1.Acute amiodarone syndrome after a single intravenous amiodarone bolus.
Xin Rong NG ; Liang Yi WEE ; Veerendra CHADACHAN
Singapore medical journal 2012;53(11):e225-7
Acute amiodarone toxicity after a single dose of intravenous amiodarone is very rarely seen. We report the case of a 64-year-old Chinese man who presented with atrial fibrillation and fluid overload due to congestive cardiac failure. He was treated with a single bolus dose of intravenous amiodarone, after which he developed elevated serum transaminases, coagulopathy, thrombocytopenia and acute renal failure. His parameters returned to normal after 25 days and his recovery was uneventful.
Acute Kidney Injury
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chemically induced
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Amiodarone
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adverse effects
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Anti-Arrhythmia Agents
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adverse effects
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Atrial Fibrillation
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drug therapy
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Blood Coagulation Disorders
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chemically induced
;
Heart Failure
;
complications
;
drug therapy
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Humans
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Male
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Middle Aged
;
Thrombocytopenia
;
chemically induced
;
Transaminases
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blood
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Treatment Outcome
2.A Case of Life-Threatening Acute Kidney Injury with Toxic Encephalopathy Caused by Dioscorea quinqueloba.
Kyung Sik KANG ; Sang Taek HEO
Yonsei Medical Journal 2015;56(1):304-306
Some herbal medications induce acute kidney injury. The acute kidney injuries caused by herbal medications are mild and commonly treated by palliative care. A 51-years-old man who drank the juice squeezed from the raw tubers of Dioscorea quinqueloba (D. quinqueloba) was admitted with nausea, vomiting and chilling. He developed a seizure with decreased level of consciousness. He was diagnosed with acute kidney injury, which was cured by continuous venovenous hemodialfiltration. Non-detoxified D. quinqueloba can cause severe acute kidney injury with toxic encephalopathy. It is critical to inform possible adverse effects of the medicinal herbs and to implement more strict regulation of these products.
Acute Kidney Injury/*chemically induced/*complications
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Dioscorea/*adverse effects
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Disease Progression
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Electroencephalography
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Humans
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Length of Stay
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Male
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Middle Aged
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Neurotoxicity Syndromes/*complications
3.Contrast-Induced Acute Kidney Injury after Coil Embolization for Aneurysmal Subarachnoid Hemorrhage
Hyun Goo LEE ; Won Ki KIM ; Je Young YEON ; Jong Soo KIM ; Keon Ha KIM ; Pyoung JEON ; Seung Chyul HONG
Yonsei Medical Journal 2018;59(1):107-112
PURPOSE: Contrast-induced acute kidney injury (CI-AKI) is associated with poor outcomes after percutaneous coronary intervention. However, CI-AKI has rarely been evaluated within the neurovascular field. The aim of this study was to investigate the incidence and clinical implication of CI-AKI after coil embolization in patients with an aneurysmal subarachnoid hemorrhage (aSAH). MATERIALS AND METHODS: Between January 2005 and March 2016, 192 patients who underwent coil embolization were enrolled in this study. CI-AKI was defined as an increase from baseline serum creatinine concentration of >25% or >0.5 mg/dL within 72 hours after coil embolization. A poor clinical outcome was defined as a score of ≥3 on the modified Rankin Scale at one-year post-treatment. RESULTS: A total of 16 patients (8.3%) died as a result of medical problems within one year. CI-AKI was identified in 14 patients (7.3%). Prominent risk factors for one-year mortality included CI-AKI [odds ratio (OR): 16.856; 95% confidence interval (CI): 3.437–82.664] and an initial Glasgow Coma Scale (GCS) score ≤8 (OR: 5.565; 95% CI: 1.703–18.184). A poor clinical outcome was associated with old age (≥65 years) (OR: 7.921; 95% CI: 2.977–21.076), CI-AKI (OR: 11.281; 95% CI: 2.138–59.525), an initial GCS score ≤8 (OR 31.02; 95% CI, 10.669–90.187), and a ruptured aneurysm (p=0.016, OR: 4.278) in posterior circulation. CONCLUSION: CI-AKI seems to be an independent predictor of the overall outcomes of aSAH after endovascular treatment.
Acute Kidney Injury/chemically induced
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Acute Kidney Injury/diagnostic imaging
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Acute Kidney Injury/etiology
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Acute Kidney Injury/mortality
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Adult
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Aged
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Aged, 80 and over
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Aneurysm/complications
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Aneurysm/diagnostic imaging
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Aneurysm/therapy
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Angiography
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Contrast Media/adverse effects
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Embolization, Therapeutic/adverse effects
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Female
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Humans
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Incidence
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Male
;
Middle Aged
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Subarachnoid Hemorrhage/complications
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Subarachnoid Hemorrhage/diagnostic imaging
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Subarachnoid Hemorrhage/therapy
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Treatment Outcome
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Young Adult
4.Acute renal failure following the use of rosiglitazone in a chronic kidney disease patient.
R Abdul GHANI ; S ZAINUDIN ; N A KAMARUDDIN ; N C T KONG
Singapore medical journal 2009;50(1):e32-4
Drug-induced acute interstitial nephritis is a well-recognised and important reversible cause of acute renal failure. Peroxisome-proliferator activated receptor-gamma agonists, such as rosiglitazone, have been proven to be safe in chronic kidney disease patients. We describe a 65-year-old man with long-standing diabetes mellitus and hypertension, presenting with a five-day history of fluid overload and uraemic symptoms. There was no ingestion of analgesics, alternative medicine and other nephrotoxic drugs, the only new prescription being rosiglitazone, which was commenced during his last clinic follow-up two weeks prior to presentation. He required haemodialysis with minimal improvement in renal profile, despite cessation of the offending drug. Renal biopsy revealed findings consistent with acute interstitial nephritis. An episode of upper gastrointestinal bleeding with bleeding duodenal ulcer limited the use of steroids. He was treated with a course of mycophenolate mofetil which showed good gradual response and he remained stable with residual renal impairment.
Acute Kidney Injury
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chemically induced
;
drug therapy
;
Aged
;
Humans
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Hypoglycemic Agents
;
adverse effects
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Immunosuppressive Agents
;
therapeutic use
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Kidney Failure, Chronic
;
complications
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Male
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Mycophenolic Acid
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analogs & derivatives
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therapeutic use
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Renal Dialysis
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Thiazolidinediones
;
adverse effects
5.Acute Kidney Injury due to Menstruation-related Disseminated Intravascular Coagulation in an Adenomyosis Patient: A Case Report.
Jungmin SON ; Dong Won LEE ; Eun Young SEONG ; Sang Heon SONG ; Soo Bong LEE ; Jin KANG ; Byeong Yun YANG ; Su Jin LEE ; Jong Ryeol CHOI ; Kyu Sup LEE ; Ihm Soo KWAK
Journal of Korean Medical Science 2010;25(9):1372-1374
The authors report a case of acute kidney injury (AKI) resulting from menstruation-related disseminated intravascular coagulation (DIC) in an adenomyosis patient. A 40-yr-old woman who had received gonadotropin for ovulation induction therapy presented with anuria and an elevated serum creatinine level. Her medical history showed primary infertility with diffuse adenomyosis. On admission, her pregnancy test was negative and her menstrual cycle had started 1 day previously. Laboratory data were consistent with DIC, and it was believed to be related to myometrial injury resulting from heavy intramyometrial menstrual flow. Gonadotropin is considered to play an important role in the development of fulminant DIC. This rare case suggests that physicians should be aware that gonadotropin may provoke fulminant DIC in women with adenomyosis.
Acute Kidney Injury/*diagnosis/etiology
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Adult
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Creatinine/blood
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Disseminated Intravascular Coagulation/*chemically induced/complications
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Endometriosis/*complications/diagnosis/surgery
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Female
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Fertilization in Vitro
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Gonadotropins/*adverse effects
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Humans
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Magnetic Resonance Imaging
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Menstruation/*physiology
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Uterus/pathology/surgery
6.Acute kidney injury (AKI) with the use of antibiotic-impregnated bone cement in primary total knee arthroplasty.
Bernard P H LAU ; V Prem KUMAR
Annals of the Academy of Medicine, Singapore 2013;42(12):692-695
Acute Kidney Injury
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chemically induced
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Aged
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Anti-Bacterial Agents
;
administration & dosage
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adverse effects
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Arthroplasty, Replacement, Knee
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Bone Cements
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adverse effects
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Drug-Related Side Effects and Adverse Reactions
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complications
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Female
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Humans
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Surgical Wound Infection
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prevention & control
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Treatment Outcome
7.Impact of benazepril on contrast-induced acute kidney injury for patients with mild to moderate renal insufficiency undergoing percutaneous coronary intervention.
Xi-ming LI ; Hong-liang CONG ; Ting-ting LI ; Li-jun HE ; Yu-jie ZHOU
Chinese Medical Journal 2011;124(14):2101-2106
BACKGROUNDThe role of angiotensin-converting enzyme inhibitors (ACEI) in contrast-induced acute kidney injury (CI-AKI) is controversial. Some studies pointed out that it was effective in the prevention of CI-AKI, while some concluded that it was one risk for CI-AKI, especially for patients with pre-existing renal impairment. The purpose of this study was to assess the influence of benazepril administration on the development of CI-AKI in patients with mild to moderate renal insufficiency undergoing coronary intervention.
METHODSOne hundred and fourteen patients with mild to moderate impairment of renal function were enrolled before coronary angioplasty, who were randomly assigned to benazepril group (n = 52) and control group (n = 62). In the benazepril group, the patients received benazepril tablets 10 mg per day at least for 3 days before procedure. CI-AKI was defined as an increase of ≥ 25% in creatinine over the baseline value or increase of 0.5 mg/L within 72 hours of angioplasty.
RESULTSPatients were well matched with no significant differences at baseline in all measured parameters between two groups. The incidence of CI-AKI was lower by 64% in the benazepril group compared with control group but without statistical significance (3.45% vs. 9.68%, P = 0.506). Compared with benazepril group, estimated glomerular filtration rate (eGFR) level significantly decreased from (70.64 ± 16.38) ml · min⁻¹·1.73 m⁻² to (67.30 ± 11.99) ml · min⁻¹·1.73 m⁻² in control group (P = 0.038). There was no significant difference for the post-procedure decreased eGFR from baseline (ΔeGFR) between two groups (benazepril group (0.67 ± 12.67) ml · min⁻¹·1.73 m⁻² vs. control group (-3.33 ± 12.39) ml · min⁻¹·1.73 m⁻², P = 0.092). In diabetic subgroup analysis, ΔeGFR in benazepril group was slightly lower than that in the control group, but the difference was not statistically significant.
CONCLUSIONSBenazepril has a protective effect on mild to moderate impairment of renal function during coronary angioplasty. It is safe to use benazepril for treatment of patients with mild to moderate impairment of renal function before coronary intervention.
Acute Kidney Injury ; chemically induced ; prevention & control ; Aged ; Angioplasty, Balloon, Coronary ; adverse effects ; Angiotensin-Converting Enzyme Inhibitors ; Benzazepines ; therapeutic use ; Contrast Media ; adverse effects ; Coronary Angiography ; Female ; Humans ; Male ; Middle Aged ; Renal Insufficiency ; complications
8.Plasma neutrophil-gelatinase-associated lipocalin and cystatin C could early diagnose contrast-induced acute kidney injury in patients with renal insufficiency undergoing an elective percutaneous coronary intervention.
Xiao-li LIU ; Zhi-jian WANG ; Qing YANG ; Miao YU ; Hua SHEN ; Bin NIE ; Hong-ya HAN ; Fei GAO ; Yu-jie ZHOU
Chinese Medical Journal 2012;125(6):1051-1056
BACKGROUNDContrast induced acute kidney injury (CIAKI) is an important complication in the use of iodinated contrast media (CM). Our study was to evaluate the neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C for early diagnosis of CIAKI.
METHODSThe patients with established or suspected coronary artery disease (CAD) with the estimated glomerular filtration rate (eGFR) was more than 30 ml × min(-1) × 1.73 m(-2) and nor more than 90 ml × min(-1)× 1.73 m(-2) were continuously enrolled. The blood samples of the first 50 patients were obtained before and at 2, 4, 8, 24 and 48 hours after procedure to identify the time points at which the biomarkers reached peaks and at which the blood samples of the rest of patients were obtained. The plasma NGAL and cystatin C measure used enzyme-linked immunosorbent assay (ELISA) kit. The diagnostic characteristics of absolute and relative increasing NGAL and cystatin C for CIAKI were evaluated.
RESULTSTotal 311 patients were enrolled, among whom 39 (12.5%) developed CIAKI. Plasma NGAL increased at 2 hours and reached peak at 4 hours after procedure, while plasma cystatin C increased at 2 hours and reached peak at 24 hours after procedure. Thus, we determine rational point of time at 4 hours for NGAL and at 24 hours after procedure for cystatin C, respectively. The plasma NGAL at 4 hours after CM exposure showed largest area under curve (AUC) of 0.662 (95% confidence interval (CI): 0.565 - 0.758, P = 0.002) with 51.5% sensitivity and 80.6% of specificity. The relative increasing 25% of NGAL showed the best sensitivity and specificity of 0.872 and 0.808, respectively, with maximum Youden index of 0.680, while cystatin C with relative increasing more than 25% had 76.9% of sensitivity and 81.2% of specificity. Combined two biomarkers might get more than 90% of specificity.
CONCLUSIONSSingle measurement of NGAL or cystatin C had poor sensitivity and specificity; however, the relative increasing 25% of NGAL at 4 hours after CM exposure demonstrated higher diagnostic values for CIAKI. Combining relative increasing plasma NGAL with relative increasing plasma cystatin C might perform better for early diagnosis of CIAKI.
Acute Kidney Injury ; blood ; chemically induced ; diagnosis ; Acute-Phase Proteins ; Aged ; Angioplasty, Balloon, Coronary ; Biomarkers ; blood ; Contrast Media ; adverse effects ; Creatinine ; blood ; Cystatin C ; blood ; Female ; Humans ; Lipocalin-2 ; Lipocalins ; blood ; Male ; Middle Aged ; Proto-Oncogene Proteins ; blood ; Renal Insufficiency ; complications
9.Drug rash with eosinophilia and systemic symptoms syndrome following cholestatic hepatitis A: a case report.
Jihyun AN ; Joo Ho LEE ; Hyojeong LEE ; Eunsil YU ; Dan Bi LEE ; Ju Hyun SHIM ; Sunyoung YOON ; Yumi LEE ; Soeun PARK ; Han Chu LEE
The Korean Journal of Hepatology 2012;18(1):84-88
Hepatitis A virus (HAV) infections occur predominantly in children, and are usually self-limiting. However, 75-95% of the infections in adults are symptomatic (mostly with jaundice), with the illness symptoms usually persisting for a few weeks. Atypical manifestations include relapsing hepatitis, prolonged cholestasis, and complications involving renal injury. Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, drug-induced hypersensitivity reaction characterized by skin rash, fever, lymph-node enlargement, and internal organ involvement. We describe a 22-year-old male who presented with acute kidney injury and was diagnosed with prolonged cholestatic hepatitis A. The patient also developed DRESS syndrome due to antibiotic and/or antiviral treatment. To our knowledge, this is the first report of histopathologically confirmed DRESS syndrome due to antibiotic and/or antiviral treatment following HAV infection with cholestatic features and renal injury.
Acute Kidney Injury/diagnosis
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Anti-Bacterial Agents/*adverse effects/therapeutic use
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Cefotaxime/adverse effects/therapeutic use
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Cholestasis/complications/*diagnosis
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Cytomegalovirus/genetics
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Cytomegalovirus Infections/drug therapy/virology
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DNA, Viral/analysis
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Eosinophilia/etiology
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Exanthema/*chemically induced/pathology
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Ganciclovir/therapeutic use
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Hepatitis A/complications/*diagnosis/drug therapy
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Humans
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Hydrocortisone/therapeutic use
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Immunoglobulins/therapeutic use
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Male
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Syndrome
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Young Adult
10.Acute Kidney Injury after Using Contrast during Cardiac Catheterization in Children with Heart Disease.
Young Ju HWANG ; Myung Chul HYUN ; Bong Seok CHOI ; So Young CHUN ; Min Hyun CHO
Journal of Korean Medical Science 2014;29(8):1102-1107
Acute kidney injury (AKI) is closely associated with the mortality of hospitalized patients and long-term development of chronic kidney disease, especially in children. The purpose of our study was to assess the evidence of contrast-induced AKI after cardiac catheterization in children with heart disease and evaluate the clinical usefulness of candidate biomarkers in AKI. A total of 26 children undergoing cardiac catheterization due to various heart diseases were selected and urine and blood samples were taken at 0 hr, 6 hr, 24 hr, and 48 hr after cardiac catheterization. Until 48 hr after cardiac catheterization, there was no significant increase in serum creatinine level in all patients. Unlike urine kidney injury molecule-1, IL-18 and neutrophil gelatinase-associated lipocalin, urine liver-type fatty acid-binding protein (L-FABP) level showed biphasic pattern and the significant difference in the levels of urine L-FABP between 24 and 48 hr. We suggest that urine L-FABP can be one of the useful biomarkers to detect subclinical AKI developed by the contrast before cardiac surgery.
Acute Kidney Injury/blood/*chemically induced/*urine
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Biological Markers/urine
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Cardiac Catheterization/*adverse effects
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Child
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Contrast Media/adverse effects/diagnostic use
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Fatty Acid-Binding Proteins/*urine
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Female
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Heart Defects, Congenital/complications/*radiography
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Humans
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Iohexol/adverse effects/*analogs & derivatives/diagnostic use
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Male
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Radiography, Interventional/adverse effects
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Reproducibility of Results
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Sensitivity and Specificity