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  1. Fulltext Nephroprotective effects of Zingiber zerumbet Smith ethyl acetate extract against paracetamol-induced nephrotoxicity and oxidative stress in rats
    Abdul Hamid Z, Budin SB, Wen Jie N, Hamid A, Husain K, Mohamed J
    J Zhejiang Univ Sci B, 2012 Mar;13(3):176-85.
    PMID: 22374609 DOI: 10.1631/jzus.B1100133
    Paracetamol (PCM) overdose can cause nephrotoxicity with oxidative stress as one of the possible mechanisms mediating the event. In this study, the effects of ethyl acetate extract of Zingiber zerumbet rhizome [200 mg per kg of body weight (mg/kg) and 400 mg/kg] on PCM-induced nephrotoxicity were examined. Rats were divided into five groups containing 10 rats each. The control group received distilled water while other groups were treated with extract alone (400 mg/kg), PCM alone (750 mg/kg), 750 mg/kg PCM+200 mg/kg extract (PCM+200-extract), and 750 mg/kg PCM+400 mg/kg extract (PCM+400-extract), respectively, for seven consecutive days. The Z. zerumbet extract was given intraperitoneally concurrent with oral administration of PCM. Treatment with Z. zerumbet extract at doses of 200 and 400 mg/kg prevented the PCM-induced nephrotoxicity and oxidative impairments of the kidney, as evidenced by a significantly reduced (P<0.05) level of plasma creatinine, plasma and renal malondialdehyde (MDA), plasma protein carbonyl, and renal advanced oxidation protein product (AOPP). Furthermore, both doses were also able to induce a significant increment (P<0.05) of plasma and renal levels of glutathione (GSH) and plasma superoxide dismutase (SOD) activity. The nephroprotective effects of Z. zerumbet extract were confirmed by a reduced intensity of renal cellular damage, as evidenced by histological findings. Moreover, Z. zerumbet extract administered at 400 mg/kg was found to show greater protective effects than that at 200 mg/kg. In conclusion, ethyl acetate extract of Z. zerumbet rhizome has a protective role against PCM-induced nephrotoxicity and the process is probably mediated through its antioxidant properties.
    Matched MeSH terms: Acute Kidney Injury/chemically induced*; Acute Kidney Injury/metabolism; Acute Kidney Injury/pathology; Acute Kidney Injury/prevention & control*
  2. A Double-Blind Randomized Controlled Trial of High Cutoff Versus Standard Hemofiltration in Critically Ill Patients With Acute Kidney Injury
    Atan R, Peck L, Prowle J, Licari E, Eastwood GM, Storr M, et al.
    Crit Care Med, 2018 10;46(10):e988-e994.
    PMID: 30074491 DOI: 10.1097/CCM.0000000000003350
    OBJECTIVES: In critically ill patients with acute kidney injury receiving vasopressors, high cytokine levels may sustain the shock state. High cutoff hemofiltration achieves greater cytokine removal in ex vivo and in animal models and may reduce the duration of shock but may also increase albumin losses.

    DESIGN: This was a single-center double-blind randomized controlled trial comparing continuous venovenous hemofiltration-high cutoff to continuous venovenous hemofiltration-standard.

    SETTING: Tertiary care hospital in Australia.

    PATIENTS: Vasopressor-dependent patients in acute kidney injury who were admitted to the ICU.

    INTERVENTIONS: Norepinephrine-free time were calculated in critically ill vasopressor-dependent patients in acute kidney injury, randomized to either continuous venovenous hemofiltration-high cutoff or continuous venovenous hemofiltration-standard.

    MEASUREMENT AND MAIN RESULTS: A total of 76 patients were randomized with the following characteristics (continuous venovenous hemofiltration-high cutoff vs continuous venovenous hemofiltration-standard); median age of 65 versus 70 year, percentage of males 47% versus 68%, and median Acute Physiology and Chronic Health Evaluation scores of 25 versus 23.5. The median hours of norepinephrine-free time at day 7 were 32 (0-110.8) for continuous venovenous hemofiltration-high cutoff and 56 hours (0-109.3 hr) (p = 0.520) for continuous venovenous hemofiltration-standard. Inhospital mortality was 55.6% with continuous venovenous hemofiltration-high cutoff versus 34.2% with continuous venovenous hemofiltration-standard (adjusted odds ratio, 2.49; 95% CI, 0.81-7.66; p = 0.191). There was no significant difference in time to cessation of norepinephrine (p = 0.358), time to cessation of hemofiltration (p = 0.563), and filter life (p = 0.21). Serum albumin levels (p = 0.192) were similar and the median dose of IV albumin given was 90 grams (20-212 g) for continuous venovenous hemofiltration-high cutoff and 80 grams (15-132 g) for continuous venovenous hemofiltration-standard (p = 0.252).

    CONCLUSIONS: In critically ill patients with acute kidney injury, continuous venovenous hemofiltration-high cutoff did not reduce the duration of vasopressor support or mortality or change albumin levels compared with continuous venovenous hemofiltration-standard.

    Matched MeSH terms: Acute Kidney Injury/blood; Acute Kidney Injury/drug therapy*; Acute Kidney Injury/mortality*; Acute Kidney Injury/therapy
  3. 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*
  4. High cut-off hemofiltration versus standard hemofiltration: a pilot assessment of effects on indices of apoptosis
    Atan R, Virzi GM, Peck L, Ramadas A, Brocca A, Eastwood G, et al.
    Blood Purif., 2014;37(4):296-303.
    PMID: 25096908 DOI: 10.1159/000363220
    To measure plasma pro-apoptotic and pro-necrotic activity in severe acute kidney injury (AKI) patients within a randomized controlled trial of continuous veno-venous hemofiltration with high cut-off filters (CVVH-HCO) versus standard filters (CVVH-Std).
    Matched MeSH terms: Acute Kidney Injury/blood*; Acute Kidney Injury/therapy*
  5. Acute renal failure after a holiday in the tropics
    Guron G, Holmdahl J, Dotevall L
    Clin. Nephrol., 2006 Dec;66(6):468-71.
    PMID: 17176921 DOI: 10.5414/cnp66468
    A 20-year-old, previously healthy woman, presented with high fever, headache and myalgia 3 days after her return from a holiday in Southeast Asia. Laboratory data on admission demonstrated a pronounced increase in plasma creatinine, marked thrombocytopenia and moderately elevated liver aminotransferases. After having ruled out malaria, dengue fever was primarily suspected and supportive intravenous fluid therapy was initiated. Still, 1 day after admission, platelet counts dropped even further and she became anuric although she did not appear hypovolemic. On day 2 after admission, urine production commenced spontaneously and the patient slowly recovered. All laboratory test results had returned to normal approximately 2 months later. Serological analysis for dengue fever was negative. It turned out that the patient had been trekking in the jungle while in Thailand and we, therefore, analyzed serology for Leptospira spirochetes which was clearly positive. The patient was diagnosed with leptospirosis which is a serious condition associated with a high mortality when complicated by acute renal failure. Differential diagnoses in patients with acute renal failure and tropical infections are reviewed. The importance of early recognition of leptospirosis, and prompt treatment with antibiotics in suspected cases, is emphasized.
    Matched MeSH terms: Acute Kidney Injury/diagnosis; Acute Kidney Injury/etiology*
  6. Role of the renal sympathetic nervous system in mediating renal ischaemic injury-induced reductions in renal haemodynamic and excretory functions
    Salman IM, Ameer OZ, Sattar MA, Abdullah NA, Yam MF, Najim HS, et al.
    Pathology, 2010 Apr;42(3):259-66.
    PMID: 20350220 DOI: 10.3109/00313021003631304
    We investigated the role of renal sympathetic innervation in the deterioration of renal haemodynamic and excretory functions during the early post-ischaemic phase of renal ischaemia/reperfusion injury.
    Matched MeSH terms: Acute Kidney Injury/etiology; Acute Kidney Injury/physiopathology*
  7. Fulltext NMR and LCMS analytical platforms exhibited the nephroprotective effect of Clinacanthus nutans in cisplatin-induced nephrotoxicity in the in vitro condition
    Mahmod II, Ismail IS, Alitheen NB, Normi YM, Abas F, Khatib A, et al.
    BMC Complement Med Ther, 2020 Oct 22;20(1):320.
    PMID: 33092571 DOI: 10.1186/s12906-020-03067-3
    BACKGROUND: Clinacanthus nutans (C. nutans) Lind. locally known as Belalai Gajah or Sabah snake grass is a medicinal plant belonging to Acanthaceae family. In Asia, this plant is traditionally used for treating skin rashes, insects and snake bites, diabetes mellitus, fever and for diuretic effect. C. nutans has been reported to possess biological activities including anti-oxidant, anti-inflammation, anti-cancer, anti-diabetic and anti-viral activities.

    METHODS: Proton Nuclear Magnetic Resonance (1H NMR) and Liquid Chromatography Mass Spectroscopy (LCMS) coupled with multivariate data analysis were employed to characterize the metabolic variations of intracellular metabolites and the compositional changes of the corresponding culture media in rat renal proximal tubular cells (NRK-52E).

    RESULTS: NMR and LCMS analysis highlighted choline, creatine, phosphocholine, valine, acetic acid, phenylalanine, leucine, glutamic acid, threonine, uridine and proline as the main metabolites which differentiated the cisplatin-induced group of NRK-52E from control cells extract. The corresponding media exhibited lactic acid, glutamine, glutamic acid and glucose-1-phosphate as the varied metabolites. The altered pathways perturbed by cisplatin nephrotoxic on NRK-52E cells included changes in amino acid metabolism, lipid metabolism and glycolysis.

    CONCLUSION: The C. nutans aqueous extract (1000 μg/mL) exhibited the most potential nephroprotective effect against cisplatin toxicity on NRK-52E cell lines at 89% of viability. The protective effect could be seen through the changes of the metabolites such as choline, alanine and valine in the C. nutans pre-treated samples with those of the cisplatin-induced group.

    Matched MeSH terms: Acute Kidney Injury/chemically induced*; Acute Kidney Injury/drug therapy*
  8. Renal effects of an emergency department chloride-restrictive intravenous fluid strategy in patients admitted to hospital for more than 48 hours
    Yunos NM, Bellomo R, Taylor DM, Judkins S, Kerr F, Sutcliffe H, et al.
    Emerg Med Australas, 2017 Dec;29(6):643-649.
    PMID: 28597505 DOI: 10.1111/1742-6723.12821
    OBJECTIVE: Patients commonly receive i.v. fluids in the ED. It is still unclear whether the choice of i.v. fluids in this setting influences renal or patient outcomes. We aimed to assess the effects of restricting i.v. chloride administration in the ED on the incidence of acute kidney injury (AKI).

    METHODS: We conducted a before-and-after trial with 5008 consecutive ED-treated hospital admissions in the control period and 5146 consecutive admissions in the intervention period. During the control period (18 February 2008 to 17 August 2008), patients received standard i.v. fluids. During the intervention period (18 February 2009 to 17 August 2009), we restricted all chloride-rich fluids. We used the Kidney Disease: Improving Global Outcomes (KDIGO) staging to define AKI.

    RESULTS: Stage 3 of KDIGO-defined AKI decreased from 54 (1.1%; 95% confidence interval [CI] 0.8-1.4) to 30 (0.6%; 95% CI 0.4-0.8) (P = 0.006). The rate of renal replacement therapy did not change, from 13 (0.3%; 95% CI 0.2-0.4) to 8 (0.2%; 95% CI 0.1-0.3) (P = 0.25). After adjustment for relevant covariates, liberal chloride therapy remained associated with a greater risk of KDIGO stage 3 (hazard ratio 1.82; 95% CI 1.13-2.95; P = 0.01). On sensitivity assessment after removing repeat admissions, KDIGO stage 3 remained significantly lower in the intervention period compared with the control period (P = 0.01).

    CONCLUSION: In a before-and-after trial, a chloride-restrictive strategy in an ED was associated with a significant decrease in the incidence of stage 3 of KDIGO-defined AKI.

    Matched MeSH terms: Acute Kidney Injury/etiology; Acute Kidney Injury/prevention & control
  9. Intravenous Rituximab in Severe Refractory Primary Focal Segmental Glomerulosclerosis
    Wee Leng G, Mustafar R, Kamaruzaman L, Mohd R, Cader RA, Wei Yen K, et al.
    Acta Med Indones, 2018 Jul;50(3):237-243.
    PMID: 30333274
    Managing primary or even secondary glomerulonephritis remains a challenge to many nephrologists. In primary focal segmental glomerulosclerosis (FSGS) with heavy proteinuria, renin aldosterone system blockade and high dose of oral prednisolone is the mainstay of treatment. Other immunosuppressive medications like Cyclophosphamide, Cyclosporine A and Mycophenolate Mofetil (MMF) are warranted if a complete remission is not achieved.  We illustrate a case of 21 year old gentleman with primary FSGS that was difficult to achieve remission despite on high dose steroid and oral Cyclophosphamide. He was also not responsive to a combination of MMF and Cyclosporine A (CSA) and even throughout the therapy he developed significant steroid and CSA toxicity. He presented to our center with severe nephrotic syndrome and acute kidney injury requiring acute haemodialysis. Despite re-challenged him again on high dose prednisolone, total of 2.4g of intravenous Cyclophosphamide, and MMF, he failed to achieve remission. He was subsequently given intravenous Rituximab 500mg/weekly for 4 doses and able to attained remission for 1 year. He relapsed again and a second course of Rituximab 500mg/weekly for 6 doses were given to attain remission. This case demonstrates the difficulty in managing refractory steroid dependent FSGS and we found that Rituximab is proven beneficial in this case to induce remission.
    Matched MeSH terms: Acute Kidney Injury/complications; Acute Kidney Injury/therapy*
  10. Fulltext Apocynin and catalase prevent hypertension and kidney injury in Cyclosporine A-induced nephrotoxicity in rats
    Tan YC, Abdul Sattar M, Ahmeda AF, Abdul Karim Khan N, Murugaiyah V, Ahmad A, et al.
    PLoS One, 2020;15(4):e0231472.
    PMID: 32298299 DOI: 10.1371/journal.pone.0231472
    Oxidative stress is involved in the pathogenesis of a number of diseases including hypertension and renal failure. There is enhanced expression of nicotinamide adenine dinucleotide (NADPH oxidase) and therefore production of hydrogen peroxide (H2O2) during renal disease progression. This study investigated the effect of apocynin, an NADPH oxidase inhibitor and catalase, an H2O2 scavenger on Cyclosporine A (CsA) nephrotoxicity in Wistar-Kyoto rats. Rats received CsA (25mg/kg/day via gavage) and were assigned to vehicle, apocynin (2.5mmol/L p.o.), catalase (10,000U/kg/day i.p.) or apocynin plus catalase for 14 days. Renal functional and hemodynamic parameters were measured every week, and kidneys were harvested at the end of the study for histological and NADPH oxidase 4 (NOX4) assessment. Oxidative stress markers and blood urea nitrogen (BUN) were measured. CsA rats had higher plasma malondialdehyde (by 340%) and BUN (by 125%), but lower superoxide dismutase and total antioxidant capacity (by 40%, all P<0.05) compared to control. CsA increased blood pressure (by 46mmHg) and decreased creatinine clearance (by 49%, all P<0.05). Treatment of CsA rats with apocynin, catalase, and their combination decreased blood pressure to near control values (all P<0.05). NOX4 mRNA activity was higher in the renal tissue of CsA rats by approximately 63% (P<0.05) compared to controls but was reduced in apocynin (by 64%), catalase (by 33%) and combined treatment with apocynin and catalase (by 84%) compared to untreated CsA rats. Treatment of CsA rats with apocynin, catalase, and their combination prevented hypertension and restored renal functional parameters and tissue Nox4 expression in this model. NADPH inhibition and H2O2 scavenging is an important therapeutic strategy during CsA nephrotoxicity and hypertension.
    Matched MeSH terms: Acute Kidney Injury/chemically induced*; Acute Kidney Injury/prevention & control
  11. Fulltext Acute renal failure following the use of rosiglitazone in a chronic kidney disease patient
    Abdul Ghani R, Zainudin S, Kamaruddin NA, Kong NC
    Singapore Med J, 2009 Jan;50(1):e32-4.
    PMID: 19224067
    Drug-induced acute interstitial nephritis is a well-recognised and important reversible cause of acute renal failure. Peroxisome-proliferator activated receptor-gamma agonists, such as rosiglitazone, have been proven to be safe in chronic kidney disease patients. We describe a 65-year-old man with long-standing diabetes mellitus and hypertension, presenting with a five-day history of fluid overload and uraemic symptoms. There was no ingestion of analgesics, alternative medicine and other nephrotoxic drugs, the only new prescription being rosiglitazone, which was commenced during his last clinic follow-up two weeks prior to presentation. He required haemodialysis with minimal improvement in renal profile, despite cessation of the offending drug. Renal biopsy revealed findings consistent with acute interstitial nephritis. An episode of upper gastrointestinal bleeding with bleeding duodenal ulcer limited the use of steroids. He was treated with a course of mycophenolate mofetil which showed good gradual response and he remained stable with residual renal impairment.
    Matched MeSH terms: Acute Kidney Injury/chemically induced*; Acute Kidney Injury/drug therapy
  12. 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
  13. Fulltext The clinical utility window for acute kidney injury biomarkers in the critically ill
    Ralib AM, Pickering JW, Shaw GM, Than MP, George PM, Endre ZH
    Crit Care, 2014;18(6):601.
    PMID: 25366893 DOI: 10.1186/s13054-014-0601-2
    INTRODUCTION: Acute Kidney Injury (AKI) biomarker utility depends on sample timing after the onset of renal injury. We compared biomarker performance on arrival in the emergency department (ED) with subsequent performance in the intensive care unit (ICU).
    METHODS: Urinary and plasma Neutrophil Gelatinase-Associated Lipocalin (NGAL), and urinary Cystatin C (CysC), alkaline phosphatase, γ-Glutamyl Transpeptidase (GGT), α- and π-Glutathione S-Transferase (GST), and albumin were measured on ED presentation, and at 0, 4, 8, and 16 hours, and days 2, 4 and 7 in the ICU in patients after cardiac arrest, sustained or profound hypotension or ruptured abdominal aortic aneurysm. AKI was defined as plasma creatinine increase ≥ 26.5 μmol/l within 48 hours or ≥ 50% within 7 days.
    RESULTS: n total, 45 of 77 patients developed AKI. Most AKI patients had elevated urinary NGAL, and plasma NGAL and CysC in the period 6 to 24 hours post presentation. Biomarker performance in the ICU was similar or better than when measured earlier in the ED. Plasma NGAL diagnosed AKI at all sampling times, urinary NGAL, plasma and urinary CysC up to 48 hours, GGT 4 to 12 hours, and π-GST 8 to 12 hours post insult. Thirty-one patients died or required dialysis. Peak 24-hour urinary NGAL and albumin independently predicted 30-day mortality and dialysis; odds ratios 2.87 (1.32 to 6.26), and 2.72 (1.14 to 6.48), respectively. Urinary NGAL improved risk prediction by 11% (IDI event of 0.06 (0.002 to 0.19) and IDI non-event of 0.04 (0.002 to 0.12)).
    CONCLUSION: Early measurement in the ED has utility, but not better AKI diagnostic performance than later ICU measurement. Plasma NGAL diagnosed AKI at all time points. Urinary NGAL best predicted mortality or dialysis compared to other biomarkers.
    TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ACTRN12610001012066. Registered 12 February 2010.
    Matched MeSH terms: Acute Kidney Injury/blood*; Acute Kidney Injury/diagnosis; Acute Kidney Injury/urine*
  14. Transcription profile of genes affected in response to pathological changes in drug-induced rat model of acute kidney injury
    Habib R, Begum S, Alam G, Ali A, Khan I, Waseem M, et al.
    Ren Fail, 2015 Aug;37(7):1225-31.
    PMID: 26114661 DOI: 10.3109/0886022X.2015.1057801
    The objective of the present study was to examine the changes in the expression profile of certain genes in rat model of gentamicin-induced acute kidney injury (AKI) and to see whether time period and routes of administration affect their expression levels.
    Matched MeSH terms: Acute Kidney Injury/chemically induced*; Acute Kidney Injury/genetics*; Acute Kidney Injury/pathology*
  15. Fulltext Plasma Cystatin C and estimates of Glomerular filtration rate using Cystatin C independently diagnose acute kidney injury in critically ill patients with Sepsis
    Azrina Md Ralib, Iqbalmunawwir Ab Rashid, Nur Aisyah Ishak, Suhaila Nanyan, Nur Fariza Ramly, Mohd Basri Mat Nor
    International Medical Journal Malaysia, 2017;16(11):8-8.
    MyJurnal
    Plasma Cystatin C (CysC) is as an early functional marker for acute kidney
    injury. Estimates of glomerular filtration rate using CysC (eGFRCysC) has been used in
    some clinical setting. We evaluated the utility of CysC and eGFRCysC in diagnosing acute
    kidney injury (AKI) and predicting death in critically ill patients with sepsis. (Copied from article).
    Matched MeSH terms: Acute Kidney Injury
  16. Assessment of antiviral and antibiotic combination treatment in influenza-A H1N1 induced acute kidney injury among hospitalized patients
    Ishaqui AA, Khan AH, Syed Sulaiman SA, Alsultan MT, Khan I, Al Nami H
    Pak J Pharm Sci, 2019 May;32(3 (Supplementary)):1225-1233.
    PMID: 31326884
    The aim of the study is to assess and compare the impact of antiviral drug alone and in combination with antibiotic for prevention of Influenza-A H1N1 induced acute kidney injury (AKI) in hospitalized patients. Hospitalized admitted patients with confirmed diagnosis of Influenza-A H1N1 infection were divided into two groups: group 1, which received antiviral (oseltamivir) drug alone and group 2, which received antiviral (oseltamivir) in combination with empirically prescribed antibiotic. Patients of both groups were assessed for incidences of AKI by two criteria i.e Acute Kidney Injury Network (AKIN) and RIFLE. A total of 329 patients (176 for group 1 and 153 for group 2) were enrolled. According to RIFLE criteria, 23(13%) of group 1 and 9(6%) patients of groups 2 were suffered from AKI with statistically significant difference (P<0.05). Also as per AKIN criteria, the incidence of AKI is statistically significantly difference (P<0.05) between both groups with 18(10%) patients and 6(4%) patients of group 1 and 2 respectively. Length of hospitalization was statistically less (P<0.05) in group 2 patients. The incidences of AKI in Influenza-A H1N1 treated with antiviral and antibiotic combination was statistically less as compared to patients who were given antiviral alone for treatment of influenza infection.
    Matched MeSH terms: Acute Kidney Injury
  17. Anticoagulant-related nephropathy: A case report
    Lee KT, Kammal WSWA, Kong BH
    Saudi J Kidney Dis Transpl, 2021 2 11;31(6):1403-1406.
    PMID: 33565454 DOI: 10.4103/1319-2442.308356
    Anticoagulant-related nephropathy (ARN) is a recently described disease entity which is an underdiagnosed complication of anticoagulation. Despite widespread usage of anticoagulants, ARN is not commonly reported. We report a case of a 64-year old man with biopsy-proven ARN who presented with over anticoagulation and acute chronic kidney injury while on warfarin therapy for his left lower limb deep-vein thrombosis. Various investigations were performed and renal biopsy confirmed the diagnosis of anticoagulant-related nephropathy.
    Matched MeSH terms: Acute Kidney Injury
  18. 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
  19. Fulltext Acute kidney injury in intensive care unit, hospital Universiti Sains Malaysia: A descriptive study
    Hamid SA, Adnan WW, Naing NN, Adnan AS
    Saudi J Kidney Dis Transpl, 2018 11 2;29(5):1109-1114.
    PMID: 30381507 DOI: 10.4103/1319-2442.243961
    Acute kidney injury (AKI) was frequently encountered complication among intensive care unit (ICU) patients and recognized as a major public health problem. The present study aimed to determine the basic features of AKI patients admitted to ICU. A retrospective cohort study was conducted among 106 AKI patients admitted to ICU, Hospital Universiti Sains Malaysia from January 1, 2007 until the end of December 2013. The AKI patients ranged from 18 to 80 years old with the mean (standard deviation) of 58.93 (15.76) years, 60.4% were male and 91.5% were Malay ethnicity. Hypertension and diabetes were in 38.1% and 28.8%, respectively. The median (interquartile range) length of ICU stay was 4.50 (9.00) days. Eighty-two patients (79.6%) were classified as the Acute Kidney Injury Network (AKIN)-I, 12 (11.7%) as AKIN-II, and nine (8.7%) as AKIN-III. Sepsis was the common etiology among AKI patients (74.3%). Twenty-four patients (22.9%) required dialysis and 90.5% were mechanically ventilated. In conclusion, AKI developed more in male patients, Malay ethnicity, presented with comorbid, caused by sepsis, admitted to ICU, required mechanical ventilation, and need for renal replacement therapy.
    Matched MeSH terms: Acute Kidney Injury/diagnosis; Acute Kidney Injury/ethnology*; Acute Kidney Injury/therapy
  20. Characterization of renal hemodynamic and structural alterations in rat models of renal impairment: role of renal sympathoexcitation
    Salman IM, Ameer OZ, Sattar MA, Abdullah NA, Yam MF, Najim HS, et al.
    J Nephrol, 2010 5 4;24(1):68-77.
    PMID: 20437405 DOI: 10.5301/jn.2010.6
    BACKGROUND: Renal sympathetic innervation plays an important role in the control of renal hemodynamics and may therefore contribute to the pathophysiology of many disease states affecting the kidney. Thus, the present study aimed to investigate the role of the renal sympathetic nervous system in the early deteriorations of renal hemodynamics and structure in rats with pathophysiological states of renal impairment.

    METHODS: Anesthetized Sprague Dawley (SD) rats with cisplatin-induced acute renal failure (ARF) or streptozotocin (STZ)-induced diabetes mellitus (DM) were subjected to a renal hemodynamic study 7 days after cisplatin and STZ administration. During the acute study, renal nerves were electrically stimulated, and responses in renal blood flow (RBF) and renal vascular resistance (RVR) were recorded in the presence and absence of renal denervation. Post mortem kidney collection was performed for histopathological assessment.

    RESULTS: In innervated ARF or DM rats, renal nerve stimulation produced significantly lower (all p<0.05, vs. innervated control) renal vasoconstrictor responses. These responses were markedly abolished when renal denervation was performed (all p<0.05); however, they appeared significantly higher compared with denervated controls (all p<0.05). Kidney injury was suppressed in denervated ARF, while, irrespective of renal denervation, renal specimens from DM rats were comparable to controls.

    CONCLUSIONS: Renal sympathoexcitation is involved in the pathogenesis of the renal impairment accompanying ARF and DM, and may even precede the establishment of an observable renal injury. There is a possible enhancement in the renal sensitivity to intrarenal norepinephrine following renal denervation in ARF and DM rats.
    Matched MeSH terms: Acute Kidney Injury/chemically induced; Acute Kidney Injury/pathology; Acute Kidney Injury/physiopathology*
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