Aspectos nutricionais na lesão renal aguda

Berbel, Marina Nogueira; Pinto, Milene Peron Rodrigues; Ponce, Daniela; Balbi, André Luís

doi:10.1590/s0104-42302011000500022

Cited by 30 publications

(18 citation statements)

References 30 publications

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“…This suggests that the fatal cases might have had more severe envenomation. Because albumin is a relatively slow-reacting negative acute-phase reactant it may be associated with higher mortality in AKI[35]. Hypoalbuminemia was as result of a generalized increase in capillary permeability and bleeding complications.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological spectrum of snake bite-induced acute kidney injury from India

Vikrant¹,

Jaryal²,

Parashar³

2017

WJN

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AIMTo study the clinico-pathological spectrum of snake bite-induced acute kidney injury (AKI).METHODSA retrospective study of patients admitted at Indira Gandhi Medical College Hospital, Shimla with snake bite-induced AKI from July 2003 to June 2016. Medical records were evaluated for patient’s information on demographic, clinical characteristics, complications and outcome. Outcomes of duration of hospital stay, requirement for intensive care unit support, treatment with dialysis, survival and mortality were analyzed. The survival and non survival groups were compared to see the difference in the demographic factors, clinical characteristics, laboratory results, and complications. In patients subjected to kidney biopsy, the findings of histopathological examination of the kidney biopsies were also analyzed.RESULTSOne hundred and twenty-one patients were diagnosed with snake bite-induced AKI. Mean age was 42.2 ± 15.1 years and majority (58%) were women. Clinical details were available in 88 patients. The mean duration of arrival at hospital was 3.4 ± 3.7 d with a range of 1 to 30 d. Eighty percent had oliguria and 55% had history of having passed red or brown colored urine. Coagulation defect was seen in 89% patients. The hematological and biochemical laboratory abnormalities were: Anemia (80.7%), leukocytosis (75%), thrombocytopenia (47.7%), hyperkalemia (25%), severe metabolic acidosis (39.8%), hepatic dysfunction (40.9%), hemolysis (85.2%) and rhabdomyolysis (68.2%). Main complications were: Gastrointestinal bleed (12.5%), seizure/encephalopathy (10.2%), hypertension, pneumonia/acute respiratory distress syndrome (ARDS) and disseminated intravascular coagulation (9.1% each), hypotension and multi organ failure (MOF) (4.5% each). Eighty-two percent patients required renal replacement therapy. One hundred and ten (90.9%) patient survived and 11 (9.1%) patients died. As compared to the survival group, the white blood cell count (P = 0.023) and bilirubin levels (P = 0.006) were significant higher and albumin levels were significantly lower (0.005) in patients who died. The proportion of patients with pneumonia/ARDS (P = 0.001), seizure/encephalopathy (P = 0.005), MOF (P = 0.05) and need for intensive care unit support (0.001) was significantly higher and duration of hospital stay was significantly shorter (P = 0.012) in patients who died. Kidney biopsy was done in total of 22 patients. Predominant lesion on kidney biopsy was acute tubular necrosis (ATN) in 20 (91%) cases. In 11 cases had severe ATN and in other nine (41%) cases kidney biopsy showed features of ATN associated with mild to moderate acute interstitial nephritis (AIN). One patient only had moderate AIN and one had patchy renal cortical necrosis (RCN).CONCLUSIONAKI due to snake bite is severe and a high proportion requires renal replacement therapy. On renal histology ATN and AIN are common, RCN is rare.

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Section: Discussionmentioning

confidence: 99%

Clinicopathological spectrum of snake bite-induced acute kidney injury from India

Vikrant¹,

Jaryal²,

Parashar³

2017

WJN

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“…It was regarded as not only a marker of inflammation or malnutrition [8–10], but also a risk factor of AKI development and mortality in critically ill patients [6, 11–14]. A meta-analysis of observational studies showed that the odds of AKI and death among patients with AKI increase by 134% (pooled odds ratio [OR], 2.34; 95% confidence interval [CI], 1.74–3.14) and 147% (pooled OR, 2.47; 95% CI, 1.51–4.05), respectively, with each 10 g L -1 serum albumin decrement [6].…”

Section: Introductionmentioning

confidence: 99%

Hypoalbuminemia at admission predicts the development of acute kidney injury in hospitalized patients: A retrospective cohort study

Lee

Baek

et al. 2017

PLoS ONE

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BackgroundDevelopment of acute kidney injury (AKI) is common and is associated with poor outcomes. We aimed to determine whether hypoalbuminemia (HA) at admission could be a risk factor for the development of AKI and mortality in hospitalized patients.MethodsWe enrolled patients who were admitted to Seoul National University Bundang Hospital from January 2013 to December 2013. HA at admission was defined as a serum albumin level < 3.4 mg/dL measured within two days after admission. AKI was defined as an increase in the serum creatinine level by ≥0.3 mg/dL or ≥1.5 times of the baseline value during the hospital stay.ResultsA total of 19,472 patients were enrolled and divided into HA and normoalbuminemia (NA) groups at admission. The incidence of AKI was 10.7% (340/3179) in the HA group and 4.1% (662/16293) in the NA group (adjusted odds ratio [OR], 1.243; 95% confidence interval [CI], 1.069–1.445; P = 0.005). The hazard ratios for the 30-day, 90-day, and 1-year mortality were 1.873 (95% CI, 1.383–2.537; P < 0.001), 1.710 (95% CI, 1.410–2.072; P < 0.001), and 1.372 (95% CI, 1.214–1.551; P < 0.001), compared to the NA group. In patients with AKI, albumin replacement improved renal recovery (OR, 2.605; 95% CI, 1.450–4.681; P = 0.001). The mortality rate was not different according to albumin replacement.ConclusionsHA is associated with the development of AKI and high mortality in hospitalized patients. Replacement of albumin after the development of AKI may contribute to renal recovery. Further clinical trials are warranted.

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“…Perforated pneumatosis cystoides intestinalis, caused by infection with a gas-producing bacterium, is thought to be the most common cause of spontaneous pneumoperitoneum in adults without perforation [10] , [11] . In adults, pneumatosis cystoides is considered to be idiopathic or secondary to chronic medical conditions [12] .…”

Section: Discussionmentioning

confidence: 99%

Spontaneous pneumoperitoneum in pediatric patients: A case series

Tallant

Nirgiotis

et al. 2016

International Journal of Surgery Case Reports

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HighlightsPneumoperitoneum may not always be an ominous sign in the pediatric population.Cases of non-surgical pneumoperitoneum in the pediatric population are scarce.The clinical picture of a patient should be the primary determinant of management.Conservative measures can be used in pediatrics with isolated pneumoperitoneum.If the diagnosis is still unclear, clinical correlation should take precedence.

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Aspectos nutricionais na lesão renal aguda

Cited by 30 publications

References 30 publications

Clinicopathological spectrum of snake bite-induced acute kidney injury from India

Clinicopathological spectrum of snake bite-induced acute kidney injury from India

Hypoalbuminemia at admission predicts the development of acute kidney injury in hospitalized patients: A retrospective cohort study

Spontaneous pneumoperitoneum in pediatric patients: A case series

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