scholarly journals A Case of Acute Kidney Injury in a Patient with Renal Hypouricemia without Intense Exercise

2020 ◽  
Vol 10 (1) ◽  
pp. 26-34
Author(s):  
Daiki Aomura ◽  
Kosuke Sonoda ◽  
Makoto Harada ◽  
Koji Hashimoto ◽  
Yuji Kamijo
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Risk Factor ◽  
Conservative Treatment ◽  
Kidney Injury ◽  
Intense Exercise ◽  
Kidney Dysfunction ◽  
Renal Hypouricemia ◽  
Orthostatic Dysregulation ◽  
Exercise Induced

Exercise-induced acute kidney injury (EIAKI) frequently develops in patients with renal hypouricemia (RHUC). However, several cases of RHUC with acute kidney injury (AKI) but without intense exercise have been reported. We encountered a 15-year-old male with RHUC who experienced AKI. He reported no episodes of intense exercise and displayed no other representative risk factors of EIAKI, although a vasopressor had been administered for orthostatic dysregulation before AKI onset. His kidney dysfunction improved with discontinuation of the vasopressor and conservative treatment. Thus, AKI can develop in patients with RHUC in the absence of intense exercise, for which vasopressors may be a risk factor.

scholarly journals Acute kidney injury in renal transplant recipients undergoing cardiac surgery

2020 ◽  
Vol 36 (1) ◽  
pp. 185-196
Author(s):  
Gregory L Hundemer ◽  
Anand Srivastava ◽  
Kirolos A Jacob ◽  
Neeraja Krishnasamudram ◽  
Salman Ahmed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Risk Factor ◽  
Renal Transplant ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Trough Levels

Abstract Background Acute kidney injury (AKI) is a key risk factor for chronic kidney disease in the general population, but has not been investigated in detail among renal transplant recipients (RTRs). We investigated the incidence, severity and risk factors for AKI following cardiac surgery among RTRs compared with non-RTRs with otherwise similar clinical characteristics. Methods We conducted a retrospective cohort study of RTRs (n = 83) and non-RTRs (n = 83) who underwent cardiac surgery at two major academic medical centers. Non-RTRs were matched 1:1 to RTRs by age, preoperative (preop) estimated glomerular filtration rate and type of cardiac surgery. We defined AKI according to Kidney Disease: Improving Global Outcomes criteria. Results RTRs had a higher rate of AKI following cardiac surgery compared with non-RTRs [46% versus 28%; adjusted odds ratio 2.77 (95% confidence interval 1.36–5.64)]. Among RTRs, deceased donor (DD) versus living donor (LD) status, as well as higher versus lower preop calcineurin inhibitor (CNI) trough levels, were associated with higher rates of AKI (57% versus 33% among DD-RTRs versus LD-RTRs; P = 0.047; 73% versus 36% among RTRs with higher versus lower CNI trough levels, P = 0.02). The combination of both risk factors (DD status and higher CNI trough level) had an additive effect (88% AKI incidence among patients with both risk factors versus 25% incidence among RTRs with neither risk factor, P = 0.004). Conclusions RTRs have a higher risk of AKI following cardiac surgery compared with non-RTRs with otherwise similar characteristics. Among RTRs, DD-RTRs and those with higher preop CNI trough levels are at the highest risk.

scholarly journals Incidence, Risk Factors, and Outcome of Acute Kidney Injury in Neurocritical Care

2018 ◽  
Vol 35 (4) ◽  
pp. 338-346 ◽  
Author(s):  
Stefan Büttner ◽  
Andrea Stadler ◽  
Christoph Mayer ◽  
Sammy Patyna ◽  
Christoph Betz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Risk Factor ◽  
Intensive Care ◽  
Kidney Disease ◽  
Neurocritical Care ◽  
Kidney Injury ◽  
Prognostic Impact ◽  
Incidence Risk

Purpose: Acute kidney injury (AKI) is a severe complication in medical and surgical intensive care units accounting for a high morbidity and mortality. Incidence, risk factors, and prognostic impact of this deleterious condition are well established in this setting. Data concerning the neurocritically ill patients is scarce. Therefore, aim of this study was to determine the incidence of AKI and elucidate risk factors in this special population. Methods: Patients admitted to a specialized neurocritical care unit between 2005 and 2011 with a length of stay above 48 hours were analyzed retrospectively for incidence, cause, and outcome of AKI (AKI Network-stage ≥2). Results: The study population comprised 681 neurocritically ill patients from a mixed neurosurgical and neurological intensive care unit. The prevalence of chronic kidney disease (CKD) was 8.4% (57/681). Overall incidence of AKI was 11.6% with 36 (45.6%) patients developing dialysis-requiring AKI. Sepsis was the main cause of AKI in nearly 50% of patients. Acute kidney injury and renal replacement therapy are independent predictors of worse outcome (hazard ratio [HR]: 3.704; 95% confidence interval [CI]: 1.867-7.350; P < .001; and HR: 2.848; CI: 1.301-6.325; P = .009). Chronic kidney disease was the strongest independent risk factor (odds ratio: 12.473; CI: 5.944-26.172; P < .001), whereas surgical intervention or contrast agents were not associated with AKI. Conclusions: Acute kidney injury in neurocritical care has a high incidence and is a crucial risk factor for mortality independently of the underlying neurocritical condition. Sepsis is the main cause of AKI in this setting. Therefore, careful prevention of infectious complications and considering CKD in treatment decisions may lower the incidence of AKI and hereby improve outcome in neurocritical care.

scholarly journals One-Year Survival and Renal Function Recovery of Acute Kidney Injury Patients with Chronic Heart Failure

2014 ◽  
Vol 5 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Wen Zhang ◽  
Dan Wen ◽  
Yan-Fang Zou ◽  
Ping-Yan Shen ◽  
Yao-Wen Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Acute Kidney Injury ◽  
Chronic Heart Failure ◽  
Clinical Characteristics ◽  
Nyha Class ◽  
Kidney Injury ◽  
Class Iii ◽  
Kidney Dysfunction ◽  
Nyha Classification

Objective: To describe and analyze the clinical characteristics of acute kidney injury (AKI) patients with preexisting chronic heart failure (CHF) and to identify the prognostic factors of the 1-year outcome. Methods: A total of 120 patients with preexisting CHF who developed AKI between January 2005 and December 2010 were enrolled. CHF was diagnosed according to the European Society of Cardiology guidelines, and AKI was diagnosed using the RIFLE criteria. Clinical characteristics were recorded, and nonrecovery from kidney dysfunction as well as mortality were analyzed. Results: The median age of the patients was 70 years, and 58.33% were male. 60% of the patients had an advanced AKI stage (‘failure') and 90% were classified as NYHA class III/IV. The 1-year mortality rate was 35%. 25.83% of the patients progressed to end-stage renal disease after 1 year. Hypertension, anemia, coronary atherosclerotic heart disease and chronic kidney disease were common comorbidities. Multiple organ dysfunction syndrome (MODS; OR, 35.950; 95% CI, 4.972-259.952), arrhythmia (OR, 13.461; 95% CI, 2.379-76.161), anemia (OR, 6.176; 95% CI, 1.172-32.544) and RIFLE category (OR, 5.353; 95% CI, 1.436-19.952) were identified as risk factors of 1-year mortality. For 1-year nonrecovery from kidney dysfunction, MODS (OR, 8.884; 95% CI, 2.535-31.135) and acute heart failure (OR, 3.281; 95% CI, 1.026-10.491) were independent risk factors. Conclusion: AKI patients with preexisting CHF were mainly elderly patients who had an advanced AKI stage and NYHA classification. Their 1-year mortality and nonrecovery from kidney dysfunction rates were high. Identifying risk factors may help to improve their outcome.

scholarly journals Renal hypouricemia with exercise induced acute kidney injury-A case report

2020 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
Srikanth Gundlapalli ◽  
Yogesh Gaur ◽  
MVenkateswar Rao ◽  
SujeethReddy Bande ◽  
P Sandhya
Keyword(s):  
Acute Kidney Injury ◽  
Case Report ◽  
Kidney Injury ◽  
Renal Hypouricemia ◽  
Exercise Induced

scholarly journals Risk Factors for Acute Kidney Injury in Acute Pancreatitis: A 7-year Retrospective Analysis of Patients in a Large Tertiary Hospital

2020 ◽  
Author(s):  
Bingjun Yu ◽  
Wenhua He ◽  
Nonghua Lu
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Acute Pancreatitis ◽  
Risk Factor ◽  
Organ Failure ◽  
Pancreatic Necrosis ◽  
Kidney Injury ◽  
Smoking History ◽  
Apache Ii Score ◽  
Lengths Of Stay

Abstract Background Acute kidney injury (AKI) is a serious complication of acute pancreatitis (AP) and causes a high risk of mortality. The aim of this study was to investigate the risk factors for AKI in patients in the early phase of AP.Methods In this retrospective observational study, 1655 AP patients were divided into an AKI and a non-AKI group. Age, sex, BMI, APACHE II score, smoking history, hypertriglyceridaemia (HTG), alcohol abuse, biliary disease, organ failure, pancreatic necrosis and necrosis debridement were collected from the hospital record database.Results 1036 males (62.6%) and 619 females (37.4%) were enrolled in this study. 1255 and 430 AP patients were included in the non-AKI and AKI groups, respectively. The mean age was 45.90±11.73 years. Hospital and intensive care unit (ICU) lengths of stay were 18.13±43.26 and 31.53±72.47 days, respectively. The incidence of organ failure and pancreatic necrosis were 25.0% and 32.2%, respectively. The morbidity of percutaneous catheter drainage (PCD) and operative necrosectomy (ON) was 10.9%, and the mortality among AP patients was 6.3%. HTG was identified as a risk factor for AKI in AP (P=0.001). The incidence of organ failure (P=0.001), pancreatic necrosis (P=0.001) and necrosis debridement were greater in the AKI group than those in the non-AKI group.Conclusions HTG is an independent risk factor for AKI in AP. AP patients with AKI have adverse outcomes such as high rates of organ failure, pancreatic necrosis, and necrosis debridement and longer hospital and ICU lengths of stay.

Exercise-Induced Acute Kidney Injury: A Case of Renal Hypouricemia

2015 ◽  
Vol 24 (2) ◽  
pp. 217-219
Author(s):  
Simge Bardak ◽  
Kenan Turgutalp ◽  
Ahmet Kiykim
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Renal Hypouricemia ◽  
Exercise Induced

scholarly journals The Albumin-to-Fibrinogen Ratio Independently Predicts Acute Kidney Injury in Infants With Ventricular Septal Defect Undergoing Cardiac Surgery With Cardiopulmonary Bypass

2021 ◽  
Vol 9 ◽  
Author(s):  
Fan Cao ◽  
Xinxin Chen ◽  
Guodong Huang ◽  
Wenhua Liu ◽  
Na Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Risk Factor ◽  
Cardiopulmonary Bypass ◽  
Ventricular Septal Defect ◽  
Independent Risk Factor ◽  
Septal Defect ◽  
Kidney Injury ◽  
Elective Cardiac Surgery

Background: Acute kidney injury (AKI) is a common and serious complication faced by children following ventricular septal defect (VSD) surgery with cardiopulmonary bypass (CPB). The objective of this study was to explore potential predictors inherent to AKI.Methods: VSD infants who were scheduled for elective cardiac surgery with CPB from 2017 to 2020 were enrolled in this study. Based on the Pediatric Risk, Injury, Failure, Loss, End-Stage Renal Disease (pRIFLE) criteria, patients were divided into AKI and non-AKI groups. Univariate and multivariate logistic regression analyses were carried out in order to evaluate potential risk factors for AKI. Receiver operating characteristic (ROC) curves were generated to evaluate the predictive probabilities of risk factors for AKI.Results: Of all the 338 enrolled VSD infants, 49 manifested AKI with an incidence of 14.5% (49/338). The ROC curve indicated that albumin-to-fibrinogen ratio (AFR) during CPB was a significant predictor of AKI [area under the curve (AUC), 0.711; p &lt; 0.001]. Based on the univariate and multivariate logistic analyses, AFR during CPB [odds ratio (OR), 1.89; 95% confidence interval (CI), 1.22–2.76, p = 0.011] was the only independent risk factor for AKI.Conclusions: This study demonstrated that a low AFR (&lt;9.35) during CPB was an independent risk factor for AKI in VSD infants following cardiac surgery with CPB.

scholarly journals Mutation in the SLC2A9 Gene: A New Family with Familial Renal Hypouricemia Type 2

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Christian Maalouli ◽  
Karin Dahan ◽  
Arnaud Devresse ◽  
Valentine Gillion
Keyword(s):  
Acute Kidney Injury ◽  
Genetic Disorder ◽  
Kidney Injury ◽  
Type Ii ◽  
Renal Hypouricemia ◽  
New Family ◽  
Exercise Induced ◽  
Renal Tubular ◽  
Work Up

Familial renal hypouricemia is a rare genetic disorder characterized by a defect in renal tubular urate reabsorption. Some patients present with exercise-induced acute kidney injury and nephrolithiasis. Type II is caused by mutations in the SLC2A9 gene. Here, we report the case of a young patient who developed acute kidney injury after exercise secondary to familial renal hypouricemia type II. The same mutation was found in other asymptomatic members of his family. We review the medical literature on this condition. This case highlights the importance of considering uric acid disorders in the work-up of acute kidney injury after exercise.

Sign in / Sign up

Export Citation Format

Share Document