Acute renal failure

Hilton, Rachel

doi:10.1136/bmj.38975.657639.ae

Cited by 97 publications

(70 citation statements)

References 25 publications

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“…Ojini and Danesi (2005), Oyedeji et al (2012), Oyelami et al (1996), Yaguo Ide and Nte (2011), Yaguo Ide and Nte (2012). AKI as a complication of tetanus was not seen in any of our patients however in the study carried out by Moura Filho et al ((2008) the prevalence of AKI was reported to be 11.8% while a higher prevalence of 34% was recorded by Hilton et (2006). These studies were however among adults.…”

Section: Discussioncontrasting

confidence: 51%

Renal function of post neonatal tetanus cases as seen in University of Port Harcourt Teaching Hospital

Yaguo¹,

Agi²,

Uchenwa-Onyenegecha³

2015

GJMS

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Section: Discussioncontrasting

confidence: 51%

Renal function of post neonatal tetanus cases as seen in University of Port Harcourt Teaching Hospital

Yaguo¹,

Agi²,

Uchenwa-Onyenegecha³

2015

GJMS

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“…Eine anhaltende Reduktion der GFR führt zu einem Unvermögen der Nieren, stickstoffhaltige Abfallprodukte auszuscheiden und resultiert in einer Azotämie. Des Weiteren kommt es zu Stö-rungen des Flüssigkeits-, Elektrolyt-und Säure-Basen-Haushalts (Hilton 2006). Das prärenale Nierenversagen ist die häu-figste Ursache für eine reversible Azotämie beim Pferd (Robinson 2009).…”

Section: Introductionunclassified

Acute renal failure in horses with gastrointestinal disease

May¹,

Schmitz²,

Gehlen³

2012

PHK

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Die prärenale akute Niereninsuffizienz ist grundsätzlich reversibel. Sie kommt beim Pferd im Verlauf gastrointestinaler Erkrankungen nicht selten vor und ist eine Folge von Dehydratation, Endotoxämie und nephrotoxischen Medikamenten. Nachfolgend werden acht Pferde vorgestellt, die initial mit unterschiedlicher Koliksymptomatik in der Klinik für Pferde der FU Berlin vorgestellt wurden. In allen Fällen wurde eine akute Niereninsuffizienz mit deutlich erhöhten Harnstoff-und Kreatininwerten erkannt. Nach Detektion der Niereninsuffizienz wurde jeweils eine intensive Infusionstherapie durchgeführt. Während diese in sieben Fällen zu einer raschen Normalisierung der Nierenparameter führte, entwickelte ein Warmblutwallach, der bereits seit einer Woche Durchfall und zunehmende Apathie zeigte, aus der akuten präre-nalen Niereninsuffizienz eine intrinsische (renale) Niereninsuffizienz. Die hier beschriebenen klinischen Fälle machen deutlich, dass nur die rechtzeitige Diagnose und die früh einsetzende und adäquate Infusionstherapie den Übergang von der prärenalen in die intrinsische (renale) Niereninsuffizienz mit nachfolgender irreversibler Schädigung der Niere verhindern kann. Die Früherkennung der Niereninsuffizienz stellt sich dabei oftmals schwierig dar, da die Symptomatik meist auch mit der gastrointestinalen Grunderkrankung oder anderen postoperativen Komplikationen erklärt werden kann. Nur zielgerichtete Blutuntersuchungen (Harnstoff, Kreatinin, Nierenfunktionsanalyse) führen zu einer gesicherten Diagnose.Schlüsselwörter: Niereninsuffizienz / prärenal / Kolik / Infusionstherapie / reversibel / Gastroenterologie Acute renal failure in horses with gastrointestinal diseasePrerenal acute renal insufficiency is a reversible condition which likely occurs in the course of gastrointestinal diseases as a result of dehydration, endotoxemia and nephrotoxic medication. Eight cases presented to the Equine Clinic of the Free University Berlin with different gastrointestinal diseases are described. In all cases renal insufficiency with elevated urea and creatinine levels was detected early in its course. All cases received sufficient fluid therapy after detection of renal insufficiency until polyuria occurred. While the administration of fluids led to the normalization of renal parameters in 7 horses, prolonged hypovolemia in one (which was presented with diarrhea and apathy for a few days) had resulted in the development of intrinsic renal failure. These case reports show that early diagnosis and immediate and adequate rehydration treatment are crucial to prevent the transition from prerenal to intrinsic renal insufficiency. Intrinsic renal failure is often accompanied by irreversible impairment of the kidneys and a worse prognosis. Early detection can be a challenge as clinical symptoms are often related to the underlying gastrointestinal disease. Specific blood examinations (urea, creatinine, renal function test) are useful in establishing a diagnosis.

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“…9 A identificação dos pacientes de risco (idosos, doentes renais crônicos, diabéticos, obesos, hipertensos) 5 e a instituição de medidas apropriadas de prevenção são cruciais. 1 A IRA mantém elevado grau de morbimortalidade, mesmo com os progressos tecnológicos alcançados. Um dos fatores mais importantes para manter esse alto grau de mortalidade é a mudança demográ-fica observada no perfil dos pacientes que apresentam essa patologia.…”

Section: Introductionunclassified

Insuficiência renal aguda nefrotóxica: prevalência, evolução clínica e desfecho

Pinto¹,

Carminatti²,

Lacet³

et al. 2009

J. Bras. Nefrol.

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Declaramos a inexistência de conflitos de interesse. ResumoIntrodução: A insuficiência renal aguda (IRA) nefrotóxica é frequente e importante causa de morbimortalidade. Objetivo: Avaliar a prevalência, o curso clínico e o desfecho da IRA nefrotóxica. Pacientes e Métodos: Coorte histórica realizada em um hospital de ensino terciário, no período de fevereiro a novembro de 1997. Foram incluídos pacientes acima de 12 anos, com diagnóstico de IRA, acompanhados pela equipe de Interconsulta de Nefrologia. Foram excluídos transplantados renais, portadores de insuficiência renal crônica, dialisados por intoxicação exógena e aqueles transferidos de hospital durante o tratamento. Resultados: Dos 234 pacientes acompanhados, 12% apresentaram IRA nefrotóxica e 24%, IRA multifatorial associada ao uso de drogas nefrotóxicas. Entre as comorbidades mais prevalentes, estão hipertensão arterial, hepatopatias, neoplasias, insuficiência cardíaca congestiva e diabetes mellitus. Quinze por cento necessitaram de diálise, e o tipo mais frequentemente usado foi hemodiálise venovenosa contínua; 42% eram oligúricos, 44,7% evoluíram para óbi-to e 33% recuperaram a função renal. Antibióticos, AINH e contraste radiológico foram as drogas nefrotóxicas mais prevalentes. Os medicamentos nefrotóxicos implicados foram, em ordem de frequência, vancomicina, aminoglicosídeos, aciclovir, quimioterá-picos e contraste radiológico. Hepatopatia foi a única variável com significância estatís-tica (p = 0,03, IC = 1,08 a 6,49) em análise multivariada. Na comparação entre IRA nefrotóxica e não nefrotóxica, houve aumento da mortalidade proporcionalmente aos dias de internação. Conclusão: IRA nefrotóxica é frequente, grave e deve ser continuamente monitorada, tanto ambulatorialmente quanto no ambiente intra-hospitalar. Palavras-chave: insuficiência renal aguda, nefrotóxica, epidemiologia. AbstRActIntroduction: Nephrotoxic acute renal failure (ARF) is a frequent and important cause of morbidity and mortality. Objective: To assess the prevalence, clinical course, and outcome of nephrotoxic ARF. Patients and Methods: Historical cohort carried out in a tertiary school hospital from February to November, 1997. Patients over 12 years of age, diagnosed with ARF, and followed up by a team of nephrologists were included. The exclusion criteria were as follows: renal transplantation, chronic renal failure, dialysis due to exogenous poisoning, and those transferred to hospital during treatment. Results: Of the 234 patients followed up, 12% had nephrotoxic ARF and 24% multifactorial ARF associated with the use of nephrotoxic drugs. The most prevalent comorbidities were as follows: hypertension, hepatopathy, neoplasias, congestive heart failure, and diabetes mellitus. Fifteen percent of the patients required dialysis, and the most commonly used type was continuous venovenous hemodialysis; 42% of the patients were oliguric; 44.7% died; and 33% recovered renal function. The most prevalent nephrotoxic drugs were antibiotics, nonsteroidal anti-inflammatory drugs, and radiograph...

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Acute renal failure

Cited by 97 publications

References 25 publications

Renal function of post neonatal tetanus cases as seen in University of Port Harcourt Teaching Hospital

Renal function of post neonatal tetanus cases as seen in University of Port Harcourt Teaching Hospital

Acute renal failure in horses with gastrointestinal disease

Insuficiência renal aguda nefrotóxica: prevalência, evolução clínica e desfecho

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