Digital Health Assistant & Symptom Checker | Symptoma
0%
Restart

Are you sure you want to clear all symptoms and restart the conversation?

About COVID-19 Jobs Press Scholarship Terms Privacy Imprint Medical Device Language
Languages
Suggested Languages
English en
Other languages 0
2.1
Non-Oliguric Renal Failure
Renal Failure Non Oliguric

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

  • Falling

    For children the pRIFLE, stages 1 (risk), 2 (injury) and 3 (failure), are defined at specific falling levels of eGFR and falling urinary output [ 5 ]. [patient.info]

    As a result, there is gradual distension of the proximal ureters, renal pelvis and calyces and fall in glomerular filtration which will be evident by renal ultrasound. [doctorslounge.com]

    With such a second hit leading to ATN, there is evidence of tubular dysfunction as assessed by diminished tubular sodium reabsorption despite a fall in glomerular filtration rate (GFR) [ 10 ]. [ndt.oxfordjournals.org]

    When BP or blood flow to the kidneys decreases and MAP falls below 65 mm Hg, both urine output and the glomerular filtration rate (GFR) decline. [americannursetoday.com]

    Although initially a hyperchloremic metabolic acidosis develops, widening of the anion gap is often seen as the result of accumulation of phosphate, sulfate and small organic anions.Typically, the fall in plasma bicarbonate does not exceed 2 mmol/L per [renalandurologynews.com]

  • Pallor

    Pallor, rash, bruising: petechiae, purpura and nosebleeds may suggest inflammatory or vascular disease, emboli or disseminated intravascular coagulation. Pericardial rub. [patient.info]

    Acute kidney injury Other names Acute renal failure (ARF) Pathologic kidney specimen showing marked pallor of the cortex, contrasting to the darker areas of surviving medullary tissue. The patient died with acute kidney injury. [en.wikipedia.org]

Urogenital

  • Oliguria

    <ul><li>Categories of anuria, oliguria, and nonoliguria may be useful in differential diagnosis of ARF. [slideshare.net]

    Oliguria should be taken seriously and evaluated adequately. [emcrit.org]

    Use of automated biochemical monitoring, aminoglycoside antibiotic utilization, and administration of potent diuretics and mannitol in settings of oliguria all contribute to its increased incidence. [jamanetwork.com]

    Abstract Oliguria has been considered a cardinal feature of acute renal failure. However, many recent reports indicate that acute renal failure usually occurs in the setting of well-maintained urine output. [ncbi.nlm.nih.gov]

  • Uremia

    ( N18.9 ) extrarenal uremia ( R39.2 ) prerenal uremia ( R39.2 ) renal insufficiency (acute) ( N28.9 ) uremia of newborn ( P96.0 ) acute N17.9 ICD-10-CM Diagnosis Code N17.9 Acute kidney failure, unspecified 2016 2017 2018 2019 Billable/Specific Code [icd10data.com]

    […] management of renal insufficiency 495 Management of renal osteodystrophy 505 Peritoneal dialysis 516 Jonas Bergstrom M D 521 Dialysis access surgery 533 Dialyzers and water treatment 545 Dialysis ultrafiltration and hemofiltration 555 Use of drugs in uremia [books.google.de]

    Management of acute renal failure <ul><li>Management of volume homeostasis </li></ul><ul><li>Management of electrolyte homeostasis </li></ul><ul><li>Management of acid- base homeostasis </li></ul><ul><li>Management of uremia </li></ul><ul><li>Nutritional [slideshare.net]

    The equilibrium between GFR and tubular reabsorption is lost in advanced uremia, sometimes in earlier stages, depending on the concomitant complications as hypertension or/ and the primary renal diseases [ 21 ]. [ncbi.nlm.nih.gov]

    AKI may lead to a number of complications, including metabolic acidosis, high potassium levels, uremia, changes in body fluid balance, and effects on other organ systems, including death. [en.wikipedia.org]

  • Polyuria

    Recovery phase: due to recovery of renal function (polyuria). ARF due to other causes as partial obstruction may present as polyuria. ARF due to postrenal obstruction may present as anuria. [doctorslounge.com]

    Consequently, in advanced renal failure, accompanied by low residual GFR, patients might present different diuresis, from oligoanuria to polyuria. [ncbi.nlm.nih.gov]

    However, polyuria may occur due to either reduced fluid reabsorption by damaged renal tubules, or the osmotic effect of accumulated metabolites. [patient.info]

    Serum electrolytes need to be closely monitored if polyuria ensues, and replacement of approximately half of the urinary volume with 0.45% saline is recommended. Crystals may cause micro-obstructive uropathy within the tubules. [unboundmedicine.com]

  • Hematuria

    1) Evidence of renal damage Based on abnormal urinalysis [proteinuria, hematuria] or structural abnormalities found with US or 2) GFR < 60 mL/min for 3 or more months!!! [quizlet.com]

    Creatine phosphokinase determination (if rhabdomyolysis is suspected based on clinical history of dehydration or muscle pain with appearance of apparent gross hematuria without red blood cells seen on microscopic examination). [clinicaladvisor.com]

    Urine findings include red blood cell casts, hematuria, and proteinuria. It is important to evaluate all patients with glomerulonephritis for diseases such as systemic lupus erythematosus. [aafp.org]

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]

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]

About 9 (8 Pf and 1 Pv) patients having oliguric renal failure and six patients (all Pf) of nonoliguric renal failure who died during the course of treatment were subjected to trucut percutaneous needle necropsy done by surface marking for renal histopathology [acronyms.thefreedictionary.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]

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]

Classification into such groups, which can be simply made, is valuable in assessing prognosis and the results of treatment. [onlinelibrary.wiley.com]

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]

Languages
Suggested Languages
English en
Other languages 0
2.1
About Symptoma.com COVID-19 Jobs Press Scholarship
Contact Terms Privacy Imprint Medical Device