heart failure who continue using renin-angiotensin-aldosterone-system (RAAS) inhibitors, diuretics, or non-steroidal-anti-inflammatory drugs (NSAIDs) during times of fluid loss have a high risk of developing complications like acute kidney injury (AKI). The aim of this study was to assess how often advice to discontinue high-risk medication was offered to high-risk patients consulting the general practitioner (GP) with increased fluid loss. Furthermore, we assessed the number and nature of the complications that occurred after GP consultation. Methods We performed a cross-sectional study with patients from seven Dutch general practices participating in the Family Medicine Network between 1-6-2013 and 1-7-2018. We included patients who used RAAS-inhibitors, diuretics, or NSAIDs, and had at least one of the following risk factors: age ≥70 years, CKD, or heart failure. From this population, we selected patients with a ‘dehydration-risk’ episode (vomiting, diarrhoea, fever, chills, or gastrointestinal infection). We manually checked their electronic patient files and assessed the percentage of episodes in which advice to discontinue the high-risk medication was offered and whether a complication occurred in three months after the ‘dehydration-risk’ episode. Results We included 3607 high-risk patients from a total of 44.675 patients (8.1%). We found that patients were advised to discontinue the high-risk medication in 38 (4.6%) of 816 ‘dehydration-risk’ episodes. In 59 of 816 episodes (7.1%) complications (mainly AKI) occurred. Conclusions Dutch GPs do not frequently advise high-risk patients to discontinue high-risk medication during ‘dehydration-risk’ episodes. Complications occur frequently. Timely discontinuation of high-risk medication needs attention.

scholarly journals Increased Interleukin-6 as Infl ammatory Response and Magnesium Defi ciency in Pre-dialysis Chronic Kidney Disease of Indonesian Children

2021 ◽  
Vol 9 (2) ◽  
pp. 93
Author(s):  
Astrid Kristina Kardani ◽  
Ninik Asmaningsih Soemyarso ◽  
Jusli Aras Aras ◽  
Risky Vitria Prasetyo ◽  
Mohammad Sjaifullah Noer
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Interleukin 6 ◽  
Inverse Correlation ◽  
Cross Sectional Study ◽  
The Body ◽  
Cross Sectional ◽  
Duration Of Illness ◽  
History Of ◽  
Spearman’S Correlation

Chronic kidney disease (CKD) is a serious health problem in children, with increasing morbidity and mortality rates throughout the world. Children with CKD tend to experience magnesium (Mg) defi ciency that can stimulate an infl ammatory response in the body. One of the infl ammatory responses is an increase of Interleukin-6 (IL-6).  Study to analyze the correlation between Mg and IL-6 in pre-dialysis CKD children. The methods a cross sectional study was conducted in Dr Soetomo General Academic Hospital from November 2018 to April 2019. Children with pre-dialyis CKD were included in this study. Variables of serum Mg level (mg/dL) and infl ammatory marker (IL-6) were measured from the blood and analyzed by ELISA method. The correlation between Mg and IL-6 was analyzed with Spearman’s correlation test with p <0.05.  Result a total of 47 children (27 boys vs 20 girls) between 3 months to 18 years old, with pre-dialysis CKD and no history of magnesium supplementation were included. The primary disease that causes of CKD were lupus nephritis (38.3%), nephrotic syndrome (23.4%), urologic disorder (23.4%),  tubulopathy (10.6%) and others (4.3%). The average IL-6 level was 55.42±43.04 pg/dL and Mg level was 2.06±1.54 mg/dL. There were no signifi cant correlation between IL-6 level and Mg level with staging of CKD and duration of illness (p>0.05), but there was a signifi cant correlation between serum Mg level and IL-6 level (r=-0.748; p<0.001). Magnesium levels have a signifi cant inverse correlation with IL-6 levels in pre-dialysis CKD children. The lower the Mg levels in the blood, the higher IL-6 levels and vice versa. 

scholarly journals FREQUENCY OF ACUTE KIDNEY INJURY AMONG PATIENTS UNDERGOING CORONARY ANGIOGRAPHY

2021 ◽  
Vol 70 (Suppl-4) ◽  
pp. S828-32
Author(s):  
Sajid Khan ◽  
Abdul Hameed Siddiqui ◽  
Ariz Samin ◽  
Syed Hassan Mustafa ◽  
Akhtar Gul ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Coronary Angiography ◽  
Serum Creatinine ◽  
Study Design ◽  
Kidney Injury ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Baseline Serum ◽  
Control And Prevention

Objective: To determine the frequency of acute kidney injury among patients undergoing coronary angiography. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Department of Cardiology, Hayatabad Medical Complex, Peshawar, from Jan 2018 to Jul 2018. Methodology: This study was conducted in the in the Department of Cardiology, Hayatabad Medical Complex, Peshawar from 22nd Jan 2018 to 22nd Jul 2018. Through a descriptive cross-sectional study design, a total of 116 patients scheduled for coronary angiography were included in the study in a consecutive manner and baseline / follow up serum creatinine was recorded to detect acute kidney injury. Results: In this study 116 patients were included, 61.2% males and 38.8% females. Mean age of the patients was 55.6 years with a standard deviation of 6.6 years. Mean baseline serum creatinine level was 0.9 ± 0.11mg/dl which was 1.5 ± 0.11 48 hours after coronary angiography (p 0.000). AKI was recorded in 19.8% of patients. Conclusion: Acute kidney injury after coronary angiography is not uncommon in our population. More studies are recommended on its risk factors and complications to draw future directions for its control and prevention.

Sign in / Sign up

Export Citation Format

Share Document