Highest Recorded Serum Creatinine

Serum creatinine is a commonly used laboratory marker to assess kidney function; however, there has not been an established level of serum creatinine to predict mortality. After extensive literature review, we present a case of the highest recorded serum creatinine of 73.8 mg/dL in a 23-year-old male with the history of pediatric deceased donor kidney transplant (DDKT). He initially presented with uremia and signs of acute renal allograft failure after two months of immunosuppressive medication nonadherence, ultimately requiring emergent hemodialysis, which was complicated by new onset seizures. This was the patient’s fourth episode of late acute rejection and emphasizes the need for education of immunosuppressant adherence and periodic monitoring of renal function in high-risk patients. Though there is no known creatinine level incompatible with life, this patient appears to have the highest known serum creatinine in a uremic patient on record.

Acute Guillain Barre Syndrome in A Hemodialysis Patient with Diabetic Nephropathy: A Case Report

Acute Guillain Barre syndrome is a common type of autoimmune mediated acute peripheral neuropathy. Its initial symptoms are symmetrical limb weakness, sensory disturbance, pain or other symptoms. This paper reports a case of acute Guillain Barre syndrome in a uremic patient with diabetic nephropathy and long-term regular hemodialysis, in order to further explore the clinical manifestations and differential characteristics of uremic patients with acute Guillain Barre syndrome, improve the early diagnosis rate of uremic patients with acute Guillain Barre syndrome, make the patients get timely treatment, so as to reduce the disability of such patients To improve the prognosis of the disease.

Lentiform fork sign in a uremic patient with a high anion gap metabolic acidosis with seizures: a case report from North West of Ireland

Background Lentiform fork sign is a neuroradiological abnormality which is encountered in the clinical practice associated with uremic encephalopathy, dialysis disequilibrium syndrome and metabolic acidosis. Case presentation We describe here a case of this neuro-radiological abnormality which was encountered in a patient with uraemia and high anion gap metabolic acidosis who presented with generalised convulsion and later had some tremor in her hands. In our patient, there were few predisposing factors which might have possibly resulted in this abnormality chronic kidney disease, diabetes mellitus, and metabolic acidosis. Conclusion The Lentiform fork sign is a rare occurrence which can be related to a long list of toxic and metabolic causes but in conjunction with metabolic acidosis in chronic kidney disease patients, it can narrow down this list of alternate diagnosis.

Intestinal dialysis in a uremic patient with diabetic nephropathy: A challenging case and a unique experience

Background: The beneficial use of intestinal (dietary) dialysis in patients with chronic renal failure has been increasingly described during the previous two decades. The cornerstone of the dietary management during intestinal dialysis is protein restriction that is compensated by adequate caloric intake. On the other hand the dietary management of diabetic patients includes calorie restriction that is compensated by adequate intake of proteins. Therefore, the dietary prescription of intestinal dialysis in diabetic patients can be challenging and are not expected to be convenient for many patients. However, a beneficial effect of intestinal in a patient with insulin dependent diabetes mellitus and symptomatic uremia has been reported. The aim of this paper is report a beneficial effect of intestinal dialysis in a diabetic uremic patient who had insulin dependent diabetes mellitus. Patients and methods: A 28-year-old female patient with insulin dependent diabetes mellitus, and symptomatic uremia and refused treatment with dialysis. She had marked weakness and was unable to stand and walk unaided. However, she didn’t have a life threatening uremic complication such as gastrointestinal bleeding or encephalopathy on referral. The patient was treated with intestinal dialysis. Results: The patient experienced amelioration of symptoms of uremia with improved general wellbeing in association with lowering of urea levels and creatinine during the period of therapy. She was unable to stand and walk unaided before the start of therapy, but she was able to climb more than 10 steps upstairs unaided after three weeks of therapy.