No abstract available.
Child ; Humans ; Hydronephrosis/*congenital/diagnosis/etiology ; Male ; Multicystic Dysplastic Kidney/diagnosis/*etiology ; Polyps/*complications/diagnosis/surgery ; Ureteral Diseases/complications/diagnosis/surgery ; Ureteral Obstruction/diagnosis/*etiology

Biomarkers ; analysis ; Biopsy ; Child ; Female ; Fluid Therapy ; Humans ; Kidney Diseases ; etiology ; Rhabdomyolysis ; diagnosis ; etiology ; therapy ; Virus Diseases ; complications

Changes in renal function are one of the most common manifestations of severe illness. There is a clinical need to intervene early with proven treatments in patients with potentially deleterious changes in renal function. Unfortunately progress has been hindered by poor definitions of renal dysfunction and a lack of early biomarkers of renal injury. In recent years, the definitional problem has been addressed with the establishment of a new well-defined diagnostic entity, acute kidney injury (AKI), which encompasses the wide spectrum of kidney dysfunction, together with clearer definition and sub-classification of the cardio-renal syndromes. From the laboratory have emerged new biomarkers which allow early detection of AKI, including neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C. This review describes the new concepts of AKI and the cardio-renal syndromes as well as novel biomarkers which allow early detection of AKI. Panels of AKI biomarker tests are likely to revolutionise the diagnosis and management of critically ill patients in the coming years. Earlier diagnosis and intervention should significantly reduce the morbidity and mortality associated with acute kidney damage.
Acute Kidney Injury/*diagnosis ; Biological Markers/analysis/blood/urine ; Cystatin C/blood/urine ; Heart Failure/complications/etiology ; Humans ; Kidney Diseases/complications/*diagnosis/etiology ; Lipocalins/blood/urine ; Syndrome

Child ; Humans ; Kidney Diseases ; etiology ; pathology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications ; diagnosis

Hematoma ; diagnosis ; diagnostic imaging ; etiology ; Humans ; Kidney Diseases ; complications ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Ultrasonography

Late complications of ureteral stents are frequent, and longer indwelling times are associated with an increased frequency of complications. Although there are reports of various complications of long-term indwelling ureteral stents, a renocolic fistula secondary to a perinephric abscess resulting from an indwelling ureteral stent has not been reported. Here, we present a fatal case of a renocolic fistula secondary to a perinephric abscess caused by an encrusted forgotten double J stent in a functionally solitary kidney.
Abscess/*complications ; Aged ; Colonic Diseases/diagnosis/*etiology ; Female ; Foreign-Body Migration/complications ; Humans ; Intestinal Fistula/diagnosis/*etiology ; Kidney/ultrasonography ; Kidney Diseases/complications/diagnosis/*etiology ; Kidney Failure/etiology ; Sepsis/etiology ; Stents/*adverse effects ; Tomography, X-Ray Computed ; Ureteral Obstruction/diagnosis ; Urinary Fistula/diagnosis/*etiology

BACKGROUNDS: Deterioration of renal function in patients with cirrhosis and spontaneous bacterial peritonitis (SBP) is the most sensitive predictor of in-hospital mortality. It has been shown that high dose intravenous albumin in addition to antibiotics reduces the incidence of renal impairment and improve hospital survival in these patients. Besides, it is important to know which patients would benefit from albumin infusion. Therefore, we conducted a retrospective study to elucidate the incidence and risk factors of renal dysfunction in cirrhotic patients with SBP. METHODS: All medical records of 76 consecutive episodes of SBP in 60 patients were analyzed. Renal dysfunction after SBP was defined as elevation of BUN >30 mg/dL or serum creatinine >1.5 mg/dL in patients without preexisting renal insufficiency, or elevation of more than 50% of the baseline level in patients with renal dysfunction at the diagnosis of infection. RESULTS: Of the 76 episodes, renal dysfunction was present in 31 (40.8%). Age, concurrent use of diuretics, large volume paracentesis (LVP) with volume expander, initial BUN and creatinine level were significant risk factors on univariate analysis. Of these, age and LVP were independent risk factors on logistic regression model. CONCLUSIONS: Renal dysfunction occurs in 40.8% of hospitalized patients after SBP. Considering poor prognosis of patients with renal dysfunction in SBP, close monitoring of renal function is needed and high dose intravenous albumin with antibiotics should be used especially in the elderly and those with LVP.
Adult ; Aged ; Bacterial Infections/complications/*diagnosis ; Female ; Humans ; Incidence ; Kidney Diseases/*diagnosis/epidemiology/etiology ; Liver Cirrhosis/*complications ; Male ; Middle Aged ; Peritonitis/complications/*diagnosis/microbiology ; Risk Factors

This study was aimed to evaluate renal dysfunction during three weeks after the burn injuries in 12 patients admitted to the Hallym University Hankang Medical Center with flame burn injuries (total body surface area, 20-40%). Parameters assessed included 24-hr urine volume, blood urea nitrogen, serum creatinine, creatinine clearance, total urinary protein, urinary microalbumin, 24-hr urinary N-acetyl--D-glucosaminidase (NAG) activity, and urinary malondialdehyde (MDA). Statistical analysis was performed using repeated measures ANOVA test. The 24-hr urine volume, creatinine clearance, and urinary protein significantly increased on day 3 post-burn and fell thereafter. The urine microalbumin excretion showed two peak levels on day 0 post-burn and day 3. The 24-hr urinary NAG activity significantly increased to its maximal level on day 7 post-burn and gradually fell thereafter. The urinary MDA progressively increased during 3 weeks after the burn injury. Despite recovery of general renal function through an intensive care of burn injury, renal tubular damage and lipid peroxidation of the renal tissue suggested to persist during three weeks after the burn. Therefore, a close monitoring and intensive management of renal dysfunction is necessary to prevent burn-induced acute renal failure as well as to lower mortality in patients with major burns.
Acetylglucosaminidase/*urine ; Adult ; Aged ; Albuminuria/etiology ; Biological Markers ; Burns/*complications ; Female ; Human ; Kidney Diseases/*diagnosis/urine ; Kidney Failure, Acute/diagnosis ; Lipid Peroxidation ; Male ; Malondialdehyde/*urine ; Middle Age

OBJECTIVETo summarize the clinical characteristics, diagnosis, treatments and outcomes of perinatal autosomal recessive polycystic kidney disease.

METHODSThe clinical data of one case with infantile polycystic kidney disease diagnosed in perinatal stage and the reports of 11 cases seen in the past 15 years searched in Pubmed, OVID and Elsevier and CNKI, Wanfang database by using the polycystic kidney disease, infant, perinatal, autosomal recessive and case report as keyword were reviewed and analyzed.

RESULTSThe infant was characterized by huge kidneys, severe respiratory and renal compromise. The kidneys were symmetrically enlarged and highly echogenic by ultrasonographic examination and showed high-signal intensity on T2-weighted images by MRI. Histologic analysis showed pulmonary hypoplasia, numerous dilated and elongated tubular structures in the kidney and dilated intrahepatic biliary ducts. Among the 12 cases, 8 cases' presumptive diagnosis was made by prenatal ultrasound revealed enlarged kidneys and oligohydramnios. All cases suffered respiratory distress after birth, and 5 cases complicated pneumothorax. 6 cases died in neonatal stage because of respiratory failure.1 case died 2 m after birth because of renal failure. Five cases are alive and underwent dialysis, nephrectomy or renal transplant.

CONCLUSIONNewborn infants with perinatal autosomal recessive polycystic kidney disease often have poor outcome and died from respiratory and renal failure. Aggressive respiratory support and renal replacement therapy (including nephrectomy, dialysis and transplantation) may give these infants a favorable outcome.

Bronchopulmonary Dysplasia ; etiology ; pathology ; Fatal Outcome ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases ; diagnosis ; genetics ; pathology ; Kidney ; pathology ; Male ; Perinatology ; Polycystic Kidney, Autosomal Recessive ; complications ; diagnosis ; genetics ; pathology ; Renal Dialysis ; Renal Insufficiency ; etiology ; pathology ; Respiratory Insufficiency ; etiology ; pathology ; Retrospective Studies ; Ultrasonography

OBJECTIVETo investigate the clinical significance of serum Cyst-C and urinary microalbumin in early renal impairment in children with Henoch-Schonlein purpura (HSP).

METHODSForty-eight children with HSP and who had normal serum creatinine level and 31 healthy children were enrolled. Contents of serum Cyst-C and urinary microalbumin were measured using ELISA and immunoturbidimetry, respectively. Urinary routine examination was performed in children with HSP. The contents of serum Cyst-C and urinary microalbumin were re-examined one month after treatment (recovery phase).

RESULTSThe contents of serum Cyst-C (2.24+/- 0.81 mg/L) and urinary microalbumin (20.04+/- 10.32 mg/L) in the HSP group at the acute phase were significantly higher than those in the control (0.85+/- 0.20 and 2.30+/- 1.38 mg/L respectively; P< 0.01). Serum Cyst-C (1.70+/- 0.30 mg/L) and urinary microalbumin contents (13.20+/- 8.16 mg/L) were significantly reduced at the recovery phase compared with those at the acute phase in the HSP group (P< 0.01). The proportion of urinary routine abnormality (33.3%) was significantly lower than that of urinary microalbumin (68.8%) and serum Cyst-C abnormalities (72.9%) in the HSP group (P< 0.01).

CONCLUSIONSSerum Cyst-C and urinary microalbumin may serve as indexes in the assessment of early renal impairment in children with HSP.

Adolescent ; Albuminuria ; etiology ; Child ; Child, Preschool ; Creatine ; blood ; Cystatin C ; blood ; Female ; Glomerular Filtration Rate ; Humans ; Kidney Diseases ; diagnosis ; etiology ; Male ; Purpura, Schoenlein-Henoch ; blood ; complications ; urine