One hundred and twenty patients with a mean age of 38 years (range 12-85 years; M 91, F 37) were studied over a period of 5 years in a teaching hospital in Dhaka. Sixty-two patients presented with probable anuria with 1-4 days' duration, 63 patients presented with oliguria, and 3 were nonoliguric. The causes of acute renal failure were medical (94), surgical (22), obstetrical (13). Of the medical cases, the causes were gastroenteritis in 42 cases, gastroenteritis with CNS involvement in 11 cases, rapidly progressive glomerulonephritis in 10 cases, acute viral hepatitis in 8 cases, and septicemia in 8 cases. Of 22 surgical cases, postoperative acute renal failure was the cause in 9, road traffic accident in 6, and renal calculus disease in 7. There were 13 cases in the obstetrics group, of whom 9 were due to abortion, 2 were due to preeclampsia, and the other 2 were postoperative. The mean blood urea of all cases was 35 mmol/L and serum creatinine was 988 mumol/L. Dialysis was required in 105 cases; of these, 72 were medical cases, 21 were surgical cases, and 12 were obstetric cases. The overall survival rate was 75%. The improved survival is probably due to timely referral and prompt medical management.
Background: Chronic kidney disease (CKD) is increasingly prevalent worldwide. CKD may present with different cutaneous manifestations. Objectives: To evaluate the dermatological manifestations and compare these manifestations between patients with maintenance hemodialysis (MHD) and nondialysis groups. Methods: It was a cross sectional study conducted in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from April 2013 to March 2014. A total of 150 hospital admitted CKD patients were evaluated for dermatological manifestations. Age, gender, haemoglobin level, 24-hours urinary total protein (UTP), serum creatinine, serum fasting lipid profile, estimated glomerular filtration rate (e-GFR) and dermatological manifestations of the study subjects were recorded accordingly. Inter-group comparisons were made between patients with and those without cutaneous abnormality. Results: Out of 150 study subjects, 99 (66%) were male and 51 (34%) were female, 69 (46%) patients were on MHD and 81 (54%) patients were without dialysis, their mean (±SD) age was 44.6 ± 12.3 year. A Total of 126 (84%) patients had cutaneous abnormalities; among them 69 (54.76%) were pre-dialytic and 57 (45.24%) were on MHD group. The mean (±SD) serum creatinine was relatively higher but haemoglobin level was significantly lower (p = 0.021), while UTP was significantly higher (p = 0.038) among patients with cutaneous abnormality. There was no relationship between lipid profile with cutaneous abnormality. Among 126 (84%) patients with cutaneous abnormality; pallor was the most common cutaneous abnormality (72%) followed by xerosis (68.66%), pruritus (65.33%), half and half nails (38.66%), pigmentation (33.33%), purpura/ecchymosis (16.66%), fungal infection (16%), ulcerative stomatitis (10.66%) and bacterial infection (10%). Pigmentation (52.6%), purpura (35.
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