Microvascular endothelial function was significantly reduced in diabetic nephropathy patients with deficient vitamin D levels compared with those with nondeficient levels.

3.5-59.1mmol/L) with mean creatinine 388umol/L (range 54-926umol/ L). 55.3% had intermittent haemodialysis, 10.5% sustained low efficiency haemodialysis and 34.2% continuous renal replacement therapy. There was 26(68.4%) death, 6 (15.8%) achieved full renal recovery, 5(13.2%) partial renal recovery and 1(2.6%) was dialysis dependent. In the non-RRT group (n¼89, 70.1%), mean urea was 13.6mmol/L (range 1.4-43.3mmol/L) with mean creatinine 199.2umol/L (range 51-933umol/L). There was 19(21.3%) death, 47(52.9%) full renal recovery and 23(25.8%) partial renal recovery. Conclusions: Sepsis was the main etiology of AKI in our study with a high mortality rate. Majority of the patients had early initiation of RRT, however their outcome could not be compared with the late initiation group as both group were not matched.

The elderly are the fastest growing age group of the general population. Elderly are also reported to have higher risk of developing acute kidney injury (AKI) and poorer AKI outcome in the Caucasian population. However there are limited data on AKI outcome of elderly patient in this region. Objective: To evaluate the clinical outcomes of hospitalized elderly patients who had AKI. Methodology: This single-centre, prospective, observational study was performed on all patients who were admitted from 1 st till 31 st March 2017. Elderly was defined as individual aged 65 year or more at time of admission while acute kidney injury (AKI) was defined as a raised serum creatinine (SCr) of at least 26.5 umol/L within 48 hours or 1.5 times increment from baseline within 7 days. Laboratory SCr results of all elderly patients admitted during the study period were retrieved from the hospital Laboratory Information System (LIS). Demographic, clinical data, renal outcome, and patient outcome were collected for all elderly patients admitted during the study period who had AKI. Results were analyzed using SPSS Version 23. Results: Of a total of 874 elderly adult admissions during the study period, 126 (14.4%) cases had AKI. The elderly with AKI were predominantly male [81 (64.3%)] with a mean baseline SCr of 145.6AE95.6 ìmol/L and a mean age of 74.8AE6.5 years. One hundred and three patients (81.7%) were non-oliguric, 19 patients (15.1%) were oliguric and 4 (3.2%) had anuria. Only 28 patients (22.2%) were referred for renal consult.The mean SCr of those referred for renal consult was 384.3AE188.9ìmol/L and 13 patients (46.4%) required dialysis support (4 patients had intermittent hemodialysis, 8 patient had sustained lowefficiency dialysis and one received continuous venovenous hemofiltration). Indications for dialysis support were severe metabolic acidosis (11) and hyperkalemia (2).The mortality rate at the end of the study period was 20.5% (26/126) while 74 patients (58.7%) had full renal recovery and 26 (20.6%) had partial renal recovery. Risk factors for mortality were oliguric/anuric AKI (p<0.05) and the need for dialysis support (p<0.001). Conclusions: The mortality of AKI in elderly was relatively high at 20.5%. Elderly patients with non oliguric AKI and those who did not require dialysis support have significant better outcome. Further research is needed to evaluate the long term outcome of AKI in the elderly populations.

The number of patients in the early NC group was 34(69%) patients and 15 (31%)patients was in the late NC group. The mean age in the early NC group was 56 years (42-65), and 66 years (48-70) in the late NC group. Male to female ratio were 2:1 in both groups. There was a trend towards significance in the level of serum bicarbonate, early group 12mmol/l (9-14) compared to late NC group 16 mmol/l (11-18) with p¼0.064. However, there were no significant difference in other risk factors for mortality in relation with timing of nephrology consultation including patient's comorbidity, etiology of AKI, clinical and other blood parameters. All patients in both groups had multiorgan failure. Conclusion: There is no significant different of risk factors for mortality in term of clinical and blood parameters in both groups. Further studies should include severity of disease classification system to ascertain residual confounding factors.

Introduction: Leptospirosis, a zoonosis cause by Leptospira, is endemic in the tropics and is a relatively important cause of acute kidney injury (AKI) in this region. Mortality has been reported to be as high as 15-18% in those with AKI in the 1990's but there is lack of data on renal and patient outcome in this current age with the improvement of diagnostic techniques [microscopic agglutination test (MAT) is currently the gold standard], renal support and medical care. Objective: To study the incidence and outcome of acute kidney injury in patients with leptospirosis Methodology: This retrospective study was performed on all patients admitted from 1 st January 2015 to 31 st December 2016. Patients with confirmed leptospirosis (ie positive for both IgM antibodies and MAT) were identified from the Hospital Laboratory Information System (LIS). Patients' demography, relevant clinical data, laboratory results, renal outcome and patient outcome were retrieved from hospital's electronic medical record. Subjects with incomplete data were excluded. Results were analysed using SPSS version 23. Results: Of a total of 125,243 admissions, 35 patients were admitted with confirmed leptospirosis. Twenty-three patients (65.7%) developed AKI. The mean age of those with AKI was 35.7 AE 19.2 years and 21 (92.3%) were male. Thirteen (56.5%) were Malay while Chinese, Indians and others accounted 5 (21.7%), 4 (17.4%) and 1 (4.3%) respectively. Only 14 (60.9%) received renal consults and 4 (17.4%) required dialysis support. One patient who required dialysis, died during the admission giving a mortality rate of 4.3%. At time of discharge, 18 (78.3%) had complete renal recovery, 4 (17.4%) developed chronic kidney disease and 1 (4.3%) died before discharge. None of the patients required dialysis support at discharge. Compared to the 12 patients who did not develop AKI, male gender was found to be a risk factor of developing AKI (p¼0.023). There was a suggestion that older patients have a higher preponderance of developing AKI but this did not reach statistical significance. Conclusion: AKI is common in leptospirosis with an incidence of 65.7% but with a favorable outcome where 78.3% have a complete AKI recovery. Male gender appeared to be a risk factor of developing leptospirosis associated AKI.