scholarly journals Bilateral Central Serous Retinopathy in Patient with Chronic Kidney Disease on Haemodialysis: A Case Report

2021 ◽  
Author(s):  
Heena Dharamdasani ◽  
Shankar Chokkalingam ◽  
Siddharam Janti ◽  
Stephen Sudhakar
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Rare Case ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Central Serous Retinopathy ◽  
Unusual Association ◽  
Corrected Visual Acuity ◽  
Neurosensory Retina ◽  
History Of

Central Serous Chorioretinopathy (CSCR) is the detachment of the neurosensory retina and/or Retinal Pigment Epithelium (RPE) due to accumulation of fluid in the sub retinal space, mostly confined to the macula. Hereby, presenting a rare case of a 32-year-old patient with defective vision in both eyes, she was a known case of Chronic Kidney Disease (CKD) on haemodialysis. On examination best corrected visual acuity was 6/9, on dilated fundus examination with ring reflex in both eyes, Optical Coherence Tomography (OCT) macula showed detachment of the neurosensory retina from RPE with the sub retinal fluid. This case is considered to be rare due to the unusual association noted between CSCR and End State Renal Disease (ESRD), in a female patient with no history of usage of corticosteroids or known identifiable risk factors. Hence, it is essential to screen patients with ESRD for CSCR to prevent vision threatening complications.

A rare case of primary hyperaldosteronism associated with chronic kidney disease-difficulties in diagnosis and treatment

2019 ◽  
Author(s):  
Letiţia Leuştean ◽  
Ginuţa Marcela Bălineanu ◽  
Cosmina Rimbu ◽  
Anamaria Hrişcă ◽  
Voroneanu Elena Luminiţa ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Rare Case ◽  
Primary Hyperaldosteronism ◽  
Diagnosis And Treatment

scholarly journals An observational claims data analysis on the risk of maternal chronic kidney disease after preterm delivery and preeclampsia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maren Goetz ◽  
Mitho Müller ◽  
Raphael Gutsfeld ◽  
Tjeerd Dijkstra ◽  
Kathrin Hassdenteufel ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Preterm Birth ◽  
Kidney Disease ◽  
Preterm Delivery ◽  
Claims Data ◽  
Maternal Risk ◽  
Live Births ◽  
Increased Risk ◽  
History Of

AbstractWomen with complications of pregnancy such as preeclampsia and preterm birth are at risk for adverse long-term outcomes, including an increased future risk of chronic kidney disease (CKD) and end-stage kidney disease (ESKD). This observational cohort study aimed to examine the risk of CKD after preterm delivery and preeclampsia in a large obstetric cohort in Germany, taking into account preexisting comorbidities, potential confounders, and the severity of CKD. Statutory claims data of the AOK Baden-Wuerttemberg were used to identify women with singleton live births between 2010 and 2017. Women with preexisting conditions including CKD, ESKD, and kidney replacement therapy (KRT) were excluded. Preterm delivery (< 37 gestational weeks) was the main exposure of interest; preeclampsia was investigated as secondary exposure. The main outcome was a newly recorded diagnosis of CKD in the claims database. Data were analyzed using Cox proportional hazard regression models. The time-dependent occurrence of CKD was analyzed for four strata, i.e., births with (i) neither an exposure of preterm delivery nor an exposure of preeclampsia, (ii) no exposure of preterm delivery but exposure of at least one preeclampsia, (iii) an exposure of at least one preterm delivery but no exposure of preeclampsia, or (iv) joint exposure of preterm delivery and preeclampsia. Risk stratification also included different CKD stages. Adjustments were made for confounding factors, such as maternal age, diabetes, obesity, and dyslipidemia. The cohort consisted of 193,152 women with 257,481 singleton live births. Mean observation time was 5.44 years. In total, there were 16,948 preterm deliveries (6.58%) and 14,448 births with at least one prior diagnosis of preeclampsia (5.61%). With a mean age of 30.51 years, 1,821 women developed any form of CKD. Compared to women with no risk exposure, women with a history of at least one preterm delivery (HR = 1.789) and women with a history of at least one preeclampsia (HR = 1.784) had an increased risk for any subsequent CKD. The highest risk for CKD was found for women with a joint exposure of preterm delivery and preeclampsia (HR = 5.227). These effects were the same in magnitude only for the outcome of mild to moderate CKD, but strongly increased for the outcome of severe CKD (HR = 11.90). Preterm delivery and preeclampsia were identified as independent risk factors for all CKD stages. A joint exposure or preterm birth and preeclampsia was associated with an excessive maternal risk burden for CKD in the first decade after pregnancy. Since consequent follow-up policies have not been defined yet, these results will help guide long-term surveillance for early detection and prevention of kidney disease, especially for women affected by both conditions.

scholarly journals The Accuracy of Emergency Physicians’ Suspicions of Active Pulmonary Tuberculosis

2021 ◽  
Vol 10 (4) ◽  
pp. 860
Author(s):  
Shiang-Jin Chen ◽  
Chun-Yu Lin ◽  
Tzu-Ling Huang ◽  
Ying-Chi Hsu ◽  
Kuan-Ting Liu
Keyword(s):  
Chronic Kidney Disease ◽  
Weight Loss ◽  
Kidney Disease ◽  
Pulmonary Tuberculosis ◽  
General Ward ◽  
Chest Radiographs ◽  
Emergency Physicians ◽  
Active Pulmonary Tuberculosis ◽  
Factors Associated ◽  
History Of

Objective: To investigate factors associated with recognition and delayed isolation of pulmonary tuberculosis (PTB). Background: Precise identification of PTB in the emergency department (ED) remains challenging. Methods: Retrospectively reviewed PTB suspects admitted via the ED were divided into three groups based on the acid-fast bacilli culture report and whether they were isolated initially in the ED or general ward. Factors related to recognition and delayed isolation were statistically compared. Results: Only 24.94% (100/401) of PTB suspects were truly active PTB and 33.77% (51/151) of active PTB were unrecognized in the ED. Weight loss (p = 0.022), absence of dyspnea (p = 0.021), and left upper lobe field (p = 0.024) lesions on chest radiographs were related to truly active PTB. Malignancy (p = 0.015), chronic kidney disease (p = 0.047), absence of a history of PTB (p = 0.013), and lack of right upper lung (p ≤ 0.001) and left upper lung (p = 0.020) lesions were associated with PTB being missed in the ED. Conclusions: Weight loss, absence of dyspnea, and left upper lobe field lesions on chest radiographs were related to truly active PTB. Malignancy, chronic kidney disease, absence of a history of PTB, and absence of right and/or left upper lung lesions on chest radiography were associated with isolation delay.

scholarly journals History of kidney stones and risk of chronic kidney disease: a meta-analysis

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e2907 ◽  
Author(s):  
Weifeng Shang ◽  
Lixi Li ◽  
Yali Ren ◽  
Qiangqiang Ge ◽  
Ming Ku ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Stones ◽  
Meta Analysis ◽  
Positive Association ◽  
Significant Heterogeneity ◽  
Adjusted Risk ◽  
Increased Risk ◽  
Subgroup Analyses ◽  
History Of

Background Although the relationship between a history of kidney stones and chronic kidney disease (CKD) has been explored in many studies, it is still far from being well understood. Thus, we conducted a meta-analysis of studies comparing rates of CKD in patients with a history of kidney stones. Methods PubMed, EMBASE, and the reference lists of relevant articles were searched to identify observational studies related to the topic. A random-effects model was used to combine the study-specific risk estimates. We explored the potential heterogeneity by subgroup analyses and meta-regression analyses. Results Seven studies were included in this meta-analysis. Pooled results suggested that a history of kidney stones was associated with an increased adjusted risk estimate for CKD [risk ratio (RR), 1.47 95% confidence interval (CI) [1.23–1.76])], with significant heterogeneity among these studies (I2 = 93.6%, P < 0.001). The observed positive association was observed in most of the subgroup analyses, whereas the association was not significant among studies from Asian countries, the mean age ≥50 years and male patients. Conclusion A history of kidney stones is associated with increased risk of CKD. Future investigations are encouraged to reveal the underlying mechanisms in the connection between kidney stones and CKD, which may point the way to more effective preventive and therapeutic measures.

scholarly journals Quinine-Induced Thrombotic Microangiopathy (Q-TMA): Frequency, Presenting Features, Outcomes

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 1381-1381 ◽  
Author(s):  
Evaren E Page ◽  
Sara K. Vesely ◽  
James N. George
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Conflicts Of Interest ◽  
Elevated Serum ◽  
Kidney Injury ◽  
Long Term Outcome ◽  
Presenting Symptoms ◽  
Immune Mediated ◽  
Organ Systems ◽  
History Of

Abstract Q-TMA is an acute, severe, immune-mediated, drug-induced disorder. Q-TMA is suspected when symptoms suddenly begin within hours following quinine (Q) exposure. Diagnosis of Q-TMA is established by the history of recurrent acute symptoms following recurrent Q exposures and/or by documentation of Q-dependent antibodies reactive with platelets and/or neutrophils. The Oklahoma TTP-HUS Registry enrolls all patients for whom plasma exchange (PEX) is requested for suspected TTP or HUS. Since 1995, when routine measurement of ADAMTS13 activity began, the Registry has diagnosed 78 patients with acquired TTP (ADAMTS13 <10%). During this time we have also diagnosed 17 patients with Q-TMA; 2 additional patients were diagnosed before 1995. Seventeen of these 19 patients were tested for Q-dependent antibodies; all were positive. Nine patients had a history of recurrent acute symptoms with recurrent Q exposure, including the 2 patients not tested for Q-dependent antibodies. Q exposure was a pill in 18 patients, tonic water in one. Remarkably, 18 patients were women; all 19 patients were white. Common presenting symptoms were fever, chills, nausea and vomiting. No patients had focal neurologic abnormalities. All patients had microangiopathic hemolytic anemia (MAHA), thrombocytopenia, and acute kidney injury. Eight patients had elevated serum alanine aminotransferase (231-1345 U/L). Three patients had neutropenia (absolute neutrophil counts, 184-486). Two patients had coagulation abnormalities suggesting disseminated coagulation (DIC). One patient died from complications of the central venous catheter insertion, performed for PEX and dialysis; all other patients recovered normal platelet counts. Three of the 18 surviving patients had end-stage renal disease (2 had kidney transplants). The median estimated glomerular filtration rate (GFR) for the other 15 patients, at 2.7-19.2 years (median, 10.2) after recovery, was 36 ml/min (range, 19-98). Only two patients had normal GFR (≥90 ml/min). Eleven patients had chronic kidney disease, defined by GFR <60 ml/min. Seven of 18 patients have died 4.1-12.7 years (median, 7.8) following recovery at ages 59-87 years. Conclusion. Quinine can cause severe immune-mediated toxicities involving multiple organ systems (Am J Hematol 2016; 91: 461). Q-TMA is an acute disorder causing severe kidney injury and, in some patients, also liver toxicity, neutropenia, and/or DIC. Q-TMA is not rare. During 20 years, we enrolled 17 Q-TMA patients compared to 78 patients with acquired TTP. Chronic kidney disease is a common long-term outcome. Explicit questions are required to discover the association of systemic symptoms with quinine ingestion. Table Table. Disclosures No relevant conflicts of interest to declare.

scholarly journals A Rare Case of Simultaneous Fracture Neck of Femur on One Side and Contralateral Intertrochanteric Fracture Femur in a 41-Year-Old Female – A Case Report

2021 ◽  
Vol 11 (7) ◽  
Author(s):  
M K Rajak ◽  
S Kumar ◽  
R Thakur ◽  
I Bhaduri
Keyword(s):  
Chronic Kidney Disease ◽  
Case Report ◽  
Kidney Disease ◽  
Rare Case ◽  
Intertrochanteric Fracture ◽  
Neck Of Femur ◽  
Standing Height ◽  
Fracture Femur ◽  
Fracture Neck Of Femur ◽  
The One

Introduction: Simultaneous fractures in the neck of femur on the one side and contralateral intertrochanteric fracture of the femur with only trivial injury are among rarest injuries. Fracture neck of femur or intertrochanteric fracture either isolated or in combination such as simultaneous bilateral fracture neck of femur and simultaneous bilateral intertrochanteric fractures are relatively commonly reported in literature. Herein, we report a very rare case of a young female with chronic kidney disease who presented with simultaneous fractures neck of femur on the one side and contralateral intertrochanteric fracture of femur after a fall from standing height. Case Report: A 41-year-old female with chronic kidney disease from the past 5 years presented to us with severe pain at both hip and inability to stand after a fall from standing height. Clinical examination and investigations were done. She suffered fracture neck of femur on the right side and intertrochanteric fracture femur on the left side. Single stage fixation of both these fractures by two different methods was done successfully after optimization of her medical condition with multidisciplinary approach. She was advised weight bearing according to fixation method used and progress of fracture union. She regained her preoperative walking status gradually in 6 months. Conclusion: Simultaneous fractures in the neck of femur on the one side and intertrochanteric fracture of the femur on the other side are very rare presentation and can happen in patients with primary or secondary bone disease. Multidisciplinary team effort is needed for overall effective management and prompt surgical treatment can help achieve favorable outcome. Keywords: Simultaneous, fracture neck of femur, intertrochanteric fracture femur.

scholarly journals Focal Choroidal Excavation in a Case of Choroidal Osteoma Associated with Choroidal Neovascularization

2020 ◽  
Author(s):  
Mahdieh Azimizadeh ◽  
Seyedeh Maryam Hosseini ◽  
Esmaeil Babaei
Keyword(s):  
Choroidal Neovascularization ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Subretinal Fluid ◽  
Retinal Hemorrhage ◽  
Retinal Layers ◽  
Choroidal Osteoma ◽  
Focal Choroidal Excavation ◽  
Neurosensory Retina ◽  
The Right

Purpose: To report a case of choroidal osteoma associated with reactivation of choroidal neovascularization (CNV) and development of focal choroidal excavation (FCE). Case Report: A 34-year-old woman with choroidal osteoma complicated by CNV in the right eye for two years presented with deterioration of visual acuity in her right eye. A small retinal hemorrhage accompanied by subretinal fluid (SRF) was seen in the macular area of the right eye. Optical coherence tomography (OCT) showed that the inner retina was intact, and the outer retinal layers had outward displacement. SRF and a wedge-shaped choroidal depression were also seen. This choroidal excavation was not present on previous OCT images. The integrity of the inner retinal layers was maintained, and an optically clear space was present between the neurosensory retina and the retinal pigment epithelium. Conclusion: Choroidal osteoma can be complicated by CNV and FCE could occur as a consequence. Again, FCE can lead to CNV development. This cascade can deteriorate vision and sometime lead to permanent visual loss.

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