scholarly journals Acute kidney injury due to rhabdomyolysis after status epilepticus: Two pediatric case reports

2013 ◽  
Vol 4 (4) ◽  
Author(s):  
Ahmet Midhat Elmacı ◽  
Fatih Akın ◽  
Erhan Aksoy
Keyword(s):  
Acute Kidney Injury ◽  
Status Epilepticus ◽  
Case Reports ◽  
Kidney Injury ◽  
Pediatric Case

scholarly journals Granulomatous interstitial nephritis in a patient with SARS-CoV-2 infection

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Katarzyna Szajek ◽  
Marie-Elisabeth Kajdi ◽  
Valerie A. Luyckx ◽  
Thomas Hans Fehr ◽  
Ariana Gaspert ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Interstitial Nephritis ◽  
Kidney Biopsy ◽  
Kidney Diseases ◽  
Case Reports ◽  
Kidney Injury ◽  
Maculopapular Rash ◽  
Tubular Injury ◽  
Granulomatous Interstitial Nephritis ◽  
First Case

Abstract Background Acute kidney injury (AKI) associated with severe coronavirus disease 19 (COVID-19) is common and is a significant predictor of morbidity and mortality, especially when dialysis is required. Case reports and autopsy series have revealed that most patients with COVID-19 – associated acute kidney injury have evidence of acute tubular injury and necrosis - not unexpected in critically ill patients. Others have been found to have collapsing glomerulopathy, thrombotic microangiopathy and diverse underlying kidney diseases. A primary kidney pathology related to COVID-19 has not yet emerged. Thus far direct infection of the kidney, or its impact on clinical disease remains controversial. The management of AKI is currently supportive. Case Presentation The patient presented here was positive for SARS-CoV-2, had severe acute respiratory distress syndrome and multi-organ failure. Within days of admission to the intensive care unit he developed oliguric acute kidney failure requiring dialysis. Acute kidney injury developed in the setting of hemodynamic instability, sepsis and a maculopapular rash. Over the ensuing days the patient also developed transfusion-requiring severe hemolysis which was Coombs negative. Schistocytes were present on the peripheral smear. Given the broad differential diagnoses for acute kidney injury, a kidney biopsy was performed and revealed granulomatous tubulo-interstitial nephritis with some acute tubular injury. Based on the biopsy findings, a decision was taken to adjust medications and initiate corticosteroids for presumed medication-induced interstitial nephritis, hemolysis and maculo-papular rash. The kidney function and hemolysis improved over the subsequent days and the patient was discharged to a rehabilitation facility, no-longer required dialysis. Conclusions Acute kidney injury in patients with severe COVID-19 may have multiple causes. We present the first case of granulomatous interstitial nephritis in a patient with COVID-19. Drug-reactions may be more frequent than currently recognized in COVID-19 and are potentially reversible. The kidney biopsy findings in this case led to a change in therapy, which was associated with subsequent patient improvement. Kidney biopsy may therefore have significant value in pulling together a clinical diagnosis, and may impact outcome if a treatable cause is identified.

scholarly journals Caffeine Overdose Complicated by Acute Kidney Injury despite Mild Creatine Kinase Elevation

2020 ◽  
Vol 3 (1) ◽  
pp. 12-16 ◽  
Author(s):  
Nao Koide ◽  
Nobuhiro Sato ◽  
Daisuke Kondo ◽  
Yasuo Hirose
Keyword(s):  
Emergency Department ◽  
Acute Kidney Injury ◽  
Creatine Kinase ◽  
Suicide Attempt ◽  
Case Reports ◽  
Kidney Injury ◽  
Elevated Creatine Kinase ◽  
Caffeine Overdose

Caffeine is a commonly used stimulant in our society. Prior case reports have described acute caffeine overdose resulting in rhabdomyolysis and acute kidney injury (AKI). We present the case of a 29-year-old man who presented to the emergency department after ingesting 20.1 g of caffeine in a suicide attempt and experienced AKI with only mildly elevated creatine kinase (CK). This case highlights the possibility that AKI can result from a caffeine overdose, even if the patient’s CK is only slightly elevated.

Eculizumab Modifies Outcomes in Adults with Atypical Hemolytic Uremic Syndrome with Acute Kidney Injury

2018 ◽  
Vol 48 (3) ◽  
pp. 225-233 ◽  
Author(s):  
Mercedes Cao ◽  
Bruna N. Leite ◽  
Tamara Ferreiro ◽  
María Calvo ◽  
Constantino Fernández ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Hemolytic Uremic Syndrome ◽  
Kidney Function ◽  
Case Reports ◽  
Atypical Hemolytic Uremic Syndrome ◽  
Kidney Injury ◽  
Complete Recovery ◽  
Genetic Abnormalities ◽  
Uremic Syndrome ◽  
Meta Analyses

Background: Atypical hemolytic uremic syndrome (aHUS) is a rare disease associated with congenital or acquired genetic abnormalities that result in uncontrolled complement activation, leading to thrombotic microangiopathy and kidney failure. Until recently, the only treatment was plasma exchange or plasma infusion (PE/PI), but 60% of patients died or had permanent kidney damage despite treatment. Eculizumab, a complement inhibitor, has shown promising results in aHUS. However, data are mainly extracted from case reports or studies of heterogeneous cohorts, and no direct comparison with PE/PI is available. Methods: An observational retrospective study of adult, dialysis-dependent aHUS patients with acute kidney injury (AKI) who were treated with either PE/PI alone or with second-line eculizumab in our center. We compared the effect of PE/PI and eculizumab on kidney function, hypertension, proteinuria, hematologic values, relapse, and death. Results: Thirty-one patients were included (females, 18; sporadic aHUS, 29; mean age, 46 ± 20 years). Twenty-six patients were treated with PE/PI alone, and 5 were deemed to be plasma-resistant and received eculizumab after stopping PE/PI. Among patients receiving eculizumab, 80% attained complete recovery of kidney function, 100% stopped dialysis, 20% had decreased proteinuria, and no patient relapsed (vs. 38.5, 50, 15.4, and 11.5%, respectively, of patients receiving only PE/PI). At 1-year of follow-up, no deaths had occurred in either group. Conclusion: Eculizumab shows greater efficacy than PE/PI alone for the treatment of adult aHUS patients with AKI. Prospective studies and meta-analyses are warranted to confirm our findings and set guidelines for treatment, monitoring, and maintenance.

Rhabdomyolysis and Hepatotoxicity From Valproic Acid: Case Reports

2019 ◽  
pp. 089719001988288 ◽  
Author(s):  
Cucnhat P. Walker ◽  
Subrata Deb
Keyword(s):  
Valproic Acid ◽  
Acute Kidney Injury ◽  
Case Reports ◽  
Alternative Therapy ◽  
Kidney Injury ◽  
African American Female ◽  
Coagulation Disorders ◽  
Hyperammonemic Encephalopathy ◽  
History Of ◽  
Hispanic Male

Valproic acid (VPA) has been widely used more frequently as its approved indications have been expanded. More and more case reports on rare toxicities have been published in the literature (ie, hepatotoxicities, hyperammonemic encephalopathy, coagulation disorders, pancreatitis, thrombocytopenia). In spite of the long history of VPA, there is a lack of awareness of VPA toxicities among clinicians. We present two cases of a 44-year-old African American female and a 60-year-old Hispanic male taking chronic VPA therapy for psychiatric disorders admitted to the hospital with a combination of hepatotoxicities and acute kidney injury–associated rhabdomyolysis. In both cases, home VPA therapy was continued during hospitalization. Consequently, the female patient deceased and the male patient survived and discharged with continuation of his chronic VPA therapy. In cases of surviving patients, resumption of maintenance VPA upon discharge should be held and alternative therapy should be considered.

A rare cause of acute kidney injury: hypothyroidism / Akut böbrek hasarının nadir bir nedeni: Hipotiroidizm

2016 ◽  
Vol 41 (4) ◽  
Author(s):  
Şimal Köksal Cevher ◽  
Ezgi Çoşkun Yenigün ◽  
Ramazan Öztürk ◽  
Fatih Dede
Keyword(s):  
Acute Kidney Injury ◽  
Case Reports ◽  
Hormone Replacement ◽  
Kidney Injury ◽  
Complete Response ◽  
Routine Clinical Practice ◽  
The Other ◽  
Response To Treatment ◽  
Electrolyte Disturbances ◽  
Clinical Conditions

AbstractKidneys and thyroid are two basic organs that interact with each other, and when one of them becomes ill, functions of the other are affected. Although electrolyte disturbances are the most common symptoms reported due to hypothyroidism, some are case reports in the literature suggested that acute kidney injury developed due to hypothyroidism. Despite this, we doubt that this information comes into mind in routine clinical practice. To report a case of reversible hypothyroidism-induced acute kidney injury, and review those two clinical conditions, which are often overlooked in the nephrology practice, in the light of the literature. We reported a 75-year-old female patient who admitted for acute kidney injury associated with deep hypothyroidism, required hemodialysis, and underwent a renal biopsy since no etiological factors were detected for acute kidney injury. We emphasized that the patient’s creatinine concentrations gradually returned to normal following hormone replacement therapy. Renal dysfunction in presence of hypothyroidism is a known, but frequently overlooked entity. Hypothyroidism should not be overlooked as the cause of reversible kidney injury since it is easy to treat, and there is almost complete response to treatment in terms of renal failure.

scholarly journals Methemoglobinemia-Induced Acute Kidney Injury

2013 ◽  
Vol 6 (1) ◽  
pp. 36-41 ◽  
Author(s):  
Amir H. Qureshi ◽  
Daniel J. Soberon ◽  
Arif Asif ◽  
Tushar Vachharajani ◽  
Ali Nayer
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Renal Biopsy ◽  
Case Reports ◽  
Kidney Injury ◽  
Human Case ◽  
Morphological Features ◽  
Chronic Obstructive ◽  
Tubular Damage ◽  
Obstructive Pulmonary Disease

IntroductionMethemoglobinemia refers to the presence of increased levels of methemoglobin (Fe3+) in the blood. Methemoglobinemia can cause cyanosis, dyspnea, fatigue, seizure, arrhythmia, coma, and even death. Although methemoglobinemia is shown to cause acute kidney injury in experimental settings, human case reports are exceedingly rare. In addition, morphological features of methemoglobinemia-induced renal disease in humans remain undefined.Case PresentationA 76-year-old man with a history of chronic obstructive pulmonary disease underwent bronchoscopy following local anesthesia with a benzocaine spray. The patient developed benzocaine-induced methemoglobinemia and acute renal failure. Urinalysis disclosed numerous dysmorphic erythrocytes, erythrocyte casts, and granular casts. Urine protein excretion was approximately 1.1 g/day. Serologic tests were negative. Renal biopsy demonstrated minor glomerular abnormalities, severe acute tubular necrosis, and numerous erythrocyte casts in the tubules. Despite supportive care, renal function deteriorated necessitating hemodialysis. Four months later, the patient remained on hemodialysis. To exclude a superimposed pathology, renal biopsy was repeated and showed numerous erythrocyte casts in the tubules and severe tubular damage.ConclusionMethemoglobinemia can cause acute kidney injury in humans. Morphological features resemble those observed in methemoglobin-induced acute kidney injury in experimental settings. This case calls for a heightened awareness of potential adverse effects of methemoglobinemia on renal function.

scholarly journals Overflow diarrhea and acute kidney injury as a presentation of fecal impaction that led to obstructive uropathy

2021 ◽  
Vol 11 (3) ◽  
pp. 71-74
Author(s):  
Dhara Dave
Keyword(s):  
Acute Kidney Injury ◽  
Case Report ◽  
Elderly Population ◽  
Early Recognition ◽  
Case Reports ◽  
Obstructive Uropathy ◽  
Kidney Injury ◽  
The Elderly ◽  
Fecal Impaction ◽  
Elderly Male

Fecal impaction is a known complication of chronic constipation and is particularly bothersome in the elderly population. Common complications of fecal impaction include hemorrhoids, megacolon, overflow diarrhea, and obstructive uropathy among others. Many case reports have been reported with fecal impaction and obstructive uropathy though none have reported overflow diarrhea as a presentation. In this case report, we present an elderly male who came in with overflow diarrhea and acute kidney injury that resulted from fecal impaction that caused obstructive uropathy. He was managed with catharsis and early recognition of the condition led to a good outcome. Recognition and management of fecal impaction can be challenging especially in patients who present with diarrhea. We, therefore, outline and discuss the importance of recognition of overflow diarrhea as a complication of fecal impaction and the management of such patients.

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