Displaying publications 1 - 20 of 133 in total

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  1. Development of predisposition, injury, response, organ failure model for predicting acute kidney injury in acute on chronic liver failure
    Maiwall R, Sarin SK, Kumar S, Jain P, Kumar G, Bhadoria AS, et al.
    Liver Int, 2017 Oct;37(10):1497-1507.
    PMID: 28393476 DOI: 10.1111/liv.13443
    BACKGROUND AND AIM: There is limited data on predictors of acute kidney injury in acute on chronic liver failure. We developed a PIRO model (Predisposition, Injury, Response, Organ failure) for predicting acute kidney injury in a multicentric cohort of acute on chronic liver failure patients.

    PATIENTS AND METHODS: Data of 2360 patients from APASL-ACLF Research Consortium (AARC) was analysed. Multivariate logistic regression model (PIRO score) was developed from a derivation cohort (n=1363) which was validated in another prospective multicentric cohort of acute on chronic liver failure patients (n=997).

    RESULTS: Factors significant for P component were serum creatinine[(≥2 mg/dL)OR 4.52, 95% CI (3.67-5.30)], bilirubin [(<12 mg/dL,OR 1) vs (12-30 mg/dL,OR 1.45, 95% 1.1-2.63) vs (≥30 mg/dL,OR 2.6, 95% CI 1.3-5.2)], serum potassium [(<3 mmol/LOR-1) vs (3-4.9 mmol/L,OR 2.7, 95% CI 1.05-1.97) vs (≥5 mmol/L,OR 4.34, 95% CI 1.67-11.3)] and blood urea (OR 3.73, 95% CI 2.5-5.5); for I component nephrotoxic medications (OR-9.86, 95% CI 3.2-30.8); for R component,Systemic Inflammatory Response Syndrome,(OR-2.14, 95% CI 1.4-3.3); for O component, Circulatory failure (OR-3.5, 95% CI 2.2-5.5). The PIRO score predicted acute kidney injury with C-index of 0.95 and 0.96 in the derivation and validation cohort. The increasing PIRO score was also associated with mortality (P

    Matched MeSH terms: Acute Kidney Injury/blood; Acute Kidney Injury/diagnosis; Acute Kidney Injury/etiology*; Acute Kidney Injury/mortality
  2. "Is it possible to prevent acute kidney injury in the patients who underwent contrast medium?"
    Alharazy SM, Kong N, Saidin R, Gafor AH, Maskon O, Mohd M, et al.
    Angiology, 2014 Mar;65(3):225-6.
    PMID: 23564021 DOI: 10.1177/0003319713483544
    Matched MeSH terms: Acute Kidney Injury/chemically induced*; Acute Kidney Injury/prevention & control*
  3. Fulltext Severe Plasmodium knowlesi malaria in a tertiary care hospital, Sabah, Malaysia
    William T, Menon J, Rajahram G, Chan L, Ma G, Donaldson S, et al.
    Emerg Infect Dis, 2011 Jul;17(7):1248-55.
    PMID: 21762579 DOI: 10.3201/eid1707.101017
    The simian parasite Plasmodium knowlesi causes severe human malaria; the optimal treatment remains unknown. We describe the clinical features, disease spectrum, and response to antimalarial chemotherapy, including artemether-lumefantrine and artesunate, in patients with P. knowlesi malaria diagnosed by PCR during December 2007-November 2009 at a tertiary care hospital in Sabah, Malaysia. Fifty-six patients had PCR-confirmed P. knowlesi monoinfection and clinical records available for review. Twenty-two (39%) had severe malaria; of these, 6 (27%) died. Thirteen (59%) had respiratory distress; 12 (55%), acute renal failure; and 12, shock. None experienced coma. Patients with uncomplicated disease received chloroquine, quinine, or artemether-lumefantrine, and those with severe disease received intravenous quinine or artesunate. Parasite clearance times were 1-2 days shorter with either artemether-lumefantrine or artesunate treatment. P. knowlesi is a major cause of severe and fatal malaria in Sabah. Artemisinin derivatives rapidly clear parasitemia and are efficacious in treating uncomplicated and severe knowlesi malaria.
    Matched MeSH terms: Acute Kidney Injury/physiopathology
  4. A case of minimal change disease complicated by acute kidney injury in systemic lupus erythematosus
    Wong KW
    Saudi J Kidney Dis Transpl, 2014 Nov;25(6):1308-11.
    PMID: 25394457
    Matched MeSH terms: Acute Kidney Injury/diagnosis; Acute Kidney Injury/etiology*; Acute Kidney Injury/therapy
  5. Nephropathy in Malaria
    Wolthuis FH
    Trop Geogr Med, 1968 Mar;20(1):21-7.
    PMID: 4868143
    Matched MeSH terms: Acute Kidney Injury/etiology*
  6. Fulltext A Rare Cause of Acute Kidney Injury: Primary Renal Lymphoma in a Patient with Human Immunodeficiency Virus
    Mustafar R, Kamaruzaman L, Chien BH, Yahaya A, Mohd Nasir N, Mohd R, et al.
    Case Rep Med, 2018;2018:8425985.
    PMID: 30186328 DOI: 10.1155/2018/8425985
    We reported a case of primary renal lymphoma (PRL) presented with non-oliguric acute kidney injury and bilateral kidney infiltrates in an individual with human immunodeficiency virus (HIV) disease. Acute kidney injury secondary to lymphoma infiltrates is very rare (less than 1% of hematological malignancy). A 37-year-old gentleman with underlying human immunodeficiency virus (HIV) disease was on combined antiretroviral therapy since diagnosis. He presented to our center with uremic symptoms and gross hematuria. Clinically, bilateral kidneys massively enlarged and were ballotable. Blood investigations showed hemoglobin of 3.7 g/L, urea of 65.6 mmol/L, and serum creatinine of 1630 µmol/L with hyperkalemia and metabolic acidosis. An urgent hemodialysis was initiated, and he was dependent on regular hemodialysis subsequently. Computed tomography renal scan showed diffuse nonenhancing hypodense lesion in both renal parenchyma. Diagnosis of diffuse large B cell lymphoma with germinal center type, CD20 positive, and proliferative index 95% was confirmed via renal biopsy, and there was no bone marrow infiltrates. Unfortunately, the patient succumbs prior to initiation of chemotherapy.
    Matched MeSH terms: Acute Kidney Injury
  7. Fulltext Risk of acute kidney injury and hyponatremia in long-distance runners
    Abdullah R., Wan Md Adnan W.A.H.
    JUMMEC, 2018;21(2):4-9.
    MyJurnal
    Long-distance running has gathered some momentum among health-conscious participants. However, some
    studies have revealed association between long-distance running and development of acute kidney injury.
    Although the impact usually lasts only for a few days after the event, some participants have been admitted for
    severe acute kidney injury, the minority of which require dialysis treatment. The mechanisms underlying the
    injury may include dehydration, development of rhabdomyolysis, heat stroke and concomitant use of NSAIDS.
    Unfortunately, there is no long-term follow-up study to determine the long-term effect on kidney function.
    Acute hyponatremia may develop in a significant proportion of long-distance runners. Majority of them were
    asymptomatic but a few fatal cases which were supposedly due to cerebral oedema have been reported.
    Excessive intake of hypotonic drinks, excessive sweating and secretion of non-osmotic antidiuretic hormone
    have been postulated to be the causes of hyponatremia. This mini review will discuss the pathophysiology of
    the development of acute kidney injury and hyponatremia. It will also discuss the prevention and treatment
    of both conditions.
    Matched MeSH terms: Acute Kidney Injury
  8. Fulltext Severe Plasmodium knowlesi with dengue coinfection
    Che Rahim MJ, Mohammad N, Besari AM, Wan Ghazali WS
    BMJ Case Rep, 2017 Feb 20;2017.
    PMID: 28219910 DOI: 10.1136/bcr-2016-218480
    We report a case of severe Plasmodium knowlesi and dengue coinfection in a previously healthy 59-year-old Malay man who presented with worsening shortness of breath, high-grade fever with chills and rigors, dry cough, myalgia, arthralgia, chest discomfort and poor appetite of 1 week duration. There was a history mosquito fogging around his neighbourhood in his hometown. Further history revealed that he went to a forest in Jeli (northern part of Kelantan) 3 weeks prior to the event. Initially he was treated as severe dengue with plasma leakage complicated with type 1 respiratory failure as evidenced by positive serum NS1-antigen and thrombocytopenia. Blood for malarial parasite (BFMP) was sent for test as there was suspicion of malaria due to persistent thrombocytopenia despite recovering from dengue infection and the presence of a risk factor. The test revealed high count of malaria parasite. Confirmatory PCR identified the parasite to be Plasmodium knowlesi Intravenous artesunate was administered to the patient immediately after acquiring the BFMP result. Severe malaria was complicated with acute kidney injury and septicaemic shock. Fortunately the patient made full recovery and was discharged from the ward after 2 weeks of hospitalisation.
    Matched MeSH terms: Acute Kidney Injury/parasitology
  9. Fulltext Associated factors of dialysis-dependence among acute kidney injury patients in intensive care unit
    Kamaruddin M, Hamid SA, Adnan AS, Naing NN, Wan Adnan WN
    Saudi J Kidney Dis Transpl, 2019 11 8;30(5):1131-1136.
    PMID: 31696852 DOI: 10.4103/1319-2442.270269
    Acute kidney injury (AKI) is a common problem in hospitals and many end up requiring dialysis. The aim was to identify the associated factors of dialysis-dependent of AKI patients admitted to the intensive care units (ICUs). A retrospective cohort study was conducted where a list of 121 AKI patients admitted to ICU in Hospital Universiti Sains Malaysia was retrospectively reviewed. AKI patients aged below 18 years old, had kidney transplantation or chronic dialysis before ICU admission and had incomplete medical record were excluded from the study. Simple and multiple logistic regression analysis were used. The mean [standard deviation (SD)] age of patients was 56 (17.15) years. Majority of patients were males (63.2%) and Malay ethnic (54.1%). 49.3% of patients were in stage I, 48.3% in stage II and 76.2% in stage III. The mean (SD) duration of patients stayed in ICU was 7 days (6.92) for non-dialysis dependent and 12 days (8.37) for dialysis-dependent. The associated factors were male gender [adjusted odds ratio (OR): 3.68; 95% confidence interval [CI]: 1.53, 8.86; P = 0.004], AKI Stage III (adjusted OR: 4.51; 95% CI: 1.28, 15.91; P = 0.019), admitted in ICU (adjusted OR: 3.05; 95% CI: 1.28, 7.29; P = 0.012), and longer length of stay (adjusted OR: 1.10; 95% CI: 1.03, 1.18; P = 0.003). The factors influence of dialysis-requiring AKI were observed to be dependent on the male male gender, suffer from the advanced stage (Stage III), admitted to the ICU and had a longer length of stay in ICU. Therefore, it is important for physicians to identify patients who are at high risk of developing AKI and implement preventive strategies.
    Matched MeSH terms: Acute Kidney Injury/diagnosis; Acute Kidney Injury/etiology; Acute Kidney Injury/physiopathology; Acute Kidney Injury/therapy*
  10. 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*
  11. Association of ethnicity and acute kidney injury after cardiac surgery in a South East Asian population
    Chew ST, Mar WM, Ti LK
    Br J Anaesth, 2013 Mar;110(3):397-401.
    PMID: 23171723 DOI: 10.1093/bja/aes415
    BACKGROUND: Postoperative acute kidney injury (AKI) is a frequent and serious complication after cardiac surgery. Clinical factors alone have failed to accurately predict the incidence of AKI after cardiac surgery. Ethnicity has been shown to be a predictor of AKI in the Western population. We tested the hypothesis that ethnicity is an independent predictor of AKI in patients undergoing cardiac surgery in a South East Asian population.

    METHODS: A total of 1756 consecutive patients undergoing cardiac surgery were prospectively recruited. Among them, data of 1639 patients met the criteria for analysis. There were 1182 Chinese, 195 Indian, and 262 Malay patients. The main outcome was postoperative AKI, defined as a 25% or greater increase in preoperative to a maximum postoperative serum creatinine level within 3 days after surgery.

    RESULTS: Five hundred and seventy-nine patients (35.3%) developed AKI after cardiac surgery. Ethnicity was shown to be an independent predictor of AKI after cardiac surgery with Indians and Malays having a higher risk of developing AKI when compared with Chinese patients (odds ratio: Indian vs Chinese 1.44, Malay vs Chinese 1.51).

    CONCLUSIONS: Indians and Malays have a higher risk of developing AKI after cardiac surgery than Chinese in a South East Asian population. Ethnicity was shown to be an independent predictor of AKI after cardiac surgery.

    Matched MeSH terms: Acute Kidney Injury/epidemiology*
  12. Elucidation of the novel role of ethnicity and diabetes in poorer outcomes after cardiac surgery in a multiethnic Southeast Asian cohort
    Moorthy V, Liu W, Chan SP, Chew STH, Ti LK
    J Diabetes, 2020 Jan;12(1):58-65.
    PMID: 31210000 DOI: 10.1111/1753-0407.12961
    BACKGROUND: Although diabetes is associated with ethnicity and worse cardiac surgery outcomes, no research has been done to study the effect of both diabetes and ethnicity on cardiac surgery outcomes in a multiethnic Southeast Asian cohort. Hence, this study aimed to delineate the association of ethnicity on outcomes after cardiac surgery among diabetics in a multiethnic Southeast Asian population.

    METHODS: Perioperative data from 3008 adult patients undergoing elective cardiac surgery from 2008 to 2011 at the two main heart centers in Singapore was analyzed prospectively, and confirmatory analysis was conducted with the generalized structural equation model.

    RESULTS: Diabetes was significantly associated with postoperative acute kidney injury (AKI) and postoperative hyperglycemia. Postoperative AKI, Malay ethnicity, and blood transfusion were associated with postoperative dialysis. Postoperative AKI and blood transfusion were also associated with postoperative arrhythmias. In turn, postoperative dialysis and arrhythmias increased the odds of 30-day mortality by 7.7- and 18-fold, respectively.

    CONCLUSIONS: This study identified that diabetes is directly associated with postoperative hyperglycemia and AKI, and indirectly associated with arrhythmias and 30-day mortality. Further, we showed that ethnicity not only affects the prevalence of diabetes, but also postoperative diabetes-related outcomes.

    Matched MeSH terms: Acute Kidney Injury/ethnology; Acute Kidney Injury/epidemiology*
  13. 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*
  14. Fulltext Risk of Preeclampsia and Pregnancy Complications in Women With a History of Acute Kidney Injury
    Tangren JS, Wan Md Adnan WAH, Powe CE, Ecker J, Bramham K, Hladunewich MA, et al.
    Hypertension, 2018 08;72(2):451-459.
    PMID: 29915020 DOI: 10.1161/HYPERTENSIONAHA.118.11161
    An episode of clinically recovered acute kidney injury (r-AKI) has been identified as a risk factor for future hypertension and cardiovascular disease. Our objective was to assess whether r-AKI was associated with future preeclampsia and other adverse pregnancy outcomes and to identify whether severity of AKI or time interval between AKI and pregnancy was associated with pregnancy complications. We conducted a retrospective cohort study of women who delivered infants between 1998 and 2016 at Massachusetts General Hospital. AKI was defined using the 2012 Kidney Disease Improving Global Outcomes laboratory criteria with subsequent clinical recovery (estimate glomerular filtration rate, >90 mL/min per 1.73 m2 before conception). AKI was further classified by severity (Kidney Disease Improving Global Outcomes stages 1-3) and time interval between AKI episode and the start of pregnancy. Women with r-AKI had an increased rate of preeclampsia compared with women without previous r-AKI (22% versus 9%; P<0.001). Infants of women with r-AKI were born earlier (gestational age, 38.2±3.0 versus 39.0±2.2 weeks; P<0.001) and were more likely to be small for gestational age (9% versus 5%; P=0.002). Increasing severity of r-AKI was associated with increased risk of preeclampsia for stages 2 and 3 AKI (adjusted odds ratio, 3.5; 95% confidence interval, 2.1-5.7 and adjusted odds ratio, 6.5; 95% confidence interval, 3.5-12.0, respectively), but not for stage 1 (adjusted odds ratio, 1.7; 95% confidence interval, 0.9-3.2). A history of AKI before pregnancy, despite apparent full recovery, was associated with increased risk of pregnancy complications. Severity and timing of the AKI episode modified the risk.
    Matched MeSH terms: Acute Kidney Injury/complications*; Acute Kidney Injury/epidemiology; Acute Kidney Injury/physiopathology
  15. The patient who had a picnic at a waterfall and presented with haemoptysis and renal failure
    Thiruventhiran T, Tan SY
    Nephrol Dial Transplant, 2000 May;15(5):727-8.
    PMID: 10809822
    Matched MeSH terms: Acute Kidney Injury/microbiology*
  16. Acute renal failure following multiple wasp stings
    Thiruventhiran T, Goh BL, Leong CL, Cheah PL, Looi LM, Tan SY
    Nephrol Dial Transplant, 1999 Jan;14(1):214-7.
    PMID: 10052513
    Matched MeSH terms: Acute Kidney Injury/etiology*; Acute Kidney Injury/pathology
  17. Fulltext Predictive factors for contrast-induced acute kidney injury in high-risk patients given N-acetylcysteine prophylaxis
    Poh WY, Omar MS, Tan HP
    Ann Saudi Med, 2018 8 6;38(4):269-276.
    PMID: 30078025 DOI: 10.5144/0256-4947.2018.269
    BACKGROUND: Contrast-induced acute kidney injury (CI-AKI) is rec.ognized as a common complication of radiographic contrast-enhanced procedures. N-acetylcysteine (NAC) is commonly prescribed, but CI-AKI can still develop despite NAC administration as prophylaxis.

    OBJECTIVE: Identify the predictive factors for development of CI-AKI in patients prescribed NAC.

    DESIGN: Prospective, cross-sectional.

    SETTING: A tertiary hospital in Malaysia.

    PATIENTS AND METHODS: All adult patients who were prescribed NAC for prevention of CI-AKI were identified through an NAC drug us.age monitoring card maintained by the inpatient pharmacy. The study was conducted from March to July 2017.

    MAIN OUTCOME MEASURES: Statistically significant predictive fac.tors for development of CI-AKI despite NAC administration.

    SAMPLE SIZE: 152 RESULTS: The most commonly recognized risk factors for CI-AKI present in the study population were renal impairment (n=131, 86.2%), anemia (n=107, 70.4%), and diabetes mellitus (n=90, 59.2%). Hydration therapy was initiated in 128 patients (84.2%) prior to the contrast-enhanced procedure. Sixty-one (40.1%) were treated with nephrotoxic medications concomitantly with NAC. Fifteen (9.9%) patients developed AKI. Hypotension (OR: 6.02; 95% CI 1.25-28.97) and use of high contrast volume (OR: 6.56; 95% CI: 1.41-30.64) significantly increased the odds for AKI. Prior hydration therapy (OR: 0.13; 95% CI 0.03-0.59) showed protective effects.

    CONCLUSION: The risk predictors identified for CI-AKI were hypotension, high contrast volume and prior hydration therapy.

    LIMITATION: May not have identified other confounding factors for development of CI-AKI.

    CONFLICT OF INTEREST: None.

    Matched MeSH terms: Acute Kidney Injury/chemically induced; Acute Kidney Injury/epidemiology; Acute Kidney Injury/prevention & control*
  18. 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*
  19. Fulltext Acute anuric renal failure following jering bean ingestion
    Wong JS, Ong TA, Chua HH, Tan C
    Asian J Surg, 2007 Jan;30(1):80-1.
    PMID: 17337378
    Djenkol beans or jering (Pithecellobium jeringa) is a traditional delicacy consumed by the local population in Malaysia. Jering poisoning or djenkolism is characterized by spasmodic pain, urinary obstruction and acute renal failure. The underlying pathology is an obstructive nephropathy, which is usually responsive to aggressive hydration and diuretic therapy. We present a case of djenkolism following ingestion of jering. The patient required urgent bilateral ureteric stenting following the failure of conservative therapy. Healthcare providers need to recognize djenkolism as a cause of acute renal failure and the public educated on this potential health hazard.
    Matched MeSH terms: Acute Kidney Injury/chemically induced*
  20. Researching outcomes in septic shock: Plenty to ponder
    Choudhary N, Magoon R, Suresh V
    Am J Emerg Med, 2024 May;79:228-229.
    PMID: 37996281 DOI: 10.1016/j.ajem.2023.11.015
    Matched MeSH terms: Acute Kidney Injury*
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