Presentation
We present an unusual case of acute lymphoblastic leukemia presenting as non-oliguric renal failure and hypertension in an adult patient along with the review of literature. To access this article, please choose from the options below [lrjournal.com]
Both cases presented during the monsoon season, with fever, abdominal pain and elevated concentrations of serum creatinine (4.3 and 5.6 mg/dl). Neither case required dialysis and both were successfully treated with penicillin. [ncbi.nlm.nih.gov]
In terms of clinical presentation, two presented with flu-like symptoms, two with Weil's disease and six with atypical manifestations. Table 2 shows the microbiological diagnostic techniques used and the titres of the different varieties. [revistanefrologia.com]
ARF due to other causes as partial obstruction may present as polyuria. ARF due to postrenal obstruction may present as anuria. Diagnosis Renal failure is manifested by the rise of serum creatinine. [doctorslounge.com]
Entire Body System
- Asymptomatic
[…] manifestations are highly variable, from flu-like symptoms to very serious forms (Weil's disease with liver, kidney and meningeal involvement and alterations in haemostasis).1–3 Leptospirosis causes acute interstitial nephritis which often presents either as asymptomatic [revistanefrologia.com]
The hypocalcemia associated with AKI is usually asymptomatic and does not require specific treatment. [renalandurologynews.com]
Presence of systolic dysfunction in the studied groups Urine volumes were significantly lower in patients with systolic dysfunction, even in asymptomatic patients – Fig. 10. [ncbi.nlm.nih.gov]
Gastrointestinal
- Melena
Two days after admission the patient showed melena. [elsevier.es]
Workup
Acute kidney injury 2016: diagnosis and diagnostic workup. Crit Care. 2016;20(1):299. [PubMed] 7. Muriithi A, Nasr S, Leung N. Utility of urine eosinophils in the diagnosis of acute interstitial nephritis. [emcrit.org]
Serum
- Abnormal Renal Function
Lema G, Urzua J, Jalil R, Canessa R, Moran S, Sacco C, et al Renal protection in patients undergoing cardiopulmonary bypass with preoperative abnormal renal function. Anesth Analg 1998; 86:3-8. 59. Flancbaum L, Dick M, Choban PS, Dasta JP. [jpgmonline.com]
- Hyperglycemia
AKI may also be associated with impaired carbohydrate metabolism with hyperglycemia as a result of insulin resistance and accelerated hepatic gluconeogenesis and impaired lipid metabolism. [renalandurologynews.com]
Treatment
A case of acute interstitial nephritis (AIN) developing after cefaclor treatment is reported. Diagnosis was proofed by kidney biopsy and lymphocyte transformation test. [ncbi.nlm.nih.gov]
545 Dialysis ultrafiltration and hemofiltration 555 Use of drugs in uremia and dialysis 567 Donor and recipient selection in renal transplantation 587 Immunosuppression and treatment of rejection in renal transplantation 595 XIII 606 Renal tubular and [books.google.de]
This acute renal failure improved upon cessation of zomepirac treatment. Renal biopsy disclosed the presence of a tubulointerstitial nephritis, which was thought to have been responsible for the acute renal failure in this patient. [mayoclinic.pure.elsevier.com]
Both recovered completely and gave normal results in their post-treatment renal-function tests. [tandfonline.com]
Prognosis
Otherwise, predicting prognosis of ARF/AKI from a heterogenous group of patients with renal dysfunction would be problematic. [ndt.oxfordjournals.org]
"Immediate and long-term prognosis in acute renal failure" Ann Intern Med 73(4): 515-521, October 1970. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/5506002 18. Mudge, G H. [herdin.ph]
Classification into such groups, which can be simply made, is valuable in assessing prognosis and the results of treatment. [onlinelibrary.wiley.com]
Indicators of poor prognosis include older age, multiple organ failure, oliguria, hypotension, number of transfusions and acute on chronic kidney disease. Prognosis is closely related to the underlying cause. [patient.info]
Children less than 1 year of age have worse survival prognosis. Children admitted to an intensive care unit (ICU) have worse survival than those who are not. [clinicaladvisor.com]
Etiology
The possible etiology of the renal failure was multiple in all cases and did not differ from that seen in oliguric acute tubular necrosis (ATN). [ncbi.nlm.nih.gov]
While they may help in the diagnosis and management of very specific etiologies like hepatorenal syndrome, most of the time a fluid challenge or diuresis will be the diagnostic and therapeutic tests of choice. JAMA. 1976 Aug 9;236(6):579-81. [medicine-matters.blogs.hopkinsmedicine.org]
A low FeNa, or low urine sodium reflects poor renal perfusion of any cause, not exclusively volume depletion as an etiology of AKI, and there are many causes of “low FeNa ATN” as listed above (Table 2). [hindawi.com]
Leptospirosis renal disease: emerging culprit of chronic kidney disease unknown etiology. Nephron, 138 (2018), pp. 129-136 [9] F.J. Gifford, R.M. Gifford, M. Eddleston, N. Dhaun. Endemic nephropathy around the world. [revistanefrologia.com]
Etiology Etiologies of AKI are classically divided according to the anatomic location of the physiologic defect. [unboundmedicine.com]
Epidemiology
(Demonstrates changing pediatric AKI epidemiology over 2 decades) Bailey, D, Phan, V, Litalien, C. “Risk factors of acute renal failure in critically ill children: a prospective descriptive epidemiological study”. [clinicaladvisor.com]
The RIFLE criteria, however, has allowed for a more systematic approach which is useful in epidemiological and research studies [ 3 ]. [ndt.oxfordjournals.org]
Acute kidney injury: epidemiology and diagnostic criteria. Curr Opin Crit Care. 2006; 12: 531-537. Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG. Acute Kidney Injury Network. [austinpublishinggroup.com]
The Emerging Infections Network (EIN) is a forum for infectious diseases consultants and public health officials to report information on clinical phenomena and epidemiological issues with public health significance. [news.idsociety.org]
Pathophysiology
This edition has been thoroughly revised by world-renowned contributors to reflect recent developments in renal pathophysiology. [books.google.de]
Pathophysiology of hemodynamically mediated acute renal failure in man. Kidney Int 18: 594–604, 1980. Google Scholar 45. Blantz RC. Mechanisms of acute renal failure after uranyl nitrate. J Clin Invest 55: 621–635, 1975. [link.springer.com]
Neonatology: Pathophysiology and management of newborn. 6th ed. Philadelphia. Lippincott Williams & Wilkins. 2005;2:1000-9. 3. Gouyon JB, Guignard JP. Management of acute renal failure in newborns. Pediatr Nephrol 2000;14(10-11):1037-44. 4. [pjms.com.pk]
Prevention
[…] use of fenoldopam in the prevention of ARF. [jpgmonline.com]
Prevention of post procedural acute kidney injury in the catheterization laboratory in a real-world population. Int J Cardiol. 2016 Oct 11. 226:42-47. [Medline]. Briguori C. [medscape.com]
[…] underlying renal impairment probable that other disturbances in potassium homeostasis, such as hyopoaldosteronism and treatment with medications that impair renal potassium excretion, are also risk factors for hyperkalaemia with trimethoprim therapy prevention [gpnotebook.co.uk]
Prevention of contrast nephropathy by furosemide with matched hydration: the MYTHOS(induced diuresis with matched hydration compared to standard hydration for contrast induced nephropathy prevention) trial. JACC Cardiovasc Interv. 2012; 5: 90-97. [austinpublishinggroup.com]