Estimated GFR, as a better indicator of renal function, is significantly affected by the PCNL procedure. While significant improvement was observed in late-stage patients with CKD, unexpected deterioration could occur in patients at earlier stages.
There is no predictive factor for patients undergoing percutaneous nephrolithotomy procedure yet, but laparoscopic partial nephrectomy for tumors localized in the central portion of kidney may end up with RAP especially if no adjuvant sealing agents are used. The outcome of RAPs depends primarily on early recognition and a high index of suspicion, which facilitates correct diagnosis and appropriate management. Selective angiography and embolization together is the gold standard, both for diagnosis and treatment.
Conclusion: Over the last 15 years, the incidence of TCMS-induced AKI was 0.14% in Malaysia. Majority of the TCMS reported to be associated with AKI were unregistered with the Ministry of Health. There was also an increasing trend in deaths reported with TCMS-induced AKI in recent years. Hence it is important that stricter regulation should be enforced immediately on TCMS to ensure safety of the Malaysia population.Category: Research in AKI (Basic, translational, clinical including clinical trials) Presenter: Dr AZRINI ABDUL AZIZ Keywords: pleural effusion, CKD, fluid overload, parapneumonic effusion Introduction: Pleural disease is a common problem in patients with chronic kidney disease (CKD) as a consequence of the expanded use of long term hemodialysis and extended life spans. Methods: We retrospectively identified ESRD patients on regular hemodialysis with pleural effusion who were admitted to our centre for various reasons over a period of 1 year (January til December 2016). Demographic characteristics, medical co-morbidities, clinical presentation, therapeutic interventions and outcome of hospitalisation were recorded. Results: Pleural effusion was found in 18 patients. The mean age was 55.5 AE2.7 years, with the eldest patient being 76 years old. Majority of patients were male 13 (72.2%). Effusion was mainly unilateral 17/18 (94.4%) with the predominant side on the right 12/18 (66.7%). Only 12 patients consented for pleural tapping, in which the results showed equal distribution of transudative (6/12 patients) and exudative (6/12 patients). Fluid overload was the main cause (13/18, 72.2%) followed by parapneumonic (5/18, 27.8%). Out of the 5 parapneumonic effusion, 1 had pleural TB, 1 patient grew MRSA, 1 had fungal pneumonia(candida albicans) and 2 cultures were no growth. 1 patient with exudative effusion were diagnosed with fluid overload after all other causes were ruled out. The outcome of patients showed 5 (28.9%) requiring recurrent admission for effusion, 11 (61.1%) were discharged well (2 patients were readmitted later for other medical illness) and 2 (11.1%) patients succumbed to their illness and passed away. Conclusion: Symptomatic pleural effusion is mainly due to fluid overload in ESRD patients. However infective causes such as TB, fungal and other nosocomial infection should be investigated especially in patients with exudative and persistent effusion.
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