Acute Kidney Injury ; etiology ; Hemolytic-Uremic Syndrome ; complications ; etiology ; therapy ; Humans ; Shiga Toxin ; toxicity

Hypothermia, defined as an unintentional decline in the core body temperature to below 35degrees C, is a life-threatening condition. Patients with malnutrition and diabetes mellitus as well as those of advanced age are at high risk for accidental hypothermia. Due to the high mortality rates of accidental hypothermia, proper management is critical for the wellbeing of patients. Accidental hypothermia was reported to be associated with acute kidney injury (AKI) in over 40% of cases. Although the pathogenesis remains to be elucidated, vasoconstriction and ischemia in the kidney were considered to be the main mechanisms involved. Cases of AKI associated with hypothermia have been reported worldwide, but there have been few reports of hypothermia-induced AKI in Korea. Here, we present a case of hypothermia-induced AKI that was treated successfully with rewarming and supportive care.
Acute Kidney Injury/*etiology/therapy ; Aged ; Humans ; Hypothermia/*complications/therapy ; Male ; *Rewarming

Acute Kidney Injury ; etiology ; Diabetes Mellitus ; drug therapy ; Humans ; Male ; Nigella sativa ; chemistry ; Plant Extracts ; toxicity

Acute kidney injury (AKI) is a common complication in the neonatal intensive care unit that causes a high mortality of preterm infants and various chronic kidney diseases in adulthood. Preterm infants have immature development of the kidneys at birth. The kidneys continue to develop within a specific time window after birth. However, due to various factors during pregnancy and after birth, preterm infants tend to develop AKI. At present, serum creatinine and urine volume are used for the assessment of kidney injury, and their early sensitivity and specificity have attracted increasing attention. In recent years, various new biomarkers have been identified for early recognition of AKI. This article reviews the features, risk factors, renal function assessment, and prevention/treatment of AKI of preterm infants, in order to provide a reference for improving early diagnosis and treatment of AKI in preterm infants and long-term quality of life.
Acute Kidney Injury ; diagnosis ; etiology ; therapy ; Biomarkers ; Humans ; Infant, Newborn ; Infant, Premature

OBJECTIVE: To evaluate the therapeutic effect and safety of holmium:YAG laser lithotripsy for treating ureteral calculi combined with acute renal failure. METHODS: Ureteroscopic holmium: YAG laser lithotripsy was used in 13 cases of ureteral calculi. RESULTS: After the operation the serum Bun and Cr levels in the patients decreased to different degrees or returned to normal and the stone free rate was up to 92.3% (12/13). CONCLUSION The ureteroscopic holmium:YAG laser lithotripsy can be the first choice for the upper urinary tract obstruction associated with acute renal failure,due to its safety and efficiency. It can also deal with the double sites of ureteral diseases.
Acute Kidney Injury ; etiology ; therapy ; Adult ; Aged ; Female ; Holmium ; Humans ; Lithotripsy, Laser ; methods ; Male ; Middle Aged ; Ureteral Calculi ; complications ; Ureteroscopy

BACKGROUND: Acute kidney injury (AKI) is a common and serious complication following lung transplantation (LTx), and it is associated with high mortality and morbidity. This study assessed the incidence of AKI after LTx and analyzed the associated perioperative factors and clinical outcomes. METHODS: This retrospective study included all adult LTx recipients at the China-Japan Friendship Hospital in Beijing between March 2017 and December 2019. The outcomes were AKI incidence, risk factors, mortality, and kidney recovery. Multivariate analysis was performed to identify independent risk factors. Survival analysis was presented using the Kaplan-Meier curves. RESULTS: AKI occurred in 137 of the 191 patients (71.7%), with transient AKI in 43 (22.5%) and persistent AKI in 94 (49.2%). AKI stage 1 occurred in 27/191 (14.1%), stage 2 in 46/191 (24.1%), and stage 3 in 64/191 (33.5%) of the AKI patients. Renal replacement therapy (RRT) was administered to 35/191 (18.3%) of the patients. Male sex, older age, mechanical ventilation (MV), severe hypotension, septic shock, multiple organ dysfunction (MODS), prolonged extracorporeal membrane oxygenation (ECMO), reintubation, and nephrotoxic agents were associated with AKI (P < 0.050). Persistent AKI was independently associated with pre-operative pulmonary hypertension, severe hypotension, post-operative MODS, and nephrotoxic agents. Severe hypotension, septic shock, MODS, reintubation, prolonged MV, and ECMO during or after LTx were related to severe AKI (stage 3) (P < 0.050). Patients with persistent and severe AKI had a significantly longer duration of MV, longer duration in the intensive care unit (ICU), worse downstream kidney function, and reduced survival (P < 0.050). CONCLUSIONS AKI is common after LTx, but the pathogenic mechanism of AKI is complicated, and prerenal causes are important. Persistent and severe AKI were associated with poor short- and long-term kidney function and reduced survival in LTx patients.
Acute Kidney Injury/etiology* ; Aged ; Humans ; Incidence ; Lung Transplantation/adverse effects* ; Male ; Renal Replacement Therapy ; Retrospective Studies ; Risk Factors

Acute Kidney Injury ; therapy ; Heart Defects, Congenital ; surgery ; Humans ; Infant, Newborn ; Male ; Peritoneal Dialysis ; Postoperative Complications ; etiology

OBJECTIVETo investigate the clinical features and prognosis of acute renal failure (ARF) caused by rhabdomyolysis (RM) in children.

METHODSA retrospective analysis was performed for the clinical data, laboratory examination, and prognosis of 26 RM children with ARF.

RESULTSThe causes for all 26 RM children with ARF were non-traumatic diseases, and the three most common causes were infection (69%), diabetes (12%), and metabolic disease (8%). In the RM children with ARF, the five most frequent clinical manifestations were fever (69%), multiple organ dysfunction syndrome (69%), convulsion (46%), oliguria or anuria (35%), and tea-colored urine (27%). All 26 children had a serum creatine kinase (CK) level of >1 000 IU/L, among whom 26 had increased aspartate aminotransferase, 25 had increased alanine aminotransferase, 25 had increased creatine kinase isoenzyme, and 23 had increased lactate dehydrogenase. Serum myoglobin (Mb) was measured in 22 children and was found to increase in all these children. The mean time for CK to decrease to below 1 000 IU/L was 10±5 d. There was no significant difference in the time to CK recovery between the 10 children who were treated with conventional treatment as well as continuous venous-venous hemofiltration and those who were not treated with blood purification (P>0.05). Of all 26 RM children with ARF, 7 were withdrawn from the treatment, and 19 had normal renal function after treatment.

CONCLUSIONSARF and multiple organ dysfunction syndrome are major complications in RM children. The major primary disease for RM children with ARF is infectious disease. CK is the major marker for the diagnosis of RM. Early diagnosis and appropriate treatment may reverse ARF and improve prognosis.

Acute Kidney Injury ; etiology ; Adolescent ; Child ; Child, Preschool ; Creatine Kinase ; blood ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Rhabdomyolysis ; complications ; therapy

OBJECTIVETo evaluate protein loss in critically ill patients with acute renal failure during continuous veno-venous hemofiltration (CVVH) and analysis the major factor impacting protein clearance.

METHODSA analysis was carried out in eighteen (twelve male and six female) sepsis or severe acute pancreatitis patients with acute renal failure from September 2008 to September 2009. The average age was 45 years (39 - 62 years). CVVH was conducted for 24 h in all patients. Effluent volume, blood speed, ultrafiltration rate and transmembrane pressure (TMP) were 4000 ml/h, (277 ± 89) ml/h, (179 ± 4) ml/min and (173 ± 48) mm Hg (1 mm Hg = 0.133 kPa) respectively. Blood samples were collected before and after filtration in order to detect protein concentration. Ultrafiltrate was obtained hourly to measure protein concentration and calculate protein loss during session.

RESULTSMean protein concentration was (231 ± 67) mg/L and protein loss was (22 ± 6) g/d in ultrafiltrate samples. The difference in serum protein level during hemofiltration was not significant [(56 ± 6) g/L vs. (55 ± 10) g/L, P > 0.05], while there was a weak, but statistically significant correlation between the ultrafiltrate protein concentration and the corresponding value for serum protein (r = 0.481, P < 0.05). However, there was a strong and statistically significant correlation between the ultrafiltrate protein concentration and the TMP (r = 0.564, P < 0.01). Stepwise multiple regression analysis showed that TMP and serum protein concentration played a pivotal role in ultrafiltrate protein loss.

CONCLUSIONSIn addition to renal replacement therapy, serum protein would be cleared through hemofilter during CVVH. TMP and serum protein concentration are the main factors that affect protein loss in ultrafiltrate. As a result, it is necessary to take account of the protein loss in ultrafiltrate when setting nutritional schedule.

Acute Kidney Injury ; therapy ; Adult ; Blood Proteins ; deficiency ; Critical Illness ; Female ; Hemofiltration ; adverse effects ; Humans ; Male ; Malnutrition ; etiology ; Middle Aged

OBJECTIVETo investigate the effect of peritoneal dialysis on fluid balance and outcome in children who receive cardiac operation.

METHODSFrom July to Dec. 2000, 12 (2.08%) patients of 576 consecutive children who underwent heart operation required peritoneal dialysis because of acute renal failure. The mean age of these 12 patients was (2.9+/-2.0) years (range, 5 months-7 years) and the mean body weight was (12+/-3) kg (range, 7.4-18.5 kg).

RESULTSThe interval between the operation and the initiation of peritoneal dialysis was (21.2+/-11.4) hours (4.4-42 hours). The duration of peritoneal dialysis was (6.3+/-4.8) days (0.47-15 days). Mortality in these 12 patients was 25%. Fluid removed by peritoneal dialysis was (34.7+/-17.8) ml x kg(-1) x day(-1). Asymoptomatic hypokalemia, thrombocytopenia and hyperglycemia were frequent complications, which were easily managed. Hemodynamics and pulmonary function improved during the study period.

CONCLUSIONThe early initiation of peritoneal dialysis is an effective and safe method to treat acute renal failure after cardiac operation in children.

Acute Kidney Injury ; etiology ; therapy ; Child ; Child, Preschool ; Female ; Heart Defects, Congenital ; surgery ; Humans ; Infant ; Male ; Peritoneal Dialysis ; Postoperative Complications