Online ISSN: 2515-8260

Keywords : AKI

To Study the Renal Involvement in Hospitalized Children with Dengue Fever in A Tertiary Care Center

Dr. Pawan Kumari, Dr. Ruchi Agrawal, Dr. Bhanu Pratap Singh Rathore, Dr. Gargi Manav, Dr. Alok Kumar Goyal, Dr. Raj Kumar Gupta, Dr. Vishnu Pansari, Dr. Ashok Gupta, Dr. Neetu Tanwar, Dr. Ramesh Choudhary .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 1378-1386

Background: Dengue was one of the top 10 probable health concerns to the world in 2019 according to the World Health Organization. Dengue fever has been associated with various types of renal manifestations such as proteinuria, hematuria, glomerulonephritis, and acute kidney injury (AKI). Hence, this prospective cross-sectional observational study was designed to analyze the frequency, characteristics, and clinical outcome of dengue fever in children with renal manifestations.
Materials & Methods: This was a cross sectional observational study done on 225 cases of children with dengue fever in the Department of pediatrics, SPMCHI hospital Sawai Man Singh Medical College, Jaipur. Data regarding the need for fluid resuscitation, colloid infusion, inotrope support, ventilatory requirement were collected. Creatinine values and urine output were noted and ‘Kidney Disease Improving Global Outcome 2012 (KDIGO)’ guideline was used to stage the acute kidney injury. Various renal manifestations of dengue will be studied and compared between the severity of dengue fever. Continuous variables were summarized as mean and standard deviation and were analyzed using independent sample t test for comparison between 2 groups and ANOVA test was used for comparison between multiple groups (>2 groups).
Results: Our study showed that Mean age of 225 children with dengue in present study was 7.98 ± 4.21 years. Male to female ratio was 1.06:1. Renal involvement was highest in patients with dengue shock syndrome (28.6%), followed by those with dengue hemorrhagic fever (18.4%) and was least in those with dengue fever (4.7%). This difference in incidence of renal involvement in relation to severity of dengue was found to best artistically significant (p<0.001). The duration of hospital stay was highest in patients with Failure p RIFLE criteria (11.5 ± 4.95 days), followed by injury category (7 ± 1.41 days) and was least in risk category (5± 0.89 days), and this difference was found to best artistically significant (p=0.019).
Conclusion: We concluded that renal involvement was more common in dengue shock syndrome. Transient proteinuria and hematuria have been detected in most patients with dengue fever. So a clinician who is dealing with dengue patients should have closed watched on renal functions so kidney injury can be avoid to some extent as well as the mortality in dengue.

A Hospital Based Prospective Study to Assess the Outcome of Acute Kidney Injury (AKI) in Snake Bite Patients at Newly Established Medical College

Dr.Hanuman Ram Choudhary, Dr.Anil Kumar Sethiya, Dr.Motilal Godara

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 2673-2678

Background: Snake envenomation is a serious medical crisis, wherein the spectrum of
injury can vary from local tissue damage to involvement of almost all vital organs of the
body. Hence, the need to recommend the most effective first aid to the victims bitten by
snakes and to recommend effective steps in the management of this problem. The aim of
this study to find out the incidence of acute kidney injury in snakebite patients.
Materials and Methods: This is a hospital-based prospective observational study in 50
consecutive patients, with history of poisonous snakebite, admitted to Government
Medical College & Hospital, Barmer, newly established tertiary referral centre in
western Rajasthan, India during one-year period. Snakebite and species identification
was confirmed by a reliable history from patients, patient's relatives, specimen brought
and presence of fang marks and signs of local and systemic envenomation. All patients
were interviewed using a standardized questionnaire to maintain a record of patient's
history relevant to snakebite envenomation. All these analyses were performed using a
commercially available software Statistical Package for the Social Sciences (SPSS) 21
version on personal computer.
Results: In our study, mean age group of AKI was 40.7 ± 13.21 years, incidence of AKI
was 60% in male and 40% in female and it was found to be 94% in rural population
and 6% in urban population. Only in 4% of cases, snakes were identified. Incidence of
AKI was found to be 30%.33.33% (N=1/3) of the patients with AKI had neurotoxicity
(p>0.05). Thus, not significant. None of the patients with AKI had brown or black
coloured urine. 75 % of patients with AKI had whole blood clotting time more than
20min (p-0.000), thus highly significant. AKI developed in 62.5% patients with bite to
ASV interval <= 2hours and 37.5% with interval >2 hours (p>0.05), thus not significant.
Conclusion: Snakebites are still a common medical emergency encountered, especially
in rural areas. Timely treatment is the mainstay for reduction of morbidity and
mortality. Recognition of predictor signs is essential for clinical management and early
referral which could lead to a significant decrease in morbidity and mortality. Further
long-term studies might help to assess predictors of renal failure in snake bite

Systematic Review And Meta-Analysis: Risk Factors Of Acute Kidney Injury In Major Abdominal Surgery

Emminarty .; Hasyim Kasim; Haerani Rasyid; Syakib Bakri; Andi Makbul Aman; Husaini Umar; Muh. Ilyas; Arifin Seweng; Gita vita soraya

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 944-952

Background and objective: Acute kidney injury (AKI) is a common complication in patients undergoing major abdominal surgery. Various recent studies reported an incidence of AKI after surgery ranging from 6.7 to 32%. Risk factors for AKI in this setting may be procedure-related factors, post-operative complications and several patient-related include age, gender, comorbid disease Diabetes Melitus (DM), Hypertension (HT), Cardiovascular disease (CVD), and physical status. This study aimed to explore the risk factors of AKI in major abdominal surgery
Methods: We conducted a systematic literature search from PubMed and Cochrane Library. We included articles describing AKI in the setting of major abdominal surgery, published from 2015 until now, and cohort study design. This review was registered with PROSPERO (CRD42020216405)
Results: From 478 articles, 4 articles met our inclusion criteria describing AKI outcomes in varied population 683-3751. Prevalence of AKI 8,8 %. Age patient risk AKI in major abdominal surgery with Mean difference was 3.04 (95% CI = 1.83-4.25; P <0.00001). Meta-analysis of the four studies showed that Male had a pooled Odds ratio (OR) of 1.79 (95% CI = 1.04-3.08; P = 0.04) , DM OR 1.64 (95% CI 1.36-2.03; P <0.00001), HT pooled OR 1.90 (95% CI = 1.30-2.78; P = 0.0009), CVD has an OR of 1.58 (95% CI = 0.91-2.75; P = 0.10), physical status ASA≥ 3 (The American Society of Anesthesiologists) score has pooled OR 1.70 (95% CI = 1.16-2.49; P = 0.007)
Conclusion: Risk factors of AKI in major abdominal surgery setting are higher significantly in male, and patient with comorbid disease DM and HT had a significantly high risk of AKI, as well as physical status score ASA > 3.

Clinical Profile of Pregnant Patients With Acute Kidney Injury; Single Center Study

Ahmed Noaman Elsayed; Amir Mohammed Elokely; Mohammed Fouad Ahmed; Tareq M. Elbehedy

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 6881-6889

Background: A sudden decline of renal function occurring during pregnancy or postpartum is defined as Pregnancy-related acute kidney injury (PRAKI) includes all the causes not only the obstetric one. The incidence and etiology of PRAKI varies greatly between different regions. Data for the prevalence and prognosis cannot be interpreted without taking into account the geographic and economic context of the country in which they have been obtained. In developed countries, obstetric AKI has become a rare complication of pregnancy. However, in developing countries, AKI remains a frequent and grave complication of pregnancy. Aim: to demonstrate the demographic, clinical and laboratory characteristic of the pregnant women with AKI. Materials and Methods: A Cross-sectional study was carried out among pregnant women who were admitted to obstetrics & gynecology department in collaboration with nephrology unit in internal medicine department during a six months. This study is a part of a large study on the prevalence and outcome of AKI in pregnancy by the same authors in the same center that will be published soon. The demographic, clinical and laboratory data was obtained and analyzed
Results: During the period of the study, a total of 4130 obstetric cases were admitted to the hospital. In total, 33 patients met the diagnostic criteria of pregnancy related acute kidney injury. The mean age of the patients was 29 ± 4.58 years, and gestational age was 31.46 ± 6.34 weeks. Eleven of the 33 women (21%) were primiparous and twelve of them (79%) were multipara. There was a significant findings between the patients who were suffering from hypertensive disorders of pregnancy (Group 1) and who didn’t suffer (Group 2) as regarding low hemoglobin level and low arterial blood pressure and in group 2, while group 1 showed higher uric acid level and low albumin level with a significant finding.