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Journal of Feline Medicine and Surgery Jun 2019The aims of the study were to identify the ultrasonographic findings in cats with acute kidney injury (AKI) and to assess whether they had prognostic value.
OBJECTIVES
The aims of the study were to identify the ultrasonographic findings in cats with acute kidney injury (AKI) and to assess whether they had prognostic value.
METHODS
This was a descriptive case series. A search of the computerised records of the Queen Mother Hospital for Animals (Hatfield, UK) was performed for cats presenting with AKI between 2007 and 2016. Patients were excluded if they had historical data consistent with chronic kidney disease. Ultrasound images were reviewed for the presence of six renal ultrasonographic abnormalities: nephromegaly, cortical and medullary echogenicity, pyelectasia, and retroperitoneal and peritoneal fluid. Ultrasonographic findings were assessed individually and cumulatively to give an ultrasound score out of 6. Ultrasonographic findings were assessed for association with oligouria/anuria and survival.
RESULTS
Forty-five cats with AKI fulfilled the inclusion criteria. In total, 6.7% (3/45) of cats had normal renal size and architecture. The most common renal ultrasonographic findings were nephromegaly, pyelectasia and increased renal echogenicity. The presence of retroperitoneal fluid was associated with oligouria/anuria. Total ultrasound score (out of 6) was significantly associated with oligouria/anuria and 6 month survival.
CONCLUSIONS AND RELEVANCE
Ultrasonographic findings are common in cats presenting with AKI. The increasing number of renal ultrasonographic abnormalities and the presence of retroperitoneal fluid alone are associated with oligouria/anuria and a higher ultrasound score may suggest a poorer long-term prognosis.
Topics: Acute Kidney Injury; Animals; Cat Diseases; Cats; Retrospective Studies; Ultrasonography
PubMed: 29979100
DOI: 10.1177/1098612X18785738 -
Saudi Journal of Kidney Diseases and... 2020Hemolytic-uremic syndrome (HUS) is a leading cause of childhood acute kidney injury (AKI) worldwide, with its postdiarrheal (D+HUS) form being the most common. Scarce...
Hemolytic-uremic syndrome (HUS) is a leading cause of childhood acute kidney injury (AKI) worldwide, with its postdiarrheal (D+HUS) form being the most common. Scarce data are available regarding D+HUS epidemiology from developing countries. This study aims to reveal the characterization of D+ HUS in Egyptian children. This is a retrospective study of all children with D+HUS admitted to a tertiary pediatric hospital in Egypt between 2007 and 2017. The study included epidemiological, clinical and laboratory data; management details; and outcomes. A cohort of 132 children aged 4months to 12 years was analyzed. Yearly incidence peaked in 2017, and spring showed the highest peak. All cases had a diarrheal prodrome that was bloody in 83% of the cases. Edema and decreased urine output were the most frequent presentations (50.3% and 42.4%, respectively). Escherichia coli was detected in 56 cases. Dialysis was performed in 102 cases. Eight patients died during acute illness, while five patients experienced long-term sequels. Lactate dehydrogenase (LDH) positively correlated with serum creatinine and negatively correlated with reticulocytic count. Univariate analysis showed that longer anuria duration, short duration between diarrheal illness and development of AKI (P = 0.001), leukocyte count above 20 × 10 cells/L (P ≤ 0.001), platelet count below 30 × 10 cells/L (P = 0.02), high LDH levels (P = 0.02) and hematocrit above 30% (P = 0.0001), need for dialysis (P = 0.03), and neurological involvement (P ≤ 0.001) were associated with unfavorable outcomes. This is the first report with a detailed insight into the epidemiology of D+HUS in Egyptian children. The incidence of D+HUS is increasing in our country due to increased awareness of the disease and the poor public health measures. Anuria duration, leukocyte count, and neurological involvement are predictors of poor outcome in the current work, and LDH is introduced as a marker of disease severity.
Topics: Anuria; Biomarkers; Child; Child, Preschool; Consciousness Disorders; Creatinine; Diarrhea; Edema; Egypt; Hemolytic-Uremic Syndrome; Humans; Incidence; Infant; Kidney Failure, Chronic; L-Lactate Dehydrogenase; Leukocyte Count; Renal Dialysis; Reticulocyte Count; Retrospective Studies; Seasons; Seizures
PubMed: 33565450
DOI: 10.4103/1319-2442.308349 -
Revista Brasileira de Enfermagem 2022to verify the relationship of cardiovascular diseases with acute kidney injury and assess the prognosis of patients in renal replacement therapy.
OBJECTIVES
to verify the relationship of cardiovascular diseases with acute kidney injury and assess the prognosis of patients in renal replacement therapy.
METHODS
a cohort study, carried out in a public hospital specialized in cardiology. Treatment, comorbidities, duration of treatment, laboratory tests, discharge and deaths were analyzed.
RESULTS
of the 101 patients, 75 (74.3%) received non-dialysis treatment. The most frequent cardiological diagnoses were hypertension, cardiomyopathies and coronary syndrome. Hospitalization in patients undergoing dialysis was 18 days, hemoglobin <10.5g/dl and anuria in the first days of hospitalization contributed to the type of treatment. Each increase in hemoglobin units from the first day of hospitalization decreases the chance of dialysis by 19.2%. There was no difference in mortality.
CONCLUSIONS
the main cardiological diseases were not predictive of dialysis indication, and clinical treatment was the most frequent. Anuria and anemia were predictors for dialysis treatment.
Topics: Acute Kidney Injury; Anuria; Cohort Studies; Heart Diseases; Hemoglobins; Humans; Prognosis; Renal Dialysis
PubMed: 36197431
DOI: 10.1590/0034-7167-2022-0022 -
Clinical Profile and Treatment Outcomes of Patients with Malaria Complicated by Acute Kidney Injury.Saudi Journal of Kidney Diseases and... Mar 2023As Odisha is an endemic region for malaria with many acute kidney injury (AKI) cases, this study evaluated the clinical profile and treatment outcomes of patients with... (Observational Study)
Observational Study
As Odisha is an endemic region for malaria with many acute kidney injury (AKI) cases, this study evaluated the clinical profile and treatment outcomes of patients with malaria complicated by AKI. This prospective observational study was conducted between December 2015 and September 2017. Detailed histories and clinical examinations were recorded. On admission, tests for routine hematology, plasma glucose, liver function, renal function, serum electrolytes, thick smears, thin smears, and malarial parasites were performed. Of the 958 AKI malarial patients admitted, 202 (82.6 % males) were included in the study, with a mean age of 38.37 years. In total, 86.14%, 3.46%, and 10.39% of patients had Plasmodium falciparum, Plasmodium vivax, and mixed malaria, respectively. Headache and decreased urination (83.66% each) were the most common symptoms after fever (100%). Anuria and oliguria were reported in 5.95% and 67.82% of patients, respectively, whereas 26.23% reported a urine output of >400 mL/24 h. All patients had raised serum creatinine and urea levels, and >60% had anemia, proteinuria, and/or hyponatremia. Multiple organ dysfunction syndrome was observed in 62.87% of patients. Acute tubular necrosis was seen in 60% of renal biopsy specimens (n = 15). Of the 75.75% of patients requiring dialysis, 82.12% and 17.88% of patients required hemodialysis and peritoneal dialysis, respectively, during which 11 patients died. AKI, a serious complication of P. falciparum or P. vivax malaria, is a life-threatening condition. Fever, anemia, oligo/anuria, hepatic involvement, cerebral malaria, high serum creatinine and urea, and disseminated intravascular coagulation were the main predictors of mortality in our study.
Topics: Male; Humans; Adult; Female; Anuria; Creatinine; Malaria; Malaria, Falciparum; Malaria, Vivax; Acute Kidney Injury; Treatment Outcome; Anemia; Urea
PubMed: 38146720
DOI: 10.4103/1319-2442.391889 -
Frontiers in Veterinary Science 2021Intravenous fluid therapy has long been the mainstay of treatment of kidney disease, including acute kidney injury and uremic crisis associated with chronic kidney... (Review)
Review
Intravenous fluid therapy has long been the mainstay of treatment of kidney disease, including acute kidney injury and uremic crisis associated with chronic kidney disease. Careful management of fluid dose is critical, as animals with kidney disease may have marked derangements in their ability to regulate fluid homeostasis and acid-base status. Understanding of the physiology of renal fluid handling is necessary, along with repeated attention to parameters of fluid status, electrolytes, and acid-base balance, to achieve optimal hydration status and avoid further damage or decrease in function from dehydration or overhydration.
PubMed: 33959654
DOI: 10.3389/fvets.2021.659960 -
Giornale Italiano Di Nefrologia :... Aug 2017We describe the case of a 45-year-old woman with a clinical history of breast cancer presenting with anuric renal failure, metabolic acidosis and bilateral grade 2-3...
We describe the case of a 45-year-old woman with a clinical history of breast cancer presenting with anuric renal failure, metabolic acidosis and bilateral grade 2-3 hydronephrosis. Following insertion of bilateral ureteral stents, urinary output was 5000 ml in the subsequent 24 hours with frankly bloody urine, after which anuria recurred. A new ultrasound examination showed hydronephrotic kidneys with properly positioned stents, a distended bladder free of clots and a hypo-anechoic, well-demarcated mass enveloping the aorta. With the echo color Doppler, injection of saline solution through a Foley catheter showed fluid flow similar to a ureteral jet within the bladder. Since the catheter balloon could not be sonographically visualized in the bladder we decided to re-examine this organ. Scans over what we thought was the bladder detected the balloon in a depleted bladder and fluid underlying it. CT urography revealed bilateral hydronephrosis secondary to a reperitoneal fibrous plaque surrounding the ureters and extending to the pelvic floor that had produced an encapsulated fluid collection. The clinical and imaging findings were strongly suggestive of acute obstructive renal failure secondary to retroperitoneal fibrosis. The retroperitoneal fluid collection, which had been mistaken for the bladder, may be due to a hematoma, aurinoma, an inflammatory process or a lymphocele.
Topics: Female; Humans; Hydronephrosis; Middle Aged; Retroperitoneal Fibrosis; Retroperitoneal Space
PubMed: 28762684
DOI: No ID Found -
Monaldi Archives For Chest Disease =... Mar 2021Pheochromocytoma is a rare adrenal tumor characterized by the secretion of catecholamines and vasoactive peptides. It can cause a catecholaminergic storm and lead to...
Pheochromocytoma is a rare adrenal tumor characterized by the secretion of catecholamines and vasoactive peptides. It can cause a catecholaminergic storm and lead to acute coronary syndromes. We present the case of a 53-year-old man, without any medical history, who arrived to the hospital following a spinal trauma due a fall. He presents back and retrosternal pain, with a clinical status of acute pulmonary edema, sinus tachycardia with left bundle branch block, left ventricular apical ballooning with depressed systolic function. Blood tests show a very important increase of Troponin and transaminases. A contrast chest-abdomen CT highlighted a right adrenal solid mass, with a diameter of 78mm, partial capsular laceration, compression of the inferior vena cava and the hepatic parenchyma. The clinical condition of the patient rapidly worsens from a respiratory and hemodynamic point of view, with cardiogenic shock, anuria and sepsis, refractory to all the medical treatments, until the patient died. The autopsy confirmed that the abdominal mass was a pheochromocytoma, broken after the trauma suffered. The resulting catecholaminergic storm caused a myocardial ischemia with Takotsubo syndrome, with cardiogenic shock. This unfortunate case confirms the pheochromocytoma as important risk factor for the onset of Takotsubo syndrome, and the how dramatic and severe a catecholaminergic storm can be.
Topics: Adrenal Gland Neoplasms; Arrhythmias, Cardiac; Catecholamines; Humans; Male; Middle Aged; Pheochromocytoma; Takotsubo Cardiomyopathy
PubMed: 33691391
DOI: 10.4081/monaldi.2021.1711 -
Nigerian Medical Journal : Journal of... 2021Ureteric injuries are not uncommon in obstetric and gynaecologic surgeries. Some specific procedures predispose to these injuries. Recognition is often delayed. This...
BACKGROUND
Ureteric injuries are not uncommon in obstetric and gynaecologic surgeries. Some specific procedures predispose to these injuries. Recognition is often delayed. This study aims to present a single-center experience on the presentation, risk factors, and management of ureteric injuries.
METHODOLOGY
We retrospectively reviewed case files of patients primarily presenting or referred to our urology division with ureteric injuries following obstetrics or gynaecologic surgeries from June 2005 to May 2015. Data extracted included the time of presentation or recognition, the specific offending surgery, the laterality, and site involved, the repair performed, and outcome.
RESULTS
Twenty-three patients had injuries (with a total of 25 ureters involved owing to 2 bilateral injuries). Caesarian-section is the commonest offending surgery in 13 (56.5%). The reasons for early recognition were sudden anuria in two and urinary leakage in the operating field in four patients constituting 26.0%, while 17 (74.0%) were recognized in the post-operative period. Urinary fistulae were the commonest presentation in 13 (76.5%) patients recognized postoperatively. Transection and ligation are the commonest mechanisms of injury. The distal third was the site involved in all patients, while ureteroneocystostomy alone was the most predominant repair in 18 (72.0%). Ureteroneocystostomy with Psoas hitch and Boari flap reconstruction was offered in six (24.0%) suggesting greater than5cm ureteral loss.
CONCLUSIONS
Ureteric injuries often occur following obstetrics and gynaecologic surgeries. Caesarian-section is the commonest predisposing surgery in our center. Prompt recognition and repair is recommended.
PubMed: 38716436
DOI: 10.60787/NMJ-62-5-52 -
Cureus Dec 2023Teratogenic agents have been shown to have drastic and detrimental effects on fetuses if exposed to the agent during uterine life. The most sensitive time for a... (Review)
Review
Teratogenic agents have been shown to have drastic and detrimental effects on fetuses if exposed to the agent during uterine life. The most sensitive time for a developing fetus is during the first trimester, and teratogenic exposure during this time can lead to severe deformities in the fetus. The Food and Drug Administration has categorized teratogenic agents based on the severity of their effect on the fetus; these categories include A, B, C, D, and X. Category A is the safest, with the most dangerous, and highly contraindicated in pregnant patients being Category X. This review article will discuss the teratogenic agents leflunomide, isotretinoin, thalidomide, warfarin, tetracycline, and angiotensinogen-converting enzyme inhibitors. Leflunomide can cause cranioschisis, exencephaly, and vertebral, head, and limb malformations. Isotretinoin's main teratogenic effects include central nervous system malformations, hydrocephalus, eye abnormalities, cardiac septal defects, thymus abnormalities, spontaneous abortions, and external ear abnormalities. Thalidomide has been shown to cause limb deformities, bowel atresia, and heart defects when the embryo is exposed to the agent during development. Warfarin can lead to spontaneous abortion and intrauterine death, as well as nasal hypoplasia, hypoplasia of extremities, cardiac defects, scoliosis, and mental retardation when exposed in utero. Tetracycline's teratogenic effects include gastrointestinal distress, esophageal ulceration and strictures, teeth discoloration, hepatotoxicity, and calcifications. Angiotensinogen-converting enzyme inhibitors can cause skull hyperplasia, anuria, hypotension, renal failure, lung hypoplasia, skeletal deformation, oligohydramnios, and fetal death. Teratogenic effects can be avoided if the pregnant patient is educated on the teratogenic effects of these agents.
PubMed: 38222129
DOI: 10.7759/cureus.50465 -
Medicine Nov 2018Emphysematous pyelonephritis (EPN) or cystitis (EC) is a severe infection of the urinary tract with high mortality. EPN is uncommon among the patients of end stage of... (Review)
Review
INTRODUCTION
Emphysematous pyelonephritis (EPN) or cystitis (EC) is a severe infection of the urinary tract with high mortality. EPN is uncommon among the patients of end stage of renal failure (ESRD) CASE PRESENTATION:: A 38-year-old male with uremia and anuria who was on hemodialysis was found to have gas formation in the bilateral pelvis, ureters, and urinary bladder by CT scan. The diagnosis was emphysematous pyelonephritis and cystitis. And Foley catheter was placed and bladder irrigation was performed. Escherichia coli infection was identified in urine culture and antibiotic was prescribed accordingly. Gas disappeared completely and the patient recovered uneventfully.
CONCLUSION
This is the first case report of asymptomatic EPN and EC in uremic patient, and conservative management was optimistic in this condition. More attention should be paid to EPN and EC happening to ESRD patients.
Topics: Adult; Anuria; Conservative Treatment; Cystitis; Emphysema; Escherichia coli Infections; Humans; Male; Pyelonephritis; Renal Dialysis; Uremia
PubMed: 30407278
DOI: 10.1097/MD.0000000000011272