scholarly journals Acetazolamide Intoxication in an Elderly Patient with Diabetes and Chronic Renal Failure after Cataract Surgery

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Juliana Maria Kerber ◽  
Juliana Dias de Mello ◽  
Karolinny Borinelli de Aquino Moura ◽  
Gustavo Cardoso da Silva ◽  
Iuri Christmann Wawrzeniak ◽  
...  
Keyword(s):  
Elderly Patient ◽  
Renal Failure ◽  
Metabolic Acidosis ◽  
Chronic Renal Failure ◽  
Clinical Symptoms ◽  
Open Angle Glaucoma ◽  
Rare Complication ◽  
Severe Metabolic Acidosis ◽  
Ophthalmic Surgery ◽  
Drug Concentrations

Carbonic anhydrase inhibitors, such as acetazolamide, are widely used in the treatment of open-angle glaucoma. Severe metabolic acidosis is a rare complication of acetazolamide use, and life-threatening acidosis occurs most commonly in elderly patients, in patients with advanced renal failure, and in patients with diabetes. We describe an unusual case of an elderly patient with diabetic nephropathy and chronic renal failure who presented to the emergency department with severe metabolic acidosis and coma after exposure to high doses of acetazolamide in the postoperative period of ophthalmic surgery. As symptoms of acetazolamide intoxication and uremia are similar, high suspicion is required to detect excessive plasma drug concentrations and intoxication in patients presenting with concomitant uremia. Clinical symptoms are potentially reversible with prompt diagnosis and treatment, including supportive treatment, bicarbonate therapy, and renal replacement therapy. Hemodialysis is particularly helpful in the management of acetazolamide overdose as the medication is dialyzable.

The effect of metabolic acidosis on serum apolipoprotein A I and apolipoprotein B levels in children with chronic renal failure

1997 ◽  
Vol 29 (5) ◽  
pp. 603-607
Author(s):  
Z. Bircan ◽  
A. Kaplan ◽  
M. Soran ◽  
M. Söker ◽  
M. Kervancioĝlu ◽  
...  
Keyword(s):  
Renal Failure ◽  
Metabolic Acidosis ◽  
Chronic Renal Failure ◽  
Apolipoprotein B ◽  
Apolipoprotein A

Growth hormone stimulation tests in chronic renal failure with metabolic acidosis

2007 ◽  
Vol 40 (1) ◽  
pp. 70-72 ◽  
Author(s):  
ZELÂL BIRCAN ◽  
MEHMET KERVANCIOǦL̈ ◽  
MUSTAFA SORAN ◽  
IDRIS YILDIRIM
Keyword(s):  
Growth Hormone ◽  
Renal Failure ◽  
Metabolic Acidosis ◽  
Chronic Renal Failure ◽  
Hormone Stimulation ◽  
Stimulation Tests

Changes in serum leptin levels in chronic renal failure patients with metabolic acidosis

2001 ◽  
Vol 11 (4) ◽  
pp. 207-211 ◽  
Author(s):  
Falei Zheng ◽  
Xinxia Qiu ◽  
Suyan Yin ◽  
Yan Li
Keyword(s):  
Renal Failure ◽  
Metabolic Acidosis ◽  
Chronic Renal Failure ◽  
Serum Leptin

scholarly journals Comparative Study of the Cellular Pharmacodynamics of Calcineurin Inhibitors between Patients with Chronic Renal Failure Awaiting Renal Transplantation and Cirrhosis Patients Awaiting Liver Transplantation

2009 ◽  
Vol 18 (5-6) ◽  
pp. 639-646 ◽  
Author(s):  
Yu Kihara ◽  
Naoto Matsuno ◽  
Abuduxukuer Mijiti ◽  
Takeshi Nagao ◽  
Hironori Takeuchi ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Renal Failure ◽  
Renal Transplantation ◽  
Chronic Renal Failure ◽  
Mononuclear Cells ◽  
Venous Blood ◽  
Calcineurin Inhibitors ◽  
Peripheral Blood Mononuclear ◽  
Drug Concentrations

The in vitro response of peripheral blood mononuclear cells (PBMCs) to the suppressive effects of calcineurin inhibitors is known to correlate with the clinical efficacy of drugs used in renal transplantations. The present study was conducted to examine the differences of PBMC responses to calcineurin inhibitors between chronic renal failure (CRF) patients awaiting renal transplantation and cirrhosis patients awaiting liver transplantation. The study included 99 CRF patients awaiting renal transplantation and 27 cirrhosis patients awaiting liver transplantation. Twenty milliliters of venous blood was taken 1–7 days before transplantation. The in vitro drug concentrations giving 50% inhibition of PBMC blastogenesis stimulated with concanavalin A (IC50s) were calculated. The suppressive effects of tacrolimus against PBMC blastogenesis were more than 10–100 times stronger than those of cyclosporine. The median IC50 value for cyclosporine against the CRF PBMCs was not significantly different from the median IC50 value against the cirrhosis PBMCs. In contrast, tacrolimus sensitivity in cirrhosis PBMCs is approximately seven times higher than that in CRF PBMCs. The median IC50 value for tacrolimus against cirrhosis PBMCs was significantly lower and therefore the effect was stronger in comparison to the CRF PBMCs ( p < 0.001). These data suggest that the PBMCs of cirrhosis patients, in comparison to those of CRF patients, are highly sensitive to the suppressive effect of tacrolimus. However, PBMC sensitivity to cyclosporine was not significantly different between the CRF and cirrhosis patients. These observations raise the possibility that treatment with tacrolimus, rather than cyclosporine, may therefore be a better choice to reduce the risks of allograft rejection in liver transplantation.

Metabolic Acidosis Does Not Contribute to Chronic Renal Injury in the Rat

1995 ◽  
Vol 89 (6) ◽  
pp. 643-650 ◽  
Author(s):  
D. Throssell ◽  
J. Brown ◽  
K. P. G. Harris ◽  
J. Walls
Keyword(s):  
Renal Failure ◽  
Metabolic Acidosis ◽  
Chronic Renal Failure ◽  
Glomerular Filtration ◽  
Disease Progression ◽  
Renal Injury ◽  
Heart Weight ◽  
Normal Kidney ◽  
Renal Growth ◽  
Remnant Kidney

1. Metabolic acidosis invariably accompanies chronic renal failure, and short periods of metabolic acidosis cause renal growth and proteinuria in normal rats. Rates of ammoniagenesis are increased in chronic renal failure, and it has been suggested that this contributes to disease progression. This study assessed (i) whether prolonged acidosis causes chronic renal injury in the normal kidney and (ii) whether abrogation of acidosis slows disease progression in the remnant kidney. 2. Metabolic acidosis was induced in normal rats by dietary hydrochloric acid. Urinary excretion of total protein, lysozyme and albumin increased, peaking at week 8 but returning to baseline by week 14. At killing after 14 weeks, kidney weights, glomerular filtration rates and serum creatinine were the same in both groups, but kidney/body weight and kidney/heart weight ratios were greater in the acidotic group. All kidneys were normal by light microscopy. 3. Rats subjected to five-sixths nephrectomy were given sufficient dietary bicarbonate to abolish uraemic acidosis, and their outcome was compared with that of non-alkalinized remnants (controls). Proteinuria, glomerular filtration rates, blood pressure, histological injury and time to the development of terminal uraemia were no better in bicarbonate-supplemented animals than in controls. 4. These data demonstrate that metabolic acidosis neither causes nor exacerbates chronic renal injury. We conclude that the treatment of uraemic acidosis is unlikely to influence disease progression in patients with chronic renal failure.

scholarly journals Based on HIF-1α/Wnt/β-Catenin Pathway to Explore the Effect of Qingshen Granules on Chronic Renal Failure Patients: A Randomized Controlled Trial

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Yiping Wang ◽  
Lei Zhang ◽  
Hua Jin ◽  
Dong Wang
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Treatment Group ◽  
Signaling Pathway ◽  
Clinical Symptoms ◽  
Controlled Trial ◽  
Serum Levels ◽  
Control Group ◽  
And Control ◽  
E Cadherin

Objectives. This study investigates the effect of Qingshen Granules (QSG) on chronic renal failure patients and the HIF-1α/Wnt/β-catenin signaling pathway. Methods. Subjects were randomly divided into treatment and control groups, with 42 patients in each group. Participants in the treatment group received 10 g oral doses of QSG 3 times a day, for 12 weeks, whereas subjects in the control group were given a placebo. The effective rates of traditional Chinese medicine (TCM) symptom, serum creatinine (Scr), and estimate glomerular filtration rate (eGFR) as well as the serum levels of HIF-1α, Wnt1, β-catenin, α-SMA, and E-cadherin were evaluated. Results. Eighty patients completed the treatment program and two dropped out. After 12 weeks, the effective rates of TCM symptom and eGFR were found to be higher in the treatment group than in the control group, with statistically significant differences (P = 0.024 and 0.019, respectively). Meanwhile, lower levels of HIF-1α, Wnt1, β-catenin, α-SMA, and E-cadherin were detected in the treatment group, and the differences were statistically significant (P ≤ 0.001, P = 0.001, P ≤ 0.001, P ≤ 0.001, and P = 0.039). No adverse events occurred during the study. Conclusions. QSG can alleviate the clinical symptoms of chronic renal failure (CRF) and protect renal function in patients by influencing the HIF-1α/Wnt/β-catenin signaling pathway. The treatment exhibits no adverse effects and is thus safe to be used by humans.

Ethylene Glycol Intoxication

1992 ◽  
Vol 7 (5) ◽  
pp. 234-243 ◽  
Author(s):  
James A. Kruse
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Metabolic Acidosis ◽  
Ethylene Glycol ◽  
Specific Treatment ◽  
Severe Metabolic Acidosis ◽  
Presumptive Diagnosis ◽  
Cardiorespiratory Failure ◽  
Toxic Metabolites ◽  
Ethylene Glycol Intoxication

Commonly available as automotive antifreeze, ethylene glycol can cause toxicity and death if ingested. It is metabolized to several aldehyde and acid intermediates that can cause severe metabolic acidosis, central nervous system derangements, cardiorespiratory failure, and acute renal failure. A presumptive diagnosis can often be made by assessment of the anion gap and the osmol gap and the finding of metabolic acidosis. Corroborating findings include oxalate crystalluria and urine that fluoresces on exposure to ultraviolet light. Recognition is important because there are specific treatment methods available. Therapy consists of administering sodium bicarbonate to counter the acidosis, ethanol to slow the generation of toxic metabolites, and vitamin cofactors, which may speed detoxification of these intermediates. Hemodialysis is employed to remove both ethylene glycol and its metabolites, to correct the acidbase disturbances, and as treatment for acute renal failure.

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