MyMedR

Jering-induced acute renal failure with blue urine

Yong M, Cheong I

Trop Doct, 1995 Jan;25(1):31.

PMID: 7886826 DOI: 10.1177/004947559502500110

Matched MeSH terms: Acute Kidney Injury/etiology*; Acute Kidney Injury/urine*

Nephropathy in Malaria

Wolthuis FH

Trop Geogr Med, 1968 Mar;20(1):21-7.

PMID: 4868143

Matched MeSH terms: Acute Kidney Injury/etiology*

Fulltext The effect of regularly dosed paracetamol versus no paracetamol on renal function in Plasmodium knowlesi malaria (PACKNOW): study protocol for a randomised controlled trial

Cooper DJ, Plewes K, Grigg MJ, Rajahram GS, Piera KA, William T, et al.

Trials, 2018 Apr 24;19(1):250.

PMID: 29690924 DOI: 10.1186/s13063-018-2600-0

BACKGROUND: Plasmodium knowlesi is the most common cause of human malaria in Malaysia. Acute kidney injury (AKI) is a frequent complication. AKI of any cause can have long-term consequences, including increased risk of chronic kidney disease, adverse cardiovascular events and increased mortality. Additional management strategies are therefore needed to reduce the frequency and severity of AKI in malaria. In falciparum malaria, cell-free haemoglobin (CFHb)-mediated oxidative damage contributes to AKI. The inexpensive and widely available drug paracetamol inhibits CFHb-induced lipid peroxidation via reduction of ferryl haem to the less toxic Fe3+ state, and has been shown to reduce oxidative damage and improve renal function in patients with sepsis complicated by haemolysis as well as in falciparum malaria. This study aims to assess the ability of regularly dosed paracetamol to reduce the incidence and severity of AKI in knowlesi malaria by attenuating haemolysis-induced oxidative damage.

METHODS: PACKNOW is a two-arm, open-label randomised controlled trial of adjunctive paracetamol versus no paracetamol in patients aged ≥ 5 years with knowlesi malaria, conducted over a 2-year period at four hospital sites in Sabah, Malaysia. The primary endpoint of change in creatinine from enrolment to 72 h will be evaluated by analysis of covariance (ANCOVA) using enrolment creatinine as a covariate. Secondary endpoints include longitudinal changes in markers of oxidative stress (plasma F2-isoprostanes and isofurans) and markers of endothelial activation/Weibel-Palade body release (angiopoietin-2, von Willebrand Factor, P-selectin, osteoprotegerin) over 72 h, as well as blood and urine biomarkers of AKI. This study will be powered to detect a difference between the two treatment arms in a clinically relevant population including adults and children with knowlesi malaria of any severity.

DISCUSSION: Paracetamol is widely available and has an excellent safety profile; if a renoprotective effect is demonstrated, this trial will support the administration of regularly dosed paracetamol to all patients with knowlesi malaria. The secondary outcomes in this study will provide further insights into the pathophysiology of haemolysis-induced oxidative damage and acute kidney injury in knowlesi malaria and other haemolytic diseases.

TRIAL REGISTRATION: Clinicaltrials.gov, NCT03056391 . Registered on 12 October 2016.

Matched MeSH terms: Acute Kidney Injury/diagnosis; Acute Kidney Injury/parasitology; Acute Kidney Injury/prevention & control*

Fulltext 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

Chaisakul J, Khow O, Wiwatwarayos K, Rusmili MRA, Prasert W, Othman I, et al.

Toxins (Basel), 2021 Jul 26;13(8).

PMID: 34437392 DOI: 10.3390/toxins13080521

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.

Matched MeSH terms: Acute Kidney Injury/pathology

Nephrotoxicity of hump-nosed pit viper (Hypnale hypnale) venom in mice is preventable by the paraspecific Hemato polyvalent antivenom (HPA)

Tan CH, Tan NH, Sim SM, Fung SY, Jayalakshmi P, Gnanathasan CA

Toxicon, 2012 Dec 1;60(7):1259-62.

PMID: 22975088 DOI: 10.1016/j.toxicon.2012.08.012

Mice experimentally envenomed with Hypnale hypnale venom (1× and 1.5×LD₅₀) developed acute kidney injury (AKI) principally characterized by raised blood urea and creatinine. Prolonged blood clotting time and hemorrhage in lungs implied bleeding tendency. Pallor noted in most renal cortices was suggestive of renal ischemia secondary to consumptive coagulopathy. Intravenous infusion of Hemato polyvalent antivenom following experimental envenoming effectively prevented death and AKI in all mice, supporting its potential therapeutic use in envenoming cases.

Matched MeSH terms: Acute Kidney Injury/prevention & control*

Fulltext Acute renal failure and posterior reversible encephalopathy syndrome following multiple wasp stings: a case report

Loh HH, Tan CHH

Med J Malaysia, 2012 Feb;67(1):133-5.

PMID: 22582570 MyJurnal

Wasp stings can present in various ways, ranging from mild self-limiting illness to severe multi organ failure with a potentially fatal outcome. We report a case of multiple wasp stings leading to acute renal failure needing prolonged dialysis support and posterior reversible encephalopathy syndrome.

Matched MeSH terms: Acute Kidney Injury/etiology*

Fulltext End stage renal failure mimicking as acute renal failure in developing countries

Lal C, Gupta A, Khaira A, Tiwari SC

Med J Malaysia, 2009 Jun;64(2):184.

PMID: 20058588

Sir, We here are highlighting the scenario of presentation of renal dysfunction in developing countries like India where a large number of patients present clinically as acute renal failure (ARF) but on thorough evaluation found to have advanced stages of chronic kidney disease (CKD stages 4 and 5)1 . Historically these patients are symptomatic for few days prior to presenting. Preceding slight unwell-ness is ignored either by patient or his family physician. They are often being treated with non-specific medications like analgesics and multivitamins which act as placebo. Iron deficiency anemia is unevaluated for a renal cause. Non-standardized laboratories under diagnose early CKD. Ultrasound imaging too is of poor quality. All the more there are no nationalized health screening programmes. To add to the dismal scenario, at the tertiary care centres they are initially admitted as ARF, with a hope of significant recovery. But later on they turn out to be CKD 5.

Matched MeSH terms: Acute Kidney Injury/diagnosis*

Fulltext Adult pyloric stenosis masquerading as acute renal failure

Siow SL, Wong CM, Sohail M

Med J Malaysia, 2009 Jun;64(2):168-9.

PMID: 20058581 MyJurnal

Gastric outlet obstruction and in particular, pyloric stenosis, is relatively common in developing countries. Acute clinical presentation is often the manifestation of biochemical and electrolyte changes. The presence of metabolic alkalosis in combination with acute renal failure should alarm us to the possibility of adult pyloric stenosis. We report a case of adult pyloric stenosis that presented as acute renal failure and discuss its pathophysiology.

Matched MeSH terms: Acute Kidney Injury/etiology*

Fulltext Acute renal failure in the same hospital ten years apart

Chow YW, Lim BB, Hooi LS

Med J Malaysia, 2007 Mar;62(1):27-32.

PMID: 17682566 MyJurnal

A three month prospective study was carried out in 1994 (8/3/94 - 7/6/94) and late 2004/early 2005 (24/11/2004 - 15/2/2005) among patients with acute renal failure (ARF) (serum creatinine > 0.200 mmol/1). Incidence of ARF had increased from 0.48% (78/16,418) to 1.1% (211/18,697) of admissions between 1994 and 2004. Two thirds of patients were male. Mean age was 57.7 +/- 20.1 years in 1994 and 55.6 +/- 17.8 years in 2004. No difference was noted in causative factors, rate of oliguric ARF (about 10%) and mean peak urea and creatinine. The cause was pre-renal failure in 43.6% in 1994 and 53.5% in 2004. The second commonest cause was sepsis with 41% in 1994 and 37.9% in 2004. One in six patients needed dialysis and peritoneal dialysis was the main dialysis modality (69.2% and 74.3%). Mortality was 56.4% in 1994 and 44.5% in 2004. A quarter of deaths occurred within two days of admission due to severe underlying illness. Mortality among non-oliguric patients decreased from 52.9% in 1994 to 37.0% in 2004 (p = 0.04); for patients from intensive care units it was 78.3% in 1994 and 68.5% in 2004.

Matched MeSH terms: Acute Kidney Injury/etiology; Acute Kidney Injury/mortality*; Acute Kidney Injury/therapy

Fulltext Dialysis disequilibrium syndrome: A preventable fatal acute complication

Mah DY, Yia HJ, Cheong WS

Med J Malaysia, 2016 04;71(2):91-2.

PMID: 27326954 MyJurnal

Dialysis disequilibrium syndrome (DDS) is a neurological disorder with varying severity that is postulated to be associated with cerebral oedema. We described a case of DDS resulting in irreversible brain injury and death following acute haemodialysis. A 13-year-old male with no past medical history and weighing 30kg, presented to hospital with severe urosepsis complicated by acute kidney injury (Creatinine 1422mmol/L; Urea 74.2mmol/L, Potassium 6.3mmol/L, Sodium 137mmol/L) and severe metabolic acidosis (pH 6.99, HC03 1.7mmol/L). Chest radiograph was normal. Elective intubation was done for respiratory distress. Acute haemodialysis performed due to refractory metabolic acidosis. Following haemodialysis, he became hypotensive which required inotropes. His Riker's score was low with absence of brainstem reflexes after withholding sedation. CT Brain showed generalised cerebral oedema consistent with global hypoxic changes involving the brainstem. The symptoms of DDS are caused by water movement into the brain causing cerebral oedema. Two theories have been proposed: reverse osmotic shift induced by urea removal and a fall in cerebral intracellular pH. Prevention is the key to the management of DDS. It is important to identify high risk patients and haemodialysis with reduced dialysis efficacy and gradual urea reduction is recommended. Patients who are vulnerable to DDS should be monitored closely. Low efficiency haemodialysis is recommended. Acute peritoneal dialysis might be an alternative option, but further studies are needed.

Matched MeSH terms: Acute Kidney Injury*

Fulltext Acute renal failure requiring dialysis--a 5 year series

Hooi LS

Med J Malaysia, 1997 Sep;52(3):251-6.

PMID: 10968094

A retrospective review of 246 patients with established acute renal failure (ARF) needing dialysis from 1990-1994 is reported from Hospital Sultanah Aminah, Johor Bahru. Peritoneal dialysis was more commonly used than haemodialysis or haemofiltration. Patients on mechanical ventilation in Intensive Care Unit (ICU) who were hypercatabolic and fluid overloaded were treated with haemofiltration. Males outnumbered females by a ratio of 1.5:1. The majority were Malays (61.4%). Most patients were from the district of Johor Bahru, but 41.5% were from other districts in the Johor state. The mean age was 47.1 years (SD 18.2). The ARF was caused by acute tubular necrosis in 55.3%, post-renal obstruction in 22.8%, nephrotoxins in 5.7% and other causes in 16.2%. The proportions of patients referred from the medical, surgical and obstetric and gynaecology units were 50.8%, 45.5% and 3.7% respectively. The mortality rate was 48%. Patients with established ARF should be dialysed early as they tolerate uraemia poorly. Prevention is by prompt treatment of patients with sepsis, avoidance of hypovolaemia and nephrotoxic drugs.

Matched MeSH terms: Acute Kidney Injury/etiology; Acute Kidney Injury/mortality; Acute Kidney Injury/therapy*

Fulltext Acute renal failure in falciparum malaria

Segasothy M, Swaminathan M, Kong NC

Med J Malaysia, 1994 Dec;49(4):412-5.

PMID: 7674979

We report two patients who had cerebral malaria, heavy parasitemia, hyperbilirubinemia, hypercatabolism with rapid rises of blood urea and serum creatinine and acute renal failure. There was no evidence of intravascular hemolysis. Renal biopsy was consistent with acute tubular necrosis. Both patients responded to treatment with intravenous quinine and dialysis.

Matched MeSH terms: Acute Kidney Injury/etiology*

Fulltext Paraquat poisoning: a clinical and epidemiological review of 30 cases

Chan KW, Cheong IKS

Med J Malaysia, 1982 Sep;37(3):227-30.

PMID: 7177004

There is evidence to show that paraquat poisoning is alarmingly common in Malaysia. This paper reviews 30 cases of paraquat poisoning seen at the General Hospital, Kuala Lumpur from 1978 to 1979 inclusive. Preventive measures and management are discussed. It is felt that tighter legislation to control its use in agriculture should be implemented now.

Matched MeSH terms: Acute Kidney Injury/chemically induced

Fulltext Bilateral stones and renal failure

Suleiman AB, Awang H, Proehoeman F

Med J Malaysia, 1981 Mar;36(1):14-6.

PMID: 7321931

The clinical presentation of patients with bilateral stones is discussed. The majority of patients presenting to the Nephrology Unit were in renal failure. Aggressive medical treatment allowed
diagnostic procedures and definitive surgery to be performed in uraemic patients. Most patients presenting in uraemia benefitted from treatment.
Study Site: Urology Unit, General Hospital, Kuala Lumpur, Malaysia

Matched MeSH terms: Acute Kidney Injury/etiology*; Acute Kidney Injury/therapy

Fulltext Intravenous urogram in acute renal failure

Md Ghazali AR, Suleiman AB, Md Alif AK, Thillakanu A

Med J Malaysia, 1981 Jun;36(2):104-7.

PMID: 7343817

Thirty-four case notes of patients in acute renal failure on whom intravenous urograms (IVU) were performed, were reviewed. All patients received high doses of Conray 420 or Urotrast. Delayed films up to 48 hours were routinely done in patients suspected of having obstruction. There were no side effects of the intravenous urogram examination. IVU with high dose contrast material and nephrogram are helpful in differentiating the cause of the acute renal failure, and in excluding outflow obstruction.

Matched MeSH terms: Acute Kidney Injury/radiography*

Fulltext Acute renal failure due to multiple bee stings--case reports

Ramanathan M, Lam HS

Med J Malaysia, 1990 Dec;45(4):344-6.

PMID: 2152058

This report deals with a father and his son who developed acute renal failure following multiple bee stings. The renal lesion in these patients appears to be due to rhabdomyolysis caused by the bee venom. The other mechanisms are also discussed. The need for clinicians to be aware of acute renal failure as a complication of bee stings is stressed.

Matched MeSH terms: Acute Kidney Injury/etiology*

Fulltext 16 cases of acute renal failure due to leptospirosis

Tan DSK, Suleiman AB, Jeyaindran S

Med J Malaysia, 1986 Jun;41(2):152-5.

PMID: 3821611

A study was carried out on 16 cases of leptospirosis with acute renal failure (ARF) detected in adult patients admitted into the Medical and Nephrology wards of the General Hospital, Kuala Lumpur, over a four-year period from 1980 to 1983. Most of the cases were male, Malays and older adults. The predominant infecting serovars were L. celledoni (of the serogroup L. javanica and L. pomona (of the L. pomona serogroup]. All the cases survived, including those who required peritoneal dialysis. The sensitised erythrocyte lysis (SEL) antibody prevalence rate of the chronic renal failure cases (10.4%) was found to be similar to that of the healthy population in West Malaysia (12. 7%), confirming the observation by other workers that leptospirosis is not an important cause of chronic renal failure.

Matched MeSH terms: Acute Kidney Injury/etiology*

Fulltext Extensive crescent formation in idiopathic membranous glomerulonephritis. A case report

Cheong IK, Chong SM, Singh N, Suleiman AB

Med J Malaysia, 1981 Mar;36(1):8-10.

PMID: 7321940

We report this 21 years old Indian male with the nephrotic syndrome due to membranous nephropathy who later developed numerous epithelial crescents leading to a rapid loss of renal function. The pathogenesis of the crescentic transformation in this type of glomerulopathy is discussed.

Matched MeSH terms: Acute Kidney Injury/etiology

A case of co-infection: First reported case of severe plasmodium knowlesi malaria and dengue co-infection in Sabah, Malaysia

Wong CK, Md Fuzi NH, Baherin MF, Lee HG

Med J Malaysia, 2020 03;75(2):171-172.

PMID: 32281602

We report a rare case of severe Plasmodium knowlesi malaria and dengue co-infection in a 36-year-old lady with hyperparasitaemia, metabolic acidosis, haemolysis and acute kidney injury. She was in shock requiring inotropic support and elective intubation. She had pericardial tamponade which necessitate pericardiocentesis to allow for haemodynamic stability during haemodialysis. She underwent haemodialysis, was ventilated for six days and stayed in hospital for 29 days. She was discharged home well with almost complete renal recovery. Physicians must have a high degree of suspicion for dengue co-infection in malaria patients with plasma leakage such as pericardial effusion to allow for prompt management.

Matched MeSH terms: Acute Kidney Injury

Effect of kidney ischemia/reperfusion injury on proliferation, apoptosis, and cellular senescence in acute kidney injury in mice

Sari FT, Sari FT, Sari FT, Arfian N, Sari DCR

Med J Malaysia, 2020 05;75(Suppl 1):20-23.

PMID: 32471965

INTRODUCTION: Kidney ischemia/reperfusion injury (IRI) is the leading cause of acute kidney injury (AKI). Kidney IRI demonstrated apoptosis of epithelial cells in acute phase followed by proliferation of interstitial cells in chronic episode, and cellular senescence may contribute to development of AKI, however, its occurrence within acute or chronic episodes is still not completely understood.

METHODS: Kidney IRI was performed with bilateral pediculus clamping in Swiss Background mice (3 months, 30-40g). Mice were euthanised on day one (I/R1, n=6), day eight (I/R8, n=6), and day twelve (I/R12, n=6) to exam acute and chronic episodes. Sham operation procedure was performed in the control. Tubular injury was assessed based on periodic acid- Schift (PAS) staining. Reverse transcriptase PCR (RT-PCR) was done to quantify mRNA expression of Bax, Bcl-2, and p16. Immunohistostaining (IHC) was performed to examine localisation of apoptosis (p53) and proliferation (Bcl-2).

RESULTS: RT-PCR analysis showed upregulation of mRNA expression of Bcl-2, Bax, and p16 (p<0.05). The data showed that ischemia/reperfusion induces upregulation of Bax (p=0.20), Bcl-2 (p=0.45), p16 (p=0.18). Apoptosis and proliferation occurred in the epithelial cells in acute episodes, but occurred in interstitial areas in chronic episodes.

CONCLUSIONS: Ischemia/reperfusion injury induces upregulation proliferation, apoptosis, and cellular senescence in acute kidney injury. Apoptosis reached its peak on day 1, proliferation on day 8, and cellular senescence on day 12.

Matched MeSH terms: Acute Kidney Injury/etiology*; Acute Kidney Injury/physiopathology*

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