scholarly journals Flash-Like Albuminuria in Acute Kidney Injury Caused by Puumala Hantavirus Infection

Pathogens ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 615
Author(s):  
Paula Mantula ◽  
Johanna Tietäväinen ◽  
Jan Clement ◽  
Onni Niemelä ◽  
Ilkka Pörsti ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Acute Phase ◽  
Kidney Injury ◽  
University Hospital ◽  
Hantavirus Infection ◽  
Puumala Virus ◽  
Disappearance Rate ◽  
Time Points ◽  
Albumin Excretion ◽  
Fever Onset

Transient proteinuria and acute kidney injury (AKI) are characteristics of Puumala virus (PUUV) infection. Albuminuria peaks around the fifth day and associates with AKI severity. To evaluate albuminuria disappearance rate, we quantified albumin excretion at different time points after the fever onset. The study included 141 consecutive patients hospitalized due to acute PUUV infection in Tampere University Hospital, Finland. Timed overnight albumin excretion (cU-Alb) was measured during the acute phase in 133 patients, once or twice during the convalescent phase within three months in 94 patients, and at six months in 36 patients. During hospitalization, 30% of the patients had moderately increased albuminuria (cU-Alb 20–200 μg/min), while 57% presented with severely increased albuminuria (cU-Alb >200 μg/min). Median cU-Alb was 311 μg/min (range 2.2–6460) ≤7 days after fever onset, 235 μg/min (range 6.8–5479) at 8–13 days and 2.8 μg/min (range 0.5–18.2) at 14–20 days. After that, only one of the measurements showed albuminuria (35.4 μg/min at day 44). At six months, the median cU-Alb was 2.0 μg/min (range 0.6–14.5). Albuminuria makes a flash-like appearance in PUUV infection and returns rapidly to normal levels within 2–3 weeks after fever onset. In the case of AKI, this is a unique phenomenon.

Identification of hantavirus infection by Western blot assay and TaqMan PCR in patients hospitalized with acute kidney injury

2014 ◽  
Vol 79 (2) ◽  
pp. 166-170 ◽  
Author(s):  
Miklós Oldal ◽  
Viktória Németh ◽  
Mónika Madai ◽  
Gábor Kemenesi ◽  
Bianka Dallos ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Western Blot ◽  
Kidney Injury ◽  
Hantavirus Infection ◽  
Western Blot Assay ◽  
Taqman Pcr

Hemorrhagic fever with renal syndrome with concurrent aortic dissection: a case report

2020 ◽  
Author(s):  
Fengqi Qiu ◽  
Congcong Li ◽  
Jianya Zhou
Keyword(s):  
Acute Kidney Injury ◽  
Aortic Dissection ◽  
Kidney Injury ◽  
Hemorrhagic Fever ◽  
Sudden Onset ◽  
High Fever ◽  
Hantaan Virus ◽  
Hantavirus Infection ◽  
Microvascular Damage ◽  
Stanford B

Abstract Background Hemorrhagic fever with renal syndrome (HFRS) is caused by hantaviruses presenting with high fever, hemorrhage, acute kidney injury. Microvascular injury and hemorrhage in mucus was often observed in patients with hantavirus infection. Infection with bacterial and virus related aortic aneurysm or dissection occurs sporadically. We present a previously unreported case of hemorrhagic fever with concurrent Stanford B aortic dissection. Case presentation: A 56-year-old man complained of high fever, generalized body ache, with decreased platelet counts of 10 × 10^9/L and acute kidney injury. The ELISA test for Hantaan virus of IgM and IgG antibodies were both positive. During the convalescent period, he complained sudden onset acute chest pain radiating to the back and the CTA revealed an aortic dissection of the descending aorta extending to iliac artery. He was diagnosed with Hemorrhagic fever with renal syndrome and Stanford B aortic dissection. The patient recovered completely after surgery with other support treatments. Conclusion We present a case of HFRS complicated with aortic dissection,and no study has reported the association of HFRS with aortic disease. However, we suppose that hantavirus infection not only cause microvascular damage but may be risk factor for acute macrovascular detriment. A causal relationship has yet to be confirmed.

scholarly journals Concentration of meropenem in patients with sepsis and acute kidney injury before and after initiation of continuous renal replacement therapy: a prospective observational trial

2020 ◽  
Vol 72 (1) ◽  
pp. 147-155 ◽  
Author(s):  
Ilona Nowak-Kózka ◽  
Kamil J. Polok ◽  
Jacek Górka ◽  
Jakub Fronczek ◽  
Anna Gielicz ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Regional Citrate Anticoagulation ◽  
High Dose ◽  
Prolonged Infusion ◽  
Time Points ◽  
Drug Concentrations ◽  
Before And After

Abstract Background The effect of renal replacement therapy on drug concentrations in patients with sepsis has not been fully elucidated because the pharmacokinetic properties of many antimicrobials are influenced by both pathophysiological and treatment-related factors. The aim of this study was to determine meropenem concentrations in patients with sepsis before and after the initiation of continuous venovenous hemodialysis with regional citrate anticoagulation (RCA-CVVHD). Methods The study included 15 critically ill patients undergoing RCA-CVVHD due to sepsis-induced acute kidney injury. All participants received 2 g of meropenem every 8 h in a prolonged infusion lasting 3 h. Meropenem concentrations were measured in blood plasma using high-performance liquid chromatography coupled with tandem mass spectrometry. Blood samples were obtained at six-time points prior to and at six-time points after introducing RCA-CVVHD. Results The median APACHE IV and SOFA scores on admission were 118 points (interquartile range [IQR] 97–134 points) and 19.5 points (IQR 18–21 points), respectively. There were no significant differences in the plasma concentrations of meropenem measured directly before RCA-CVVHD and during the first 450 min of the procedure. The drug concentration reached its peak 2 h after initiating the infusion and then steadily declined. Conclusions The concentration of high-dose meropenem (2 g every 8 h) administered in a prolonged infusion was similar before and after the introduction of RCA-CVVHD in patients with sepsis who developed acute kidney injury.

Evolution of diagnostic criteria for acute kidney injury in patients with decompensated cirrhosis: A prospective study in a tertiary university hospital

2020 ◽  
Vol 44 (4) ◽  
pp. 551-563
Author(s):  
Nayana Fonseca Vaz ◽  
Vanessa Nogueira Rodrigues da Cunha ◽  
Marlone Cunha-Silva ◽  
Tiago Sevá-Pereira ◽  
Jazon Romilson de Souza Almeida ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Prospective Study ◽  
Diagnostic Criteria ◽  
Kidney Injury ◽  
University Hospital ◽  
Decompensated Cirrhosis ◽  
A Prospective Study

scholarly journals Liver Transplant Patients with High Levels of Preoperative Serum Ammonia Are at Increased Risk for Postoperative Acute Kidney Injury: A Retrospective Study

2020 ◽  
Vol 9 (6) ◽  
pp. 1629
Author(s):  
Yoon Sook Lee ◽  
Yoon Ji Choi ◽  
Kyu Hee Park ◽  
Byeong Seon Park ◽  
Jung-Min Son ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Acute Kidney Injury Network ◽  
Ammonia Level ◽  
University Hospital ◽  
Transplant Patients ◽  
Preoperative Serum ◽  
Increased Risk ◽  
Serum Ammonia ◽  
Postoperative Aki

Acute kidney injury (AKI) is one of the most frequent postoperative complications after liver transplantation (LT). Increased serum ammonia levels due to the liver disease itself may affect postoperative renal function. This study aimed to compare the incidence of postoperative AKI according to preoperative serum ammonia levels in patients after LT. Medical records from 436 patients who underwent LT from January 2010 to February 2020 in a single university hospital were retrospectively reviewed. The patients were then categorized according to changes in plasma creatinine concentrations within 48 h of LT using the Acute Kidney Injury Network criteria. A preoperative serum ammonia level above 45 mg/dL was associated with postoperative AKI (p < 0.0001). Even in patients with a normal preoperative creatinine level, when the ammonia level was greater than 45 μg/dL, the incidence of postoperative AKI was significantly higher (p < 0.0001); the AKI stage was also higher in this group than in the group with preoperative ammonia levels less than or equal to 45 μg/dL (p < 0.0001). Based on the results of our research, an elevation in preoperative serum ammonia levels above 45 μg/dL is related to postoperative AKI after LT.

scholarly journals Incidence of Acute Kidney Injury in Critically Ill Patients Receiving Vancomycin with Concomitant Piperacillin-Tazobactam, Cefepime, or Meropenem

2019 ◽  
Vol 63 (5) ◽  
Author(s):  
Adam M. Blevins ◽  
Jennifer N. Lashinsky ◽  
Craig McCammon ◽  
Marin Kollef ◽  
Scott Micek ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Retrospective Cohort ◽  
Primary Outcome ◽  
Independent Predictor ◽  
Kidney Injury ◽  
University Hospital ◽  
Increased Risk ◽  
Kdigo Guidelines

ABSTRACT Critically ill patients are frequently treated with empirical antibiotic therapy, including vancomycin and β-lactams. Recent evidence suggests an increased risk of acute kidney injury (AKI) in patients who received a combination of vancomycin and piperacillin-tazobactam (VPT) compared with patients who received vancomycin alone or vancomycin in combination with cefepime (VC) or meropenem (VM), but most studies were conducted predominately in the non-critically ill population. A retrospective cohort study that included 2,492 patients was conducted in the intensive care units of a large university hospital with the primary outcome being the development of any AKI. The rates of any AKI, as defined by the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines, were 39.3% for VPT patients, 24.2% for VC patients, and 23.5% for VM patients (P < 0.0001 for both comparisons). Similarly, the incidences of stage 2 and stage 3 AKI were also significantly higher for VPT patients than for the patients in the other groups. The rates of stage 2 and stage 3 AKI, respectively, were 15% and 6.6% for VPT patients, 5.8% and 1.8% for VC patients, and 6.6% and 1.3% for VM patients (P < 0.0001 for both comparisons). In multivariate analysis, the use of vancomycin in combination with piperacillin-tazobactam was found to be an independent predictor of AKI (odds ratio [OR], 2.161; 95% confidence interval [CI], 1.620 to 2.883). In conclusion, critically ill patients receiving the combination of VPT had the highest incidence of AKI compared to critically ill patients receiving either VC or VM.

Postoperative Acute Kidney Injury: Focus on Renal Recovery Definitions, Kidney Disease Progression and Survival

2019 ◽  
Vol 49 (3) ◽  
pp. 175-185 ◽  
Author(s):  
Thorir E. Long ◽  
Solveig Helgadottir ◽  
Dadi Helgason ◽  
Gisli H. Sigurdsson ◽  
Tomas Gudbjartsson ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Propensity Score ◽  
Matched Control ◽  
Kidney Injury ◽  
Renal Recovery ◽  
University Hospital ◽  
Control Group ◽  
One Year ◽  
Definition Of

Background: The aim of this study was to examine different definitions of renal recovery following postoperative acute kidney injury (AKI) and how these definitions associate with survival and the development and progression of chronic kidney disease (CKD). Methods: This was a retrospective study of all patients who underwent abdominal, cardiothoracic, vascular, or orthopedic surgery at a single university hospital between 1998 and 2015. Recovery of renal function following postoperative AKI was assessed comparing 4 different definitions: serum creatinine (SCr) (i) < 1.1 × baseline, (ii) 1.1–1.25 × baseline, (iii) 1.25–1.5 × baseline, and (iv) > 1.5 × baseline. One-year survival and the development or progression of CKD within 5 years was compared with a propensity score-matched control groups. Results: In total, 2,520 AKI patients were evaluated for renal recovery. Risk of incident and progressive CKD within 5 years was significantly increased if patients did not achieve a reduction in SCr to < 1.5 × baseline (hazard ratio [HR] 1.50; 95% CI 1.29–1.75) and if renal recovery was limited to a fall in SCr to 1.25–1.5 × baseline (HR 1.32; 95% CI 1.12–1.57) within 30 days. The definition of renal recovery that best predicted survival was a reduction in SCr to < 1.5 × baseline within 30 days. One-year survival of patients whose SCr decreased to < 1.5 × baseline within 30 days was significantly better than that of a propensity score-matched control group that did not achieve renal recovery (85 vs. 71%, p < 0.001). Conclusions: These findings should be considered when a consensus definition of renal recovery after AKI is established.

scholarly journals Risk Factors for Acute Kidney Injury in Patients Treated with Polymyxin B: Experience from 139 Cases at a Tertiary University Hospital in Colombia

2016 ◽  
Vol 3 (suppl_1) ◽  
Author(s):  
Carlos Gomez ◽  
Jackeline Barreto ◽  
Johanna Osorio ◽  
Luis C Alvarez ◽  
Claudia F Samboni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Polymyxin B ◽  
University Hospital

scholarly journals Urinary Metabolome Analyses of Patients with Acute Kidney Injury Using Capillary Electrophoresis-Mass Spectrometry

Metabolites ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 671
Author(s):  
Rintaro Saito ◽  
Akiyoshi Hirayama ◽  
Arisa Akiba ◽  
Yushi Kamei ◽  
Yuyu Kato ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Acute Kidney Injury ◽  
Capillary Electrophoresis ◽  
Kidney Injury ◽  
Urine Samples ◽  
Rapid Decline ◽  
Time Points ◽  
Flight Mass Spectrometry ◽  
Best Value ◽  
Time Point

Acute kidney injury (AKI) is defined as a rapid decline in kidney function. The associated syndromes may lead to increased morbidity and mortality, but its early detection remains difficult. Using capillary electrophoresis time-of-flight mass spectrometry (CE-TOFMS), we analyzed the urinary metabolomic profile of patients admitted to the intensive care unit (ICU) after invasive surgery. Urine samples were collected at six time points: before surgery, at ICU admission and 6, 12, 24 and 48 h after. First, urine samples from 61 initial patients (non-AKI: 23, mild AKI: 24, severe AKI: 14) were measured, followed by the measurement of urine samples from 60 additional patients (non-AKI: 40, mild AKI: 20). Glycine and ethanolamine were decreased in patients with AKI compared with non-AKI patients at 6–24 h in the two groups. The linear statistical model constructed at each time point by machine learning achieved the best performance at 24 h (median AUC: 89%, cross-validated) for the 1st group. When cross-validated between the two groups, the AUC showed the best value of 70% at 12 h. These results identified metabolites and time points that show patterns specific to subjects who develop AKI, paving the way for the development of better biomarkers.

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