scholarly journals Rhabdomyolysis-Induced Acute Kidney Injury in Diabetic Emergency: Underdiagnosed and an Important Association to Be Aware of

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Ami Amin ◽  
Bhavika Gandhi ◽  
Steven Torre ◽  
Alireza Amirpour ◽  
Jennifer Cheng ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Diabetic Ketoacidosis ◽  
Clinical Manifestations ◽  
Kidney Injury ◽  
Clinical Syndrome ◽  
Dark Urine ◽  
Threatening Condition ◽  
Hyperosmolar Hyperglycemic State ◽  
Life Threatening ◽  
Electrolyte Abnormalities

Rhabdomyolysis is a potentially life-threatening clinical syndrome associated with muscle injury which can cause a leakage of intracellular contents, manifested from the range of being asymptomatic to a life-threatening condition causing acute kidney injury and severe electrolyte abnormalities. Rhabdomyolysis has been associated with both diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic nonketotic syndrome, though there is an increased association with rhabdomyolysis and acute kidney injury with hyperosmolar nonketonic state compared with patients with diabetic ketoacidosis. Common clinical manifestations are muscle pain, dark urine, and generalized weakness. The causes of rhabdomyolysis are broadly categorized into three groups: traumatic, nontraumatic exertional, and nontraumatic nonexertional. Here, we present a case of rhabdomyolysis-induced acute kidney injury in a patient with hyperosmolar hyperglycemic state. The patient was discharged on insulin and needed intermittent dialysis for two months. Our case highlights the importance of the rare association of rhabdomyolysis causing acute kidney injury in a diabetic emergency.

scholarly journals Rhabdomyolysis and Acute Kidney Injury Associated With Terbinafine Use: A Case Report

2020 ◽  
Vol 7 ◽  
pp. 205435812095137 ◽  
Author(s):  
Shijie Zhou ◽  
Amit Bagga
Keyword(s):  
Acute Kidney Injury ◽  
Side Effect ◽  
Fungal Infections ◽  
Early Recognition ◽  
Clinical Status ◽  
Kidney Injury ◽  
Clinical History ◽  
Severe Side Effect ◽  
Dark Urine ◽  
Threatening Condition

Rationale: Terbinafine is an antimicrobial agent commonly prescribed for fungal infections. Its side effect profile is generally benign, but there is limited evidence that it has the potential to cause rhabdomyolysis. Rhabdomyolysis is a potentially life-threatening condition caused by profound muscle injury. It has characteristic findings of muscle pain, weakness, and dark urine. When recognized early, patients with rhabdomyolysis can be managed conservatively with hydration and watchful monitoring. However, if treatments are delayed, or in severe cases of rhabdomyolysis, complications such as electrolyte abnormalities, acute kidney injury, and disseminated intravascular coagulation can develop. Presenting concerns of the patient: A previously healthy 22-year-old male presented with nausea, vomiting, and dark urine after taking terbinafine 250 mg daily for a tinea infection for 9 days. He developed severe rhabdomyolysis with a serum creatine kinase (CK) of >100 000 U/L as well as anuric acute kidney injury. Diagnosis: The clinical history combined with the diagnostic findings suggest acute kidney injury and rhabdomyolysis associated with terbinafine use. Interventions: Terbinafine use was stopped immediately. The patient was started on intravenous fluids and bicarbonate drip. Hemodialysis was initiated to prevent further complications. After his CK level decreased and his clinical status stabilized, he was discharged home and continued to receive outpatient hemodialysis treatments. Outcome: The patient’s kidney function returned to baseline after 1 month of outpatient hemodialysis treatments. Novel finding: In this report, we present a case of rhabdomyolysis associated with terbinafine use that progressed to acute kidney injury requiring dialysis. Our case highlights a less known and severe side effect of this medication and emphasizes the importance of early recognition and treatment of rhabdomyolysis.

scholarly journals Clinical conundrums in the management of diabetic ketoacidosis in the elderly

2019 ◽  
Vol 7 (1) ◽  
pp. 10-14 ◽  
Author(s):  
Vishal Sehgal ◽  
Brian Ulmer
Keyword(s):  
Diabetes Mellitus ◽  
Atrial Fibrillation ◽  
Acute Kidney Injury ◽  
Elderly Patients ◽  
Diabetic Ketoacidosis ◽  
Kidney Injury ◽  
The Elderly ◽  
Complications Of Diabetes ◽  
Clinical Presentations ◽  
Life Threatening

Abstract One of the dreaded life-threatening complications of diabetes mellitus (DM) is diabetic ketoacidosis (DKA). American Diabetic Association (ADA) came out with 2018 guidelines on the management of DM and its complications, but these are woefully silent on the clinical conundrums that accompany DKA in elderly patients. In elderly patients, DKA is often complicated by sepsis, atrial fibrillation, polypharmacy, nonketotic hyperosmolar states, atypical clinical presentations, acute kidney injury (AKI), dementia, and noncompliance with medications. Here in we highlight these conundrums that need to be addressed to improve morbidity and mortality in elderly patients.

scholarly journals Interpretable and Continuous Prediction of Acute Kidney Injury in the Intensive Care

2021 ◽  
Author(s):  
Iacopo Vagliano ◽  
Oleksandra Lvova ◽  
Martijn C. Schut
Keyword(s):  
Machine Learning ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Recurrent Neural Networks ◽  
Kidney Injury ◽  
Predictive Performance ◽  
Continuous Model ◽  
Machine Learning Model ◽  
Threatening Condition ◽  
Life Threatening

Acute kidney injury (AKI) is a common and potentially life-threatening condition, which often occurs in the intensive care unit. We propose a machine learning model based on recurrent neural networks to continuously predict AKI. We internally validated its predictive performance, both in terms of discrimination and calibration, and assessed its interpretability. Our model achieved good discrimination (AUC 0.80-0.94). Such a continuous model can support clinicians to promptly recognize and treat AKI patients and may improve their outcomes.

scholarly journals Rhabdomyolysis induced acute kidney injury following physical exertion and severe hypercalcaemia in recovery phase-a case report

2015 ◽  
Vol 9 (2) ◽  
pp. 107-111
Author(s):  
Azizun Nessa ◽  
Md Fazlul Hoque ◽  
Md Amzad H Fakir ◽  
AKM Mijanur Rahman
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Physical Exertion ◽  
Armed Forces ◽  
Recovery Phase ◽  
Medical College ◽  
Specialized Centre ◽  
Threatening Condition ◽  
Life Threatening ◽  
Severe Hypercalcaemia

In military profession, acute kidney injury (AKI) due to rhabdomyolysis is not uncommon because of its nature of job. This life threatening condition needs early aggressive management in a specialized centre to restore normal renal function. Here we report a case of rhabdomyolysis due to physical exertion who developed acute kidney injury and required haemodialysis. Patient developed hypercalcaemia in his recovery phase which was successfully managed. DOI: http://dx.doi.org/10.3329/jafmc.v9i2.21849 Journal of Armed Forces Medical College Bangladesh Vol.9(2) 2013

scholarly journals Cardiogenic shock and acute kidney injury: the rule rather than the exception

2020 ◽  
Author(s):  
N Ghionzoli ◽  
C Sciaccaluga ◽  
GE Mandoli ◽  
G Vergaro ◽  
F Gentile ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cardiogenic Shock ◽  
Severe Depression ◽  
Kidney Injury ◽  
Cardiorenal Syndrome ◽  
Current Evidence ◽  
Evidence Based ◽  
Threatening Condition ◽  
Life Threatening ◽  
Worse Prognosis

Abstract Cardiogenic shock (CS) is a life-threatening condition of poor end-organ perfusion, caused by any cardiovascular disease resulting in a severe depression of cardiac output. Despite recent advances in replacement therapies, the outcome of CS is still poor, and its management depends more on empirical decisions rather than on evidence-based strategies. By its side, acute kidney injury (AKI) is a frequent complication of CS, resulting in the onset of a cardiorenal syndrome. The combination of CS with AKI depicts a worse clinical scenario and holds a worse prognosis. Many factors can lead to acute renal impairment in the setting of CS, either for natural disease progression or for iatrogenic causes. This review aims at collecting the current evidence-based acknowledgments in epidemiology, pathophysiology, clinical features, diagnosis, and management of CS with AKI. We also attempted to highlight the major gaps in evidence as well as to point out possible strategies to improve the outcome.

scholarly journals Preventive strategies for acute kidney injury in cancer patients

2020 ◽  
Author(s):  
Laura Cosmai ◽  
Camillo Porta ◽  
Marina Foramitti ◽  
Valentina Perrone ◽  
Ludovica Mollica ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Cancer Patients ◽  
Kidney Injury ◽  
Clinical Approach ◽  
Related Risk ◽  
Threatening Condition ◽  
Huge Impact ◽  
Life Threatening ◽  
History Of

Abstract Acute kidney injury (AKI) is a common complication of cancer that occurs in up to 50% of neoplastic patients during the natural history of their disease; furthermore, it has a huge impact on key outcomes such as overall prognosis, length of hospitalization and costs. AKI in cancer patients has different causes, either patient-, tumour- or treatment-related. Patient-related risk factors for AKI are the same as in the general population, whereas tumour-related risk factors are represented by compression, obstruction, direct kidney infiltration from the tumour as well by precipitation, aggregation, crystallization or misfolding of paraprotein (as in the case of multiple myeloma). Finally, treatment-related risk factors are the most common observed in clinical practice and may present also with the feature of tumour lysis syndrome or thrombotic microangiopathies. In the absence of validated biomarkers, a multidisciplinary clinical approach that incorporates adequate assessment, use of appropriate preventive measures and early intervention is essential to reduce the incidence of this life-threatening condition in cancer patients.

scholarly journals Risk stratification in cardiogenic shock: a focus on the available evidence

2021 ◽  
Author(s):  
C. Sciaccaluga ◽  
G. E. Mandoli ◽  
N. Ghionzoli ◽  
F. Anselmi ◽  
C. Sorini Dini ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Cardiogenic Shock ◽  
Clinical Syndrome ◽  
Diagnostic Assessment ◽  
Prognostic Scores ◽  
Current Evidence ◽  
Efficient Resource ◽  
Threatening Condition ◽  
Life Threatening ◽  
Future Direction

AbstractCardiogenic shock is a clinical syndrome which is defined as the presence of primary cardiac disorder that results in hypotension together with signs of organ hypoperfusion in the state of normovolaemia or hypervolaemia. It represents a complex life-threatening condition, characterized by a high mortality rate, that requires urgent diagnostic assessment as well as treatment; therefore, it is of paramount important to advocate for a thorough risk stratification. In fact, the early identification of patients that could benefit the most from more aggressive and invasive approaches could facilitate a more efficient resource allocation. This review attempts to critically analyse the current evidence on prognosis in cardiogenic shock, focusing in particular on clinical, laboratoristic and echocardiographic prognostic parameters. Furthermore, it focuses also on the available prognostic scores, highlighting the strengths and the possible pitfalls. Finally, it provides insights into future direction that could be followed in order to ameliorate risk stratification in this delicate subset of patients.

scholarly journals Determinants of Outcomes of Acute Kidney Injury: Clinical Predictors and Beyond

2021 ◽  
Vol 10 (6) ◽  
pp. 1175
Author(s):  
Emaad M. Abdel-Rahman ◽  
Faruk Turgut ◽  
Jitendra K. Gautam ◽  
Samir C. Gautam
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Complete Recovery ◽  
Severe Form ◽  
Clinical Syndrome ◽  
Current Evidence ◽  
Clinical Predictors ◽  
End Stage

Acute kidney injury (AKI) is a common clinical syndrome characterized by rapid impairment of kidney function. The incidence of AKI and its severe form AKI requiring dialysis (AKI-D) has been increasing over the years. AKI etiology may be multifactorial and is substantially associated with increased morbidity and mortality. The outcome of AKI-D can vary from partial or complete recovery to transitioning to chronic kidney disease, end stage kidney disease, or even death. Predicting outcomes of patients with AKI is crucial as it may allow clinicians to guide policy regarding adequate management of this problem and offer the best long-term options to their patients in advance. In this manuscript, we will review the current evidence regarding the determinants of AKI outcomes, focusing on AKI-D.

scholarly journals A Biochemical and Pharmacological Characterization of Phospholipase A2 and Metalloproteinase Fractions from Eastern Russell’s Viper (Daboia siamensis) Venom: Two Major Components Associated with Acute Kidney Injury

Toxins ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 521
Author(s):  
Janeyuth Chaisakul ◽  
Orawan Khow ◽  
Kulachet Wiwatwarayos ◽  
Muhamad Rusdi Ahmad Rusmili ◽  
Watcharamon Prasert ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Phospholipase A2 ◽  
Protein Identification ◽  
Clinical Manifestations ◽  
Kidney Injury ◽  
Factor X ◽  
Pharmacological Characterization ◽  
Russell’S Viper

Acute kidney injury (AKI) following Eastern Russell’s viper (Daboia siamensis) envenoming is a significant symptom in systemically envenomed victims. A number of venom components have been identified as causing the nephrotoxicity which leads to AKI. However, the precise mechanism of nephrotoxicity caused by these toxins is still unclear. In the present study, we purified two proteins from D. siamensis venom, namely RvPLA2 and RvMP. Protein identification using LCMS/MS confirmed the identity of RvPLA2 to be snake venom phospholipase A2 (SVPLA2) from Thai D. siamensis venom, whereas RvMP exhibited the presence of a factor X activator with two subunits. In vitro and in vivo pharmacological studies demonstrated myotoxicity and histopathological changes of kidney, heart, and spleen. RvPLA2 (3–10 µg/mL) caused inhibition of direct twitches of the chick biventer cervicis muscle preparation. After administration of RvPLA2 or RvMP (300 µg/kg, i.p.) for 24 h, diffuse glomerular congestion and tubular injury with minor loss of brush border were detected in envenomed mice. RvPLA2 and RvMP (300 µg/kg; i.p.) also induced congestion and tissue inflammation of heart muscle as well as diffuse congestion of mouse spleen. This study showed the significant roles of PLA2 and SVMP in snake bite envenoming caused by Thai D. siamensis and their similarities with observed clinical manifestations in envenomed victims. This study also indicated that there is a need to reevaluate the current treatment strategies for Thai D. siamensis envenoming, given the potential for irreversible nephrotoxicity.

Sign in / Sign up

Export Citation Format

Share Document