Acute renal failure following multiple wasp stings

Thiruventhiran, T.; Goh, Bak Leong; Leong, Chee Loon; Cheah, Phaik Leng; Looi, Lai‐Meng; Tan, Si Yen

doi:10.1093/ndt/14.1.214

Cited by 53 publications

(87 citation statements)

References 7 publications

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“…In this retrospective study, we found that the mortality rate of AKI following multiple wasp stings was 9.3%, which is lower than that of previous reports, in which patients with AKI following multiple wasp or bee stings were treated with IHD and PD and had a mortality rate between 16% and 25% (6,9,10). Previous studies also showed that, among the patients who survived, 1-3 months was required to recover full kidney function (4,6,(8)(9)(10)(24)(25)(26).…”

Section: Discussioncontrasting

confidence: 60%

“…Previous studies also showed that, among the patients who survived, 1-3 months was required to recover full kidney function (4,6,(8)(9)(10)(24)(25)(26). In our study, the average recovery time of kidney function was shorter in the CVVH or CVVH + PE group than in IHD group, and we believe that this might be partially related to the different RRT modalities used.…”

Section: Discussionmentioning

confidence: 99%

“…Wasp and bee stings are associated with a wide variety of reactions, ranging from mild local reactions (such as edema, erythema, and urticaria) to fatal systemic complications (such as anaphylactic shock, rhabdomyolysis, AKI, myocardial infarction, acute hepatic failure, and encephalitis) (2)(3)(4)(5). AKI is usually caused by intravascular hemolysis, rhabdomyolysis, shock, and the direct toxic effects of the venom; the triad of AKI, hemolysis, and rhabdomyolysis often occurs in patients subjected to multiple wasp or bee stings (6). Renal biopsy usually reveals acute tubular necrosis (5,6), as well as occasional acute interstitial nephritis (7).…”

Section: Introductionmentioning

confidence: 99%

“…AKI is usually caused by intravascular hemolysis, rhabdomyolysis, shock, and the direct toxic effects of the venom; the triad of AKI, hemolysis, and rhabdomyolysis often occurs in patients subjected to multiple wasp or bee stings (6). Renal biopsy usually reveals acute tubular necrosis (5,6), as well as occasional acute interstitial nephritis (7). More than half of the victims who experience multiple wasp or bee stings develop AKI, and most of these patients require intermittent hemodialysis (IHD) or peritoneal dialysis (PD) (4,(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

“…More than half of the victims who experience multiple wasp or bee stings develop AKI, and most of these patients require intermittent hemodialysis (IHD) or peritoneal dialysis (PD) (4,(8)(9)(10). The mortality rate of patients who experience AKI due to wasp stings has been reported to be as high as 25% (6). Few large case series have addressed the outcomes of wasp or bee sting-induced AKI, and to our knowledge no studies have focused on the differing modalities of renal replacement therapy (RRT) in these patients.…”

Section: Introductionmentioning

confidence: 99%

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Recovery from AKI Following Multiple Wasp Stings

Zhang

Yang

Tang

et al. 2013

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objective To observe the outcomes of AKI following multiple wasp stings.Design, setting, participants, & measurements Eighty-one patients (mean age 6 SD, 45.5614.7 years; 55 men and 26 women; mean Acute Physiology and Chronic Health Evaluation II score, 16.8562.78) with AKI following multiple wasp stings between 1997 and 2011 were retrospectively analyzed. Data on their demographic characteristics, initial modalities of renal replacement therapy (RRT), urine output, serum creatinine, bilirubin, myoglobin, and other variables were collected. Renal outcomes included complete recovery of kidney function, CKD, and death. Subgroup analysis was performed according to initial modality of RRT in the first 48 hours, including continuous veno-venous hemofiltration (CVVH), intermittent hemodialysis (IHD), and CVVH plus plasma exchange (PE).Results Of the 75 patients available for follow-up, 7 (9.3%) died, and 8 (10.7%, all in the IHD group) developed CKD. The average RRT time was 18.268.4 days, and the average kidney function recovery time was 36.0 (29.0, 41.0) days. Subgroup analysis showed no difference in the mortality rates between the CVVH, CVVH + PE, and IHD groups (8.0%, 7.1%, and 11.1%, respectively; P.0.99). The recovery time for kidney function was significantly shorter in the CVVH and CVVH + PE groups than in the IHD group (31.968.5 days, 28.669.4 days, and 41.668.1 days, respectively; P,0.001).Conclusions This is a large case series report on the outcomes of patients with AKI following multiple wasp stings. Most patients survived with complete recovery of their kidney function. Despite the lack of difference in mortality rates, the patients who began RRT with CVVH and CVVH + PE experienced a better and more rapid recovery of kidney function than those initiated with IHD.

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Section: Discussioncontrasting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Recovery from AKI Following Multiple Wasp Stings

Zhang

Yang

Tang

et al. 2013

Clinical Journal of the American Society of Nephrology

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Acute renal failure following wasp sting in children

Vachvanichsanong

Dissaneewate

2009

Eur J Pediatr

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The medical records of patients admitted between 1985 and 2007 with wasp stings were retrospectively analyzed. Among the 45 children, seven developed acute renal failure. Classical clinical and laboratory data pointed to hemolysis and rhabdomyolysis as the underlying pathophysiology. All patients had hyponatremia and hyperkalemia as well as metabolic acidosis. Six patients had anemia. Five patients were oliguric for 9 to 15 days. Maximum serum creatinine was 4.0 to 11.9 mg/dl. Peritoneal dialysis was performed for 3 to 15 days. One patient died due to hyperkalemia, the remaining ones recovered completely. This paper wants to remind pediatricians to watch for acute renal failure in children with wasp stings.

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Multiple hymenoptera stings in children: clinical and laboratory manifestations

Broides

Maimon

Landau³

et al. 2010

Eur J Pediatr

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Multiple hymenoptera stings are a cause of rhabdomyolysis, elevated liver enzymes, clotting abnormalities, kidney injury, and even death. However, the progression of the clinical and laboratory findings has been described mainly in sporadic case reports. We report the clinical and laboratory manifestations of multiple hymenoptera stings in six children who were hospitalized and referred for a nephrology evaluation and follow-up over a 12-year period. One patient succumbed 13 h after the stinging accident. In the five surviving patients, we found somewhat similar pattern of clinical and laboratory course: rhabdomyolysis with elevated liver enzymes are the earliest manifestations, followed by kidney injury and anemia. An asymptomatic phase of several days between the stinging accident and severe kidney injury can occur. There was a strong seasonal association, with all six events occurring in August or September. In children with multiple hymenoptera stings, a somewhat predictable clinical and laboratory course is expected and an initial laboratory evaluation is needed, and even in asymptomatic children, a repeated laboratory evaluation is highly recommended.

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Acute renal failure following multiple wasp stings

Cited by 53 publications

References 7 publications

Recovery from AKI Following Multiple Wasp Stings

Recovery from AKI Following Multiple Wasp Stings

Acute renal failure following wasp sting in children

Multiple hymenoptera stings in children: clinical and laboratory manifestations

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