The effects of vasopressin on hemodynamics and renal function in severe septic shock: a case series

2001 ◽  
Vol 27 (8) ◽  
pp. 1416-1421 ◽  
Author(s):  
Cheryl L. Holmes ◽  
Keith R. Walley ◽  
Dean R. Chittock ◽  
Tara Lehman ◽  
James A. Russell
Keyword(s):  
Septic Shock ◽  
Renal Function ◽  
Case Series ◽  
Severe Septic Shock

The effects of norepinephrine on hemodynamics and renal function in severe septic shock states

1993 ◽  
Vol 19 (3) ◽  
pp. 151-154 ◽  
Author(s):  
E. M. Redl-Wenzl ◽  
C. Armbruster ◽  
G. Edelmann ◽  
E. Fischl ◽  
M. Kolacny ◽  
...  
Keyword(s):  
Septic Shock ◽  
Renal Function ◽  
Severe Septic Shock

scholarly journals Hemoadsorption in a Case of Severe Septic Shock and Necrotizing Fasciitis Caused by Nontraumatic Renal Rupture due to Pyelonephritis with Obstructive Uropathy

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Lampros Kousoulas ◽  
Uwe Wittel ◽  
Stefan Fichtner-Feigl ◽  
Stefan Utzolino
Keyword(s):  
Septic Shock ◽  
Renal Function ◽  
Necrotizing Fasciitis ◽  
Lower Limb ◽  
Rescue Therapy ◽  
Obstructive Uropathy ◽  
Combined Treatment ◽  
Retroperitoneal Abscess ◽  
Renal Rupture ◽  
Severe Septic Shock

Background. Nontraumatic renal rupture due to pyelonephritis with obstructive uropathy is an uncommon but life-threatening situation. Case Presentation. A 25-year-old female presented to the emergency department with acute worsening of abdominal pain that began four weeks earlier. She was found to have peritonitis, leukocytosis, severe lactic acidosis, and a pronounced anemia and imaging was consistent with nontraumatic renal rupture with retroperitoneal abscess, perforation of the colon, and severe necrotizing fasciitis of the right lower limb. She underwent a right nephrectomy, a right hemicolectomy, surgical debridement of the retroperitoneum, and an upper thigh amputation. Due to severe septic shock and rhabdomyolysis with acute renal failure we performed a combined treatment of hemoadsorption using a Cytosorb hemoadsorber and continuous venovenous hemodialysis (CVVHD). Subsequently the patient recovered and was discharged home with no signs of infections and with normal renal function. Conclusion. We present a case of pyelonephritis with nontraumatic renal rupture leading to necrotizing fasciitis with osteomyelitis of the lower limb. The early treatment of the patient with a Cytosorb hemoadsorber led to a rapid hemodynamic and metabolic stabilization and preservation of the renal function, suggesting that hemoadsorption might be a rescue therapy in patients with severe septic shock and traumatic rhabdomyolysis.

scholarly journals Efficacy of 4-hour rescue therapeutic plasma exchange in severe septic shock patients

2020 ◽  
Vol 58 (2) ◽  
pp. 75-80
Author(s):  
Rabab Mahmoud Ahmed ◽  
Amin R. Soliman ◽  
Ahmad Yousry ◽  
Khaled Marzouk ◽  
Farouk Faris
Keyword(s):  
Septic Shock ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Plasma Exchange ◽  
Case Series ◽  
Early Initiation ◽  
Therapeutic Plasma Exchange ◽  
Case Series Study ◽  
Norepinephrine Dose ◽  
Severe Septic Shock

AbstractBackground.Early intervention for septic shock is crucial to reduce mortality and improve outcome. There is still a great debate over the exact time of therapeutic plasma exchange (TPE) administration in septic shock patients. This study aims to investigate the effect of early initiation (within 4 hours) of TPE in severe septic shock on hemodynamics & outcome.Methods. We conducted a prospective, before-after case series study on 16 septic shock patients requiring high doses of vasopressors admitted in two ICUs from Cairo, Egypt. All of our patients received TPE within 4 hours of ICU admission. The fresh frozen plasma exchange volume = 1.5 × plasma volume.Results. In the 16 patients included in the study, mean arterial pressure was significantly improved after the initial TPE (p < 0.002) and norepinephrine dose which significantly reduced post TPE (p < 0.001). In addition, norepinephrine dose to mean arterial pressure significantly improved (p < 0.001). There was reduction of a net 6 hours fluid balances following the first TPE were observed in all the patients (p < 0.03) by a mean of 757 ml. Systemic vascular resistance index was markedly improved post-TPE along with statistically improved cardiac index (p < 0.01). Stroke volume variance was also significantly decreased after the TPE sessions (p < 0.01). C-reactive protein significantly improved after TPE (P < 0.01).Conclusion. Early initiation of TPE in severe septic shock patients might improve hemodynamic measures.

Secondary Oxalate Nephropathy: Causes and Clinicopathological Characteristics of a Case Series

Nephron ◽  
2021 ◽  
pp. 1-8
Author(s):  
Shaoshan Liang ◽  
Lijuan Li ◽  
Dacheng Chen ◽  
Dandan Liang ◽  
Feng Xu ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Replacement Therapy ◽  
Renal Biopsy ◽  
Replacement Therapy ◽  
Case Series ◽  
Common Cause ◽  
Renal Function Recovery ◽  
Function Recovery ◽  
Renal Biopsies ◽  
Oxalate Nephropathy

<b><i>Introduction:</i></b> Secondary oxalate nephropathy (OxN) is associated with a variety of causes and has not been well characterized in Chinese population. To investigate the etiology, clinicopathological features, and outcomes of secondary OxN, we report a case series from a single center in China. <b><i>Methods:</i></b> A retrospective analysis of 68 patients diagnosed with secondary OxN by renal biopsy from January 2013 to February 2019 in Jinling Hospital was performed. <b><i>Results:</i></b> Secondary OxN accounted for 0.23% of the renal biopsies and 2.31% of patients who received renal biopsies due to acute kidney injury (AKI). A total of 49 men and 19 women with an average age of 51.6 ± 11.8 years were enrolled. The most common cause was iatrogenic medication, followed by oxalate-rich diet and industry exposure. Stage 1, 2, and 3 AKI and AKI on chronic kidney disease (ACKD) were found in 4.4, 8.8, 69.1, and 17.6% of the patients, respectively. The peak serum creatinine during hospitalization was 8.62 ± 4.67 mg/dL. The median urinary oxalate excretion was 51.5 (23.2–147.1) mg/24 h. Kidney biopsy showed extensive calcium oxalate crystal deposits with acute tubulointerstitial nephritis. Thirty-four patients (50.0%) required renal replacement therapy. At the end of a follow-up that lasted 8.7 (0.1–72.1) months, 81.0% of patients achieved renal function recovery in 50 (14–432) days. Patients with renal function recovery had a lower rate of ACKD, a higher level of hemoglobin, a lower level of urine lysozyme, and a lower degree of interstitial fibrosis/tubular atrophy, interstitial inflammation, and global glomerulosclerosis than those in the nonrecovery group. <b><i>Conclusions:</i></b> In this case series of secondary OxN, the most common cause was iatrogenic medication, and it presented with AKI or ACKD. Half of the patients required renal replacement therapy, and in most of them, the renal function was reversible. Renal biopsy played an important role in diagnosis and prognosis evaluation.

Surgery-Related Outcomes and Postoperative Split Renal Function by Scintigraphy Evaluation in Robot-Assisted Partial Nephrectomy in Complex Renal Tumors: An Initial Case Series

2015 ◽  
Vol 29 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Kazushi Tanaka ◽  
Junya Furukawa ◽  
Katsumi Shigemura ◽  
Nobuyuki Hinata ◽  
Takeshi Ishimura ◽  
...  
Keyword(s):  
Renal Function ◽  
Partial Nephrectomy ◽  
Case Series ◽  
Renal Tumors ◽  
Robot Assisted ◽  
Split Renal Function

scholarly journals Case series: Transplantation of kidneys from donors with renal artery aneurysm

2017 ◽  
Vol 11 (7) ◽  
pp. E307-10 ◽  
Author(s):  
Mahmoud Alameddine ◽  
Zhobin Moghadamyeghaneh ◽  
Giselle Guerra ◽  
Mahmoud Morsi ◽  
Mohammed Osman ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Artery ◽  
Ex Vivo ◽  
Average Length ◽  
Graft Function ◽  
Case Series ◽  
Artery Aneurysm ◽  
Renal Artery Aneurysm ◽  
Antibody Mediated Rejection ◽  
The Mean

Introduction: With the present disparity between organ availability and recipient demands, we reported our experience in transplanting kidneys with renal artery aneurysm after back-table reconstruction.Methods: Four patients were identified. The repair consisted of excision of the aneurysm with ostial closure, and for one of the cases, an ovarian vein patch was used. We reviewed the safety and outcomes of this procedure. All donors were asymptomatic before surgery and were diagnosed incidentally during living donor evaluation. The nephrectomies performed were hand-assisted laparoscopic approaches. All recipients had followup renal function and ultrasound duplex of renal artery at six and 12 months and then annually.Results: The mean age of the recipients was 28.7 years (range 3‒45). The mean size of the aneurysm was 7.4 ± 2.7 mm. All patients had immediate graft function with median serum creatinine of 1.9 ± 1.5 mg/dL at discharge. The average length of hospital stay was 6.25 ± 2.6 days. They also maintained good renal function with an average estimated glomerular filtration rate (eGFR) of 102.8 mL/min/1.73m2 (range 53.4‒199 mL/min/1.73m2) and patent vessels at one year. One patient suffered from acute antibody-mediated rejection and lost his graft (medication non-compliance). One patient had two simultaneous benign renal cysts that were resected. Three of the kidneys were right-sided and one left. Mean cold ischemia time was 86 ± 18 minutes. No deaths have been recorded.Conclusions: Transplanting kidneys with a renal artery aneurysm after ex-vivo repair is safe and the outcomes are encouraging. Also, it may play an important role in

scholarly journals Low-Dose Aminophylline for the Treatment of Neonatal Non-Oliguric Renal Failure—Case Series and Review of the Literature

2008 ◽  
Vol 13 (2) ◽  
pp. 80-87
Author(s):  
Bethany A. Lynch ◽  
Peter Gal ◽  
J. Laurence Ransom ◽  
Rita Q. Carlos ◽  
Mary Ann V.T. Dimaguila ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Chart Review ◽  
Low Dose ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Review Of The Literature ◽  
Oliguric Renal Failure ◽  
The Impact

OBJECTIVE Aminophylline is a methylxanthine with multiple physiologic actions. At low doses, aminophylline can antagonize adenosine and improve renal function via increased glomerular filtration rate. Despite its clinical use, little data exists in neonates for this indication. Therefore, the objective of this report is to describe the impact of aminophylline on renal function indices in a series of neonates with acute renal failure. MATERIALS AND METHODS This was a retrospective chart review of 13 neonates with acute renal failure who received aminophylline during a 15-month study period. Aminophylline was administered at 1 mg/kg intravenously or orally every twelve hours. Forty-six percent (n = 6) of the patients received a 5 mg/kg loading dose before initiation of maintenance therapy. Most patients had already received other treatments for renal failure, including diuretics and dopamine. RESULTS Resolution of acute renal failure (with normalization of serum creatinine and blood urea nitrogen) was documented in 10 patients (77%). Four of the thirteen patients died from complications due to their prematurity. Failure of low-dose aminophylline was observed in 3 of the 4 patients who died. CONCLUSIONS Low-dose aminophylline in neonates with acute renal failure is associated with an improvement in renal function indices.

THE CHANGES OF RENAL FUNCTION STATUS BASED ON PROTEINURIA AND GLOMERULUS FILTRATION RATE IN PATIENTS WITH HISTORY OF PREECLAMPSIA WITH SEVERE FEATURES

2021 ◽  
pp. 279-282
Author(s):  
Chairul Adilla Ardy ◽  
Muara Panusunan Lubis ◽  
Cut Adeya Adella ◽  
Hotma Partogi Pasaribu ◽  
Muhammad Rusda ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Late Onset ◽  
Case Series ◽  
Sampling Technique ◽  
Time Interval ◽  
History Of ◽  
The Mean

Background: Preeclampsia with severe features is an endothelial disease that causes renal system disorders during pregnancy. Preeclampsia is an important cause of acute kidney injury and risk for chronic kidney disease. Methods: This study was a case series conducted at the Department of Obstetrics and Gynecology, H. Adam Malik General Hospital Medan, Indonesia starting from December 2019 until January 2020. Total sampling technique was employed obtaining 31 subjects with a history of preeclampsia with severe features for at least 3 months to 2 years postpartum, without a history of chronic disease, diabetes mellitus, and congenital kidney disorders. Proteinuria, serum creatinine, and GFR calculations were performed. Results: There were 31 patients who met the inclusion and exclusion criteria. At a time interval of 4 - ≤13 months postpartum, 2 levels of proteinuria +1 (0-2), serum creatinine 0.81 ± 0.21 mg/dl, and levels of GFR 109.57 ± 25.13 (ml/min/1.73 m ). Whereas at the time interval of >13 - 24 months postpartum, levels of proteinuria +1 (0-3), serum creatinine 0.85 ± 0.23 mg/dl, and GFR 2 levels of 104. 41 ± 28.45 (ml/min/1.73 m ). The mean of serum creatinine before delivery was 0.69 ± 0.15 mg/dl and after delivery was 0.83 ± 0.22 mg/dl. The mean of GFR postpartum at group of history of early onset preeclampsia was 103.07 ± 25.23 2 2 (ml/min/1.73 m ) and group of history of late onset preeclampsia was 113.40 ± 28.24 (ml/min/1.73 m ). Conclusion: There was a tendency for a decrease in renal function among women with a history of preeclampsia with severe features with ndings of persistent proteinuria from more than 3 to 24 months postpartum, an increase in mean of serum creatinine levels from before and after delivery and a decrease in GFR, but it was not signicant. This was related to the slow course of chronic kidney disease, so it had to be followed up periodically.

scholarly journals Effects of norepinephrine on hemodynamics, vascular elasticity, cardiac pump function, and inflammatory factors in patients with septic shock

2019 ◽  
Vol 17 ◽  
pp. 205873921983839
Author(s):  
Fengzhi Wang ◽  
Mancui Zhang ◽  
Xiujuan Wang ◽  
Xiaopeng Zhong ◽  
Po Ding
Keyword(s):  
Septic Shock ◽  
Blood Vessel ◽  
Inflammatory Factors ◽  
Control Group ◽  
Pump Function ◽  
Heart Pump ◽  
Cardiac Pump Function ◽  
Vascular Elasticity ◽  
Experimental Group ◽  
Severe Septic Shock

The effects of norepinephrine on hemodynamics, vascular elasticity, cardiac pump function, and inflammatory factors in patients with septic shock remained unknown. In this study, we included 124 cases of severe septic shock patients in our hospital. The patients were randomly divided into control group (treated with dopamine) and experimental group (treated with dopamine plus norepinephrine), while the hemodynamic index (heart rate (HR)), blood vessel elasticity index, heart pump function, and inflammatory factor index were recorded. After 12 h of treatment, both groups showed decreased HR, increased levels of cardiac index (CI), mean arterial pressure (MAP), central venous pressure (CVP), peripheral vascular resistance index (PVRI), and vascular elasticity ( P < 0.05). To date, lower HR, higher levels of CI, MAP, CVP, and PVRI were observed in the experimental group ( P < 0.05). Furthermore, the vascular elastic coefficient, stiffness index, arterial compliance, and the precursors of plasma amino-terminal brain natriuretic peptide were also significantly higher in the experimental group than those in the control group ( P < 0.05). However, inflammatory cell tumor necrosis factor alpha factor test group (TNF alpha), interleukin-1 (IL-1), and interleukin-6 (IL-6) concentrations were significantly lower than the control group ( P < 0.05), compared to experimental group ( P < 0.05). This research indicates that phenylephrine could significantly improve hemodynamics in patients with severe septic shock, by maintaining blood vessel elasticity, improving heart pump function, and reducing the inflammatory factors’ activities, and this method could be used as a line of vascular tension of the medications used in patients with septic shock.

Increasing mean arterial pressure in patients with septic shock: effects on oxygen variables and renal function

2005 ◽  
Vol 22 (Supplement 34) ◽  
pp. 177
Author(s):  
M. Leone ◽  
J. Albanèse ◽  
I. Boyadjev ◽  
F. Antonini ◽  
C. Martin
Keyword(s):  
Septic Shock ◽  
Renal Function ◽  
Mean Arterial Pressure ◽  
Arterial Pressure
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