When acute kidney injury in the intensive care unit is not acute tubular necrosis: A case report of κ-light chain crystalline tubulopathy

2019 ◽  
Vol 91 (5) ◽  
pp. 311-316
Author(s):  
Neal Shah ◽  
Ivy Rosales ◽  
Rex Neal Smith ◽  
Jacob E. Berchuck ◽  
Andrew J. Yee ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Case Report ◽  
Light Chain ◽  
Acute Tubular Necrosis ◽  
Kidney Injury ◽  
Tubular Necrosis

scholarly journals PENATALAKSANAAN SEPSIS AKI PADA PASIEN MULTIPLE MYELOMA DENGAN HIPERKALSEMIA BERAT

2018 ◽  
Vol 1 (1) ◽  
pp. 54-65
Author(s):  
Agus Sumedi
Keyword(s):  
Intensive Care Unit ◽  
Multiple Myeloma ◽  
Mechanical Ventilation ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Case Report ◽  
Light Chain ◽  
Bone Lesion ◽  
Kidney Injury ◽  
Vasoactive Agents

This case report talking about a female 56 yo with Multiple Myeloma (MM) suffer from Pneumonia and Acute Kidney Injury (AKI). MM is haematology cancer produce free light chain that impair renal tubulus, cause anemia, bone lesion and hypercalcemia. This patient came to hospital withsevere pneumonia, acute kidney injury andsevere hypercalcemia. In intensive care unit supported by mechanical ventilation, diuretic, antibiotics administration,haemodialysis,vasoactive agents, bisphosphonat and others.The acitenobacter baumanni was identified from sputum culture and then developed become multidrugs resistant leading to septic syock and multi organs dysfunction and death in two weeks.

scholarly journals A Case Report on Deliberate Self-poisoning with Imidacloprid in a Young Female - Overview of a Newer Insecticide Poisoning

2021 ◽  
Vol 43 (1) ◽  
pp. 60-62
Author(s):  
Sabin Thapaliya ◽  
Bhupendra K Basnet ◽  
Santa K Das ◽  
Rakshya Thapa
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Case Report ◽  
Organophosphorus Compounds ◽  
East Asian ◽  
Kidney Injury ◽  
Young Female ◽  
Neurological Manifestations ◽  
Asian Countries

Imidacloprid is a newer insecticide of the group Neonicotinoids. It is safer to humans and hence considered a better alternative to organophosphorus compounds, especially in areas like Nepal with higher incidence of deliberate self-poisoning. There has been an increase in the number of reported cases of imidacloprid poisoning from South-East Asian countries, but none from Nepal. We report a case admitted in Intensive Care Unit with neurological manifestations, respiratory failure and development of Acute Kidney Injury following acute imidacloprid poisoning.

P0580ACUTE INTERSTITIAL NEPHRITIS RELATED TO EMPAGLIFLOZIN

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Alon Bnaya ◽  
Eyal Itzkowitz ◽  
Jawad Atrash ◽  
Mohsen Abu-Alfeilat ◽  
Linda Shavit
Keyword(s):  
Diabetes Mellitus ◽  
Acute Kidney Injury ◽  
Case Report ◽  
Interstitial Nephritis ◽  
Acute Tubular Necrosis ◽  
Kidney Injury ◽  
Acute Interstitial Nephritis ◽  
Sglt2 Inhibitors ◽  
Hemodynamic Changes ◽  
Tubular Necrosis

Abstract Background and Aims SGLT-2 inhibitors are effective anti-hyperglycemic agents with proved cardiovascular and renal benefits. However, there have been post marketing reports of episodes of acute kidney injury (AKI), some requiring hospitalization and even dialysis in patients receiving SGLT2 inhibitors. This phenomenon may be related to volume contraction and hemodynamic changes, particularly in patients with other risk factors (such as patients on RAAS blocking agents or NSAIDS, patients with CKD). We present a case of acute interstitial nephritis (AIN) and acute tubular necrosis related to an SGLT2-inhibitor. Method Case report description. Results A 67-year-old women was admitted with weakness, dizziness and abdominal pain. Her medical history was remarkable for hypertension, diabetes mellitus, ischemic heart disease and peripheral vascular disease. Her medications included bisoprolol, losartan, amlodipine, sitagliptin and aspirin. Two months prior the current presentation, empagliflozin was prescribed by her primary physician for her diabetes mellitus. However, several days after initiation of empgliflozin she felt weak and dizzy and empagliflozin was discontinued. A week before the current presentation, empagliflozin was re-initiated by her cardiologist. The patient reported no recent illness, fevers, rash, arthralgias, respiratory symptoms or bone pain. She denied exposure to other new medications (including NSAIDS and antibiotics). On admission, blood pressure was 165/76 mm Hg. The rest of the physical examination was unremarkable. Laboratory studies revealed acute kidney injury (creatinine 3.19 mg/dL, BUN 28 mg/dL, baseline creatinine 0.9 mg/dL). Complete blood count demonstrated no eosinophilia or thrombocytopenia. Urinalysis showed a few leukocytes but no red cells or casts. The urine protein to creatinine ratio was 5160 mg of protein per gram creatinine. Abdominal ultrasonography showed normal-size kidneys and no hydronephrosis. Immunologic and infectious serologies were unremarkable. over several days the patient became oligo-anuric and creatinine peaked to 9.22 mg/dL and hemodialysis was initiated. Empiric treatment with prednisone was given and a renal biopsy was performed. Four glomeruli were seen on light microscopy. The glomeruli were normocellular. An interstitial infiltrate of lymphocytes and small numbers of eosinophils were seen. Thining of the renal tubular brush border with intra-tubular necrotic content was a also seen. Immunofluorescence was negative. The findings were compatible with acute interstitial nephritis and acute tubular necrosis (Figure 1). The patient was discharged with a regimen of intermittent hemodialysis and steroid therapy. Three months later, urine output and kidney function improved, and the patient was weaned off dialysis. Conclusion In this case report, we describe previously unreported histologically proven AIN likely related to empagliflozin exposure. Although SGLT2 inhibitors have been reported to be associated with AKI it has been supposed to be related to volume contraction and hemodynamic changes. As virtually any drug can cause AIN, further proof of the drug's causation in our case was an onset of renal dysfunction with re- institution of empagliflozin, biopsy-proven AIN and absence of other drugs, infection or systemic disease that might cause AIN. With the dramatic increase in use of SGLT-2 inhibitors worldwide, treating physicians should be aware of AIN as a possible cause of AKI in this context.

scholarly journals COVID-19 and acute kidney injury; a case report

2020 ◽  
Vol 9 (3) ◽  
pp. e26-e26
Author(s):  
Hassan Ghobadi ◽  
Mohammad Ebrahimi Kalan ◽  
Jafar Mohammad-Shahi ◽  
Ziyad Ben Taleb ◽  
Abbas Ebrahimi Kalan ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Renal Function ◽  
Intensive Care ◽  
Case Report ◽  
Kidney Injury ◽  
Prior History ◽  
Normal Value ◽  
Definitive Evidence ◽  
History Of

Although there is no definitive evidence that coronavirus disease 2019 (COVID-19) affects the kidneys adversely, amongst those who develop severe COVID-19 infection and require hospitalization, acute kidney injury (AKI) was reported. Here, we report the clinical outcome associated with AKI in a 32-year-old man with confirmed COVID-19 infection with no prior history of renal malfunction. The AKI was identified during intensive care unit (ICU) course with the median creatinine and blood urea nitrogen values of 3.1 mg/dL (normal value: 0.6-1.2 mg/dL) and 145 mg/dL (normal value:15-45 mg/dL), respectively. Renal function of patients hospitalized with COVID-19 infection needs to be monitored regularly to intervene as early as possible and to prevent the development of AKI and further kidney complications.

scholarly journals POS-004 HYPOALBUMINEMIA AND ACUTE KIDNEY INJURY IN PATIENTS ADMITTED TO INTENSIVE CARE UNIT

2021 ◽  
Vol 6 (4) ◽  
pp. S2
Author(s):  
A. BACA ◽  
M. Carmoma Antonio ◽  
M. Wasung ◽  
P. Visoso ◽  
M. Sebastian Alberto
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Kidney Injury

scholarly journals Dosing of daptomycin in intensive care unit patients with acute kidney injury undergoing extended dialysis--a pharmacokinetic study

2009 ◽  
Vol 25 (5) ◽  
pp. 1537-1541 ◽  
Author(s):  
J. T. Kielstein ◽  
C. Eugbers ◽  
S. M. Bode-Boeger ◽  
J. Martens-Lobenhoffer ◽  
H. Haller ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Pharmacokinetic Study ◽  
Kidney Injury

scholarly journals Intensive care unit physician-delivered point of care renal tract ultrasound in acute kidney injury is feasible

2018 ◽  
Vol 19 (4) ◽  
pp. 313-318 ◽  
Author(s):  
Prashant Parulekar ◽  
Ed Neil-Gallacher ◽  
Alex Harrison
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Point Of Care ◽  
Kidney Injury ◽  
Diagnostic Quality ◽  
The Core ◽  
Low Incidence

Acute kidney injury is common in critically ill patients, with ultrasound recommended to exclude renal tract obstruction. Intensive care unit clinicians are skilled in acquiring and interpreting ultrasound examinations. Intensive Care Medicine Trainees wish to learn renal tract ultrasound. We sought to demonstrate that intensive care unit clinicians can competently perform renal tract ultrasound on critically ill patients. Thirty patients with acute kidney injury were scanned by two intensive care unit physicians using a standard intensive care unit ultrasound machine. The archived images were reviewed by a Radiologist for adequacy and diagnostic quality. In 28 of 30 patients both kidneys were identified. Adequate archived images of both kidneys each in two planes were possible in 23 of 30 patients. The commonest reason for failure was dressings and drains from abdominal surgery. Only one patient had hydronephrosis. Our results suggest that intensive care unit clinicians can provide focussed renal tract ultrasound. The low incidence of hydronephrosis has implications for delivering the Core Ultrasound in Intensive Care competencies.

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