MyMedR

Fulltext Acute and sub-acute oral toxicity of Dracaena cinnabari resin methanol extract in rats

Al-Afifi NA, Alabsi AM, Bakri MM, Ramanathan A

BMC Complement Altern Med, 2018 Feb 05;18(1):50.

PMID: 29402248 DOI: 10.1186/s12906-018-2110-3

BACKGROUND: Dracaena cinnabari (DC) is a perennial tree that located on the Southern coast of Yemen native to the Socotra Island. This tree produces a deep red resin known as the Dragon's blood, the Twobrother's Blood or Damm Alakhwain. The current study performed to evaluate the safety of the DC resin methanol extract after a single or 28 consecutive daily oral administrations.

METHODS: In assessing the safety of DC resin methanol extract, acute and sub-acute oral toxicity tests performed following OECD guidelines 423 and 407, respectively, with slight modifications. In acute oral toxicity test, DC resin methanol extract administered to female Sprague Dawley rats by oral gavage at a single dose of 300 and 2000 mg/kg body weight. Rats observed for toxic signs for 14 days. In sub-acute oral toxicity test, DC resin methanol extract administered to the rats by oral gavage at 500, 1000, and 1500 mg/kg body weight daily up to 28 days to male and female Spradgue Dawley rats. The control and high dose in satellite groups were also maintained and handled as the previous groups to determine the late onset toxicity of DC resin methanol extract. At the end of each test, hematological and biochemical analysis of the collected blood were performed as well as gross and microscopic pathology.

RESULTS: In acute oral toxicity, no treatment-related death or toxic signs were observed. It revealed that the DC resin methanol extract could be well tolerated up to the dose 2000 mg/kg body weight and could be classified as Category 5. The sub-acute test observations indicated that there are no treatment-related changes up to the high dose level compared to the control. Food consumption, body weight, organ weight, hematological parameters, biochemical parameters and histopathological examination (liver, kidney, heart, spleen and lung) revealed no abnormalities. Water intake was significantly higher in the DC resin methanol extract treated groups compared to the control.

CONCLUSION: This study demonstrates tolerability of DC resin methanol extract administered daily for 28 days up to 1500 mg/kg dose.

Matched MeSH terms: Kidney/drug effects

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*

Fulltext Acute kidney injury following coronary artery bypass graft surgery in a tertiary public hospital in Malaysia: an analysis of 1228 consecutive cases

Hiew KC, Sachithanandan A, Muhammad Nor MA, Badmanaban B, Jasid AM, Ismail F, et al.

Med J Malaysia, 2016 Jun;71(3):126-30.

PMID: 27495886 MyJurnal

Acute kidney injury (AKI) following cardiac surgery is well established but the reported incidence is variable due to varying definitions and criteria. Furthermore there is a paucity of such data from Southeast Asia.

Matched MeSH terms: Acute Kidney Injury*

Acute kidney injury in a Malaysian intensive care unit: Assessment of incidence, risk factors, and outcome

Md Ralib A, Mat Nor MB

J Crit Care, 2015 Jun;30(3):636-42.

PMID: 25701354 DOI: 10.1016/j.jcrc.2015.01.018

Acute kidney injury (AKI) is common and carries a high mortality rate. Most epidemiological studies were retrospective and were done in Western populations. We aim to assess its incidence using both urine output and creatinine criteria and its association with risk factors and outcome.

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

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

Acute kidney injury: epidemiology and course in critically ill children

Tai CW, Gibbons K, Schibler A, Schlapbach LJ, Raman S

J Nephrol, 2021 Jun 02.

PMID: 34076880 DOI: 10.1007/s40620-021-01071-5

BACKGROUND: Acute kidney injury (AKI) is a major cause of morbidity and mortality in critically ill children. The aim of this paper was to describe the prevalence and course of AKI in critically ill children and to compare different AKI classification criteria.

METHODS: We conducted a retrospective observational study in our multi-disciplinary Pediatric Intensive Care Unit (ICU) from January 2015 to December 2018. All patients from birth to 16 years of age who were admitted to the pediatric ICU were included. The Kidney Disease Improving Global Outcomes (KDIGO) definition was considered as the reference standard. We compared the incidence data assessed by KDIGO, pediatric risk, injury, failure, loss of kidney function and end- stage renal disease (pRIFLE) and pediatric reference change value optimised for AKI (pROCK).

RESULTS: Out of 7505 patients, 9.2% developed AKI by KDIGO criteria. The majority (59.8%) presented with stage 1 AKI. Recovery from AKI was observed in 70.4% of patients within 7 days from diagnosis. Both pRIFLE and pROCK were less sensitive compared to KDIGO criteria for the classification of AKI. Patients who met all three-KDIGO, pRIFLE and pROCK criteria had a high mortality rate (35.0%).

CONCLUSION: Close to one in ten patients admitted to the pediatric ICU met AKI criteria according to KDIGO. In about 30% of patients, AKI persisted beyond 7 days. Follow-up of patients with persistent kidney function reduction at hospital discharge is needed to reveal the long-term morbidity due to AKI in the pediatric ICU.

Matched MeSH terms: Kidney; Acute Kidney Injury

Acute polyhydramnios causing bilateral obstructive hydronephrosis and impaired renal function

Valayatham V, Kakarla A, Rymer J

J Obstet Gynaecol, 2007 Oct;27(7):736-7.

PMID: 17999311

Matched MeSH terms: Kidney/physiopathology*

Fulltext Acute presentation of tuberous sclerosis: case report

Sathyamoorthy P

Singapore Med J, 1993 Aug;34(4):358-60.

PMID: 8266217

Incomplete form of tuberous sclerosis (TS) may present with acute complications such as haematuria, retroperitoneal haemorrhage or pneumothorax. Such cases may pose diagnostic difficulty. A patient with incomplete form of TS without any cerebral impairment who presented as an acute surgical abdomen is reported. The diagnostic criteria of TS are reviewed. Visceral manifestations of TS including acute complications are discussed. The importance of recognising such presentations is stressed.

Matched MeSH terms: Kidney Neoplasms/pathology; Polycystic Kidney Diseases/diagnosis

Fulltext Acute protein loading in the assessment of renal reserve

Loo CS, Zaki M, Sulaiman AB, Sukanya AB, Voon YC, Kua SL

Med J Malaysia, 1994 Mar;49(1):36-43.

PMID: 8057988

Functional renal reserve is a measure of the capacity of the kidney to increase the glomerular filtration in response to the stimulus of a protein meal or amino acid infusion. The aim of this study was to evaluate the usefulness of protein meal test to measure functional renal reserve in normal subjects and various groups of renal patients. One hundred and twenty five subjects from the Nephrology Clinic, Kuala Lumpur General Hospital were subjected to a protein loading test to measure their renal reserve. Each subject had to eat a 100 gram cooked chicken meat and timed 2 hours urine collections before and after the test meal were done to measure the creatinine clearances. The 62 healthy subjects showed a mean renal reserve (creatinine clearance after protein loading-baseline creatinine clearance) of 31.0 ml/min. The 31 subjects with various kidney diseases showed a mean renal reserve of 13.5 ml/min. The 19 renal transplant recipients showed renal reserve of 13.2 ml/min. The 12 nephrectomised donors showed renal reserve of 5.4ml/min. Renal reserve may be used to assess suitability of living related transplant donor for nephrectomy.

Study site: Nephrology Clinic, Kuala Lumpur General Hospital

Matched MeSH terms: Kidney Diseases/physiopathology; Kidney Diseases/urine*; Kidney Function Tests/methods*

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*

Fulltext Acute renal failure and hepatitis: a rare manifestation of typhoid Fever - a case report

Sulaiman W, Gunavathy M, Othman M

Malays J Med Sci, 2007 Jan;14(1):65-6.

PMID: 22593655 MyJurnal

Hepatitis complicating typhoid fever has been previously reported widely. Occurrence of acute renal failure and hepatitis together is exremenly rare. A case report of complicated acute renal failure and hepatitis in a tyhoid patient is reported and discussed.

Matched MeSH terms: Acute Kidney Injury

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 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 Acute renal failure following jering ingestion

H'ng PK, Nayar SK, Lau WM, Segasothy M

Singapore Med J, 1991 Apr;32(2):148-9.

PMID: 2042077

We report two cases of acute renal failure that followed the ingestion of jering. Features of jering poisoning included clinical presentation of bilateral loin pain, fever, nausea, vomiting, oligo-anuria, haematuria and passage of sandy particles in the urine. Blood urea (40.8 mmol/l; 21.9 mmol/l) and serum creatinine (1249 mumols/l; 693 mumols/l) were markedly elevated. With conservative therapy which included rehydration with normal saline and alkalinisation of the urine with sodium bicarbonate, the acute renal failure resolved.

Matched MeSH terms: Acute Kidney Injury/etiology*

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: Kidney Tubular Necrosis, Acute/etiology; Kidney Tubular Necrosis, Acute/pathology; Kidney Tubules/pathology; Acute Kidney Injury/etiology*; Acute Kidney Injury/pathology

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: Kidney Failure, Chronic/complications; Acute Kidney Injury/chemically induced*; Acute Kidney Injury/drug therapy

Acute renal failure in 2K2C Goldblatt hypertensive rats during antihypertensive therapy: comparison of an angiotensin AT1 receptor antagonist and clonidine analogues

Sattar MA, Yusof AP, Gan EK, Sam TW, Johns EJ

J Auton Pharmacol, 2001 5 15;20(5-6):297-304.

PMID: 11350495

1. This study compared the effect of a non-peptide angiotensin II receptor antagonist and a series of clonidine analogues on blood pressure and renal function in a two-kidney two-clip Goldblatt rat model of hypertension subjected to 2 weeks of dietary sodium deprivation. 2. Animals received either vehicle, the angiotensin II antagonist, ZD7155 or structural analogues derived from clonidine (AL-11, AL-12 and CN-10) at 10 mg kg-1 day-1 for 4 days. 3. All groups of rats had systolic blood pressure in the hypertensive range (160-180 mmHg). ZD7155 caused a 33-mmHg fall in blood pressure (P < 0.05) and raised plasma urea and creatinine four- to six-fold. 4. AL-12 decreased blood pressure by 30 mmHg (P < 0.05), but had no effect on water intake, urine flow or plasma urea and creatinine. AL-11 and CN-10 had minimal effects on blood pressure and water intake and while CN-10 decreased urine flow on the third treatment day, AL-11 markedly reduced urine flow by some 70%. 5. These data show that in this sodium deficient renovascular model of hypertension, blockade of angiotensin II receptors normalizes blood pressure but causes renal failure, whereas the vasodepressor action of the clonidine analogue AL-12 occurs without detriment to renal function. These findings imply that angiotensin II receptor antagonists could lead to renal failure if used as antihypertensive agents in renovascular hypertension whereas this would be avoided with the use of clonidine-like analogues.

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

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: Kidney/pathology; Kidney Tubular Necrosis, Acute/etiology; Kidney Tubular Necrosis, Acute/pathology; 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 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*

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