Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia
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Saudi J Kidney Dis Transpl · Jul 2014
Observational StudyOutcome of sepsis-associated acute kidney injury in an intensive care unit: an experience from a tertiary care center of central Nepal.
Acute kidney injury (AKI) is a common and major complication of sepsis. Sepsis-induced AKI is associated with higher morbidity and mortality. A prospective study was designed to include all the patients with a provisional diagnosis of sepsis with AKI admitted in our intensive care unit from August 2009 to September 2010. ⋯ This prospective study showed that the major causes of AKI were medical illness and pneumonia. Mortality in sepsis-induced AKI is significantly high. This highlights the importance of prevention of AKI in sepsis by early and renal-friendly aggressive treatment of sepsis and the need for improvement in the management of such AKI cases.
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Saudi J Kidney Dis Transpl · May 2014
Comparative StudyA comparative study of phosphate binders in patients with end stage kidney disease undergoing hemodialysis.
In the present study, a comparative evaluation of the effects of calcium acetate, calcium carbonate, sevelamer hydrochloride and lanthanum carbonate was carried out in 120 patients with end stage kidney disease (ESKD) undergoing hemodialysis. Biochemical parameters, like serum phosphorous, serum calcium and serum alkaline phosphatase level and intact parathyroid hormone level, were measured. A statistically significant reduction in serum phosphorous, serum calcium, calcium × phosphorous and serum alkaline phosphatase level were observed with all phosphate binders during 3 months of treatment. ⋯ All treatments were well tolerated and safety profiles were consistent with previous reports in hemodialysis patients. It is concluded that all phosphate binders are safe and effective for the treatment of hyperphosphatemia in patients with ESKD undergoing hemodialysis. However, sevelamer hydrochloride seems to be superior among all with lowering incidence of hypercalcemia.
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Saudi J Kidney Dis Transpl · May 2014
Case ReportsRhabdomyolysis and acute kidney injury after acupuncture sessions.
Rhabdomyolysis is usually caused by muscle injury, drugs or alcohol and presents with muscle weakness and pain. It is characterized by rise in serum creatine kinase, aminotransferases and electrolytes as well as myoglobinuria. ⋯ Muscle pain and weakness as well as vascular injury have been reported after acupuncture. We report a case of severe rhabdomyolysis and acute kidney injury after acupuncture sessions.
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Saudi J Kidney Dis Transpl · May 2014
Observational StudyPlasma neutrophil gelatinase-associated lipocalin (NGAL) and plasma cystatin C (CysC) as biomarker of acute kidney injury after cardiac surgery.
Acute kidney injury (AKI) is a common and serious condition that frequently occurs after cardiopulmonary bypass and other cardiac surgeries. The objective of this work is to evaluate the utility of new markers for kidney damage, plasma neutrophil gelatinase-associated lipocalin (NGAL) and plasma cystatin C (CysC) as early predictors of AKI after cardiac surgery. Fifty cardiac patients were recruited for this study, and they were divided into two groups of 25 patients each. ⋯ The sensitivity and specificity of NGAL at 3 h post-operative was 94.1% and 93.9% respectively, while plasma CysC sensitivity and specificity was 54.7% and 72.7%, respectively. After 6 h post-operative, NGAL sensitivity increased to 98.1% with slight decrease of the specificity to 91.9%, while CysC sensitivity and specificity increased to 75.2% and 75.8%, respectively. In conclusion, plasma NGAL and plasma CysC may be considered as early predictors of AKI after cardio-pulmonary bypass operations.
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Saudi J Kidney Dis Transpl · May 2014
Outcome of patients with acute kidney injury in severe sepsis and septic shock treated with early goal-directed therapy in an intensive care unit.
Acute kidney injury (AKI) in the intensive care unit (ICU) is commonly caused by severe sepsis and septic shock. There is limited data regarding the incidence and outcomes of patients developing AKI treated with early goal-directed therapy (EGDT). Our aim was to observe the incidence and outcomes of patients with AKI in severe sepsis and septic shock, treated with EGDT as compared with historic controls. ⋯ Septic AKI is a complex syndrome. The incidence and outcomes have not improved despite advances in sepsis management and EGDT. Very early detection of septic AKI and targeted therapies may improve outcomes.