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Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

DRESS syndrome is an uncommon condition with an estimated incidence that varies between 1:1000 and 1:10,000 drug exposures. In hospitalized patients, DRESS accounts for 10-20% of all cutaneous adverse drug reactions; the risk of developing it varies from drug to drug. 75% of cases are due to some high-risk drugs, such as aromatic anticonvulsants, allopurinol, and some antibacterial agents such as sulfonamides or beta-lactams. We present the case of a patient who developed DRESS syndrome with renal involvement associated with the use of linezolid, a drug that has been infrequently associated with severe drug reactions. [ABSTRACT FROM AUTHOR]

Background: Acute kidney injury that occurs in critical illness of patients infected with SARS-CoV-2 requires renal replacement therapy, as demonstrated by large studies in China and Italy where 12 % required renal replacement therapy. Purpose: To present the use of popliteal venous access for catheter placement in critically ill patients in the prone position, in whom renal replacement therapy will be started, and the supine position is impossible. Case presentation: A young patient of 42 years of age, hospitalized for COVID-19 pneumonia, a few days later presents severe ARDS, requiring mechanical ventilation and a prone position strategy, on the third day he develops acute kidney injury, renal replacement therapy was started, due to his oxygenation disorder and hemodynamic instability, the supine position was impossible, so it was decided to place a temporary catheter for hemodialysis in the left popliteal vein guided by ultrasound. Discussion and conclusion: Considering our case, the patient could not be placed supine due to severe hypoxemia, and first-line venous accesses such as jugular, femoral and subclavian were limited by position. Popliteal venous access is safe, offering advantages such as operator comfort when inserting the catheter under ultrasound guidance, being an easy access route, and secondly, it presents less risk of contamination, so we recommend this venous access as an alternative in this group of patients. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Sepsis-induced acute kidney injury (AKI) is a significant threat, contributing to worse outcomes in intensive care unit (ICU) patients. Thus, understanding the complex relationship between sepsis and renal dysfunction in ICU patients is crucial. We aimed to investigate the factors that may predispose to the development and the clinical consequences of new-onset AKI in septic medical ICU patients in this study. METHODS: This retrospective cohort was conducted between December 2019 and April 2023 in the tertiary medical ICU of Gazi University Hospital, Ankara, Turkiye. Participants included septic medical ICU patients aged =18 without AKI on ICU admission. Data included demographics, comorbidities, disease severity and prognostic scoring, ICU admission, and ICU follow-up data. Statistical analyses, including logistic regression, were performed to identify independent risk factors for new-onset AKI development and ICU mortality. RESULTS: Patients with new-onset AKI (36% incidence) had higher APACHE-II (21 [16-27] vs. 16 [12-18]) and SOFA (6 [3-9] vs. 3 [2-5]) scores and lower GCS (10 [6-15] vs. 14 [10-15]) on ICU admission (p<0.01 for all results). Independent risk factors for both new AKI development and ICU mortality included invasive mechanical ventilation (IMV) (OR (95% CI): 5.02 [1.59-15] for AKI and OR (95% CI): 13.2 [3-58.8] for ICU mortality, p<0.01), new-onset shock (OR (95% CI): 3.98 [1.42-11.1] for AKI, OR (95% CI): 14.5 [4.4-43.5] for mortality, p<0.01), and higher APACHE-II score (OR (95% CI): 1.08 [1.01-1.16]), for AKI, p=0.05 and (OR (95% CI): 1.04 [1.01-1.08], for mortality, p=0.01). AKI was more frequent in patients whose source of infection was the respiratory system (45% vs. 29%, p=0.01) and catheter-related bloodstream infection (CRBSI) (17% vs. 8%, p=0.03) than those who did not. New AKI development was associated with longer ICU stay (9 [5-18] vs. 5 [3-10] days, p<0.01) and was independently associated with ICU mortality (OR (95% CI): 28.6 [6.6-125], p<0.01). CONCLUSION: This study reveals new-onset AKI incidence of 36% in septic medical ICU patients. Additionally, it underlines the potential impact of infection sources on new AKI development. New-onset shock, IMV, and disease severity were independently associated with both new-onset AKI and ICU mortality in this population. [ABSTRACT FROM AUTHOR]

Copyright of Médicas UIS is the property of Universidad Industrial de Santander and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVES: To determine the incidence of acute kidney injury during the first 7 days post-orthotopic liver transplantation and to identify factors associated with acute kidney injury. MATERIALS AND METHODS: A retrospective, single-center analysis was conducted from 2018 to 2023, including patients undergoing liver transplantation. Preoperative, intraoperative, and postoperative variables were analyzed. Variables were evaluated in three multivariate linear regression models. A p value < 0.05 was considered statistically significant. RESULTS: A total of 45 patients were included from which 19 manifested acute kidney injury according to KDIGO criteria. In the preoperative univariate analysis, BUN, urea, MELD-Na score, intraoperative hypotension, time at Intensive Care Unit, and intrahospital stay days (6 vs 9) were statistically significantly associated with acute kidney injury. In the multivariate analysis, only preoperative MELD-Na score, intraoperative hypotension, and time at Intensive Care Unit remained statistically significantly associated with the development of acute kidney injury after orthotopic liver transplantation. CONCLUSIONS: The incidence of acute kidney injury after orthotopic liver transplantation was lower than previously reported in Mexico and in international studies. Similarly, the main factors associated with acute kidney injury after orthotopic liver transplantation were preoperative MELD-Na score, intraoperative hypotension, and time at intensive therapy. [ABSTRACT FROM AUTHOR]

Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Acute kidney injury (AKI) is a condition frequently encountered by the nephrologist in the ICU and hospital wards. Purpose: To explore the main pathophysiological determinants of volume status and their clinical application in the management of critically ill patients. Methodology: This article explains the physiology of intravenous fluid (IVF) administration, critically discusses current prescription patterns, and examines the most frequently used devices and tests for hemodynamic monitoring and predicting the response to volume administration. Results: The first cause to rule out is always hypovolemia. Initial management typically involves the early administration of intravenous fluids (IVF), even before nephrologist evaluation. It is essential for nephrologists to understand that additional fluid administration is not without risk and can lead to volume overload. Therefore, IVF administration should only be performed after a positive volume response maneuver. Conclusions: An algorithm is proposed to guide volume administration in patients with AKI. [ABSTRACT FROM AUTHOR]

Introduction: Acute kidney injury is an early-stage renal damage that can be detected by neutrophilic gelatinaseassociated lipocalin protein. Aim: To evaluate the usefulness of neutrophilic gelatinase-associated lipocalin protein as an early marker of Acute Kidney Injury. Methodology: narrative review following the PRISMA statement criteria. PubMed, Scopus, and LILACS were the databases consulted. Results: 23 articles published in the last five years were identified. The evidence shows that this protein has biochemical characteristics useful in the early diagnosis of renal injury in different situations and populations. Discussion: The behavior of NGAL has demonstrated its increase in plasma up to 2 hours after the onset of renal impairment. Likewise, its synthesis is not affected by variables such as sex, body mass index, high protein intake, excess physical activity, and alteration in glomerular filtration, which do modify Crs concentrations. Conclusions: Neutrophilic gelatinase-associated lipocalin meets the criteria to become an early biomarker for Acute Kidney Injury. [ABSTRACT FROM AUTHOR]

Mannitol has been used for many years as an osmotic agent in the management of various medical conditions, including cerebral edema and glaucoma. However, its use has been associated with complications such as changes in blood volume and the internal milieu, leading to its progressive substitution by hypertonic saline solutions. In addition, it has been used to prevent and manage acute kidney injury, particularly in surgical patients, and to preserve diuresis in conditions that may promote acute tubular necrosis. Mannitol has also been used in hemodialysis patients to prevent and treat acute complications such as intradialytic hypotension, cramps, and dialysis disequilibrium syndrome. However, most of the studies are retrospective and of low power. Despite the known associated complications, mannitol continues to be used in many centers due to its availability and easy administration. This review aims to evaluate the efficacy and safety of mannitol in managing kidney diseases. [ABSTRACT FROM AUTHOR]

Introduction: This article summarizes the clinical practice guideline (CPG) for the prevention and management of acute kidney injury in the Social Security of Peru (EsSalud). Objective: Provide clinical recommendations based on evidence for the prevention and management of acute kidney injury in EsSalud. Methods: A guideline development group (GEG) was formed that included medical specialists and methodologists. The GEG formulated 6 clinical questions to be answered by this CPG. Systematic searches of systematic reviews and -when considered relevant-primary studies were carried out in PubMed during 2022. Evidence was selected to answer each of the clinical questions posed. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In regular work meetings, the GEG used the GRADE methodology to review the evidence and formulate the recommendations, the points of good clinical practice, and the corresponding flowcharts. Finally, the CPG was approved with Resolution No. 099-IETSI-ESSALUD-2022. Results: This CPG addressed 6 clinical questions on prevention, diagnosis and management (fluid therapy). Based on these questions, 5 recommendations (3 strong and 2 conditional), 2 BPCs, and 2 flowcharts were formulated. Conclusion: This article summarizes the methodology and evidence-based conclusions of the CPG for the prevention and management of acute kidney injury in EsSalud. [ABSTRACT FROM AUTHOR]

Copyright of Revista Médica Clínica Las Condes is the property of Editorial Sanchez y Barcelo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of INSPILIP. Revista Ecuatoriana de Ciencia, Tecnología e Innovacion en Salud Pública is the property of Instituto Nacional de Investigacion en Salud Publica (INSPI) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: COVID-19 challenged our health system, within the broad clinical spectrum acute kidney injury was presented as a catastrophic event, acute kidney injury and the risk of dependency after dialysis constitute a clinical problem with high repercussions in the funcionality. Objective: To identify risk factors for dialysis dependence after acute kidney injury from COVID-19 Material and methods: A retrospective observational cohort study was carried out at the Hospital de Especialidades del Centro Médico Nacional Siglo XXI, of the Mexican Institute of Social Security, from March 2020 to March 2021. 317 patients were included, we performed descriptive statistics, we compared differences between the stages of acute kidney injury, finding a difference in obesity with a frequency of 2.2% in stage 1, 20.82% stage 2 and 14.51% stage 3, with p value = 0.018. Results: We found dialysis dependence one year after hospital-acquired acute kidney injury induced by COVID-19 in 58 patients (18.9%), we analyzed by KDIGO stage, in those patients who had AKI KDIGO 1 (2.83%) it depended on dialysis at one year, in the KDIGO stage 2 (3.78%), in the KDIGO stage 3 (11.67%) Conclusions: Our study allowed us to identify that the risk factors associated with dialysis dependence are: male gender, type 2 diabetes mellitus, obesity, cardiovascular disease. [ABSTRACT FROM AUTHOR]

Introduction: hyperchloremia and hypernatremia are common complications in critically ill children and have been associated with the development of acute kidney injury (AKI) and mortality. Objective: to estimate the incidence of hyperchloremia and hypernatremia during the first 72 hours of admission to a pediatric intensive care unit (PICU), and to evaluate their association with AKI and mortality. Material and methods: prospective cohort study, conducted over a period of 15 months. Patients with disorders in plasma levels of chloride (Cl-) or sodium (Na+), as well as with AKI at the time of admission, were excluded. Values > 110 mEq/L Cl- and > 145 mEq/L Na+ were considered as hyperchloremia and hypernatremia, respectively. A sample size of 255 patients was calculated. Statistical analysis. Odds Ratio (OR) and 95% confidence intervals (95% CI) were calculated for bivariate and multivariate analyses. Results: among 241 patients, the incidence of hyperchloremia was 12.4% (n = 30), and of hypernatremia 18.6% (n = 45). The frequency of AKI was 35.6%, and mortality was 14.1%. In logistic regression analysis, hypernatremia was associated with AKI (OR 2.7, 95% CI 1.3-5.7, p < 0.006), but not with mortality. While hyperchloremia was not identified as a risk for AKI or death. Conclusions: hyperchloremia and hypernatremia are common in critically ill pediatric patients, but only hypernatremia seems to confer a higher risk of complications. [ABSTRACT FROM AUTHOR]

Copyright of Universitas Médica is the property of Pontificia Universidad Javeriana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Toxicología is the property of Asociacion Espanola de Toxicologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Acute kidney injury (AKI) is frequent in sepsis (25 to 51%), with high mortality (40 to 80%) and long-term complications. Despite its importance we do not have accessible markers in intensive care. In other entities (post-surgical and COVID-19) the neutrophil/lymphocyte and platelet (N/LP) ratio has been associated with acute kidney injury; however, this relationship has not been studied in a pathology with a severe inflammatory response such as sepsis. Objective: To demonstrate the association between N/LP with AKI secondary to sepsis in intensive care. Material and methods: Ambispective cohort study in patients over 18 years who were admitted to intensive care with a diagnosis of sepsis. The N/LP ratio was calculated from admission up to the seventh day and up to the diagnosis of AKI and outcome. Statistical analysis was performed with chi squared test, Cramer's V and multivariate logistic regression. Results: Out of the 239 patients studied, the incidence of AKI developed in 70%. 80.9% of patients with N/LP ratio > 3 had AKI (p < 0.0001, Cramer's V 0.458, OR 3.05, 95% CI 1.602-5.8) and increased renal replacement therapy (21.1 vs. 11.1%, p = 0.043). Conclusion: N/LP ratio > 3 has a moderate association with AKI secondary to sepsis in the intensive care unit. [ABSTRACT FROM AUTHOR]

Ascites is a frequently encountered condition with diverse underlying causes. Among these, uroperitoneum is a rare etiology characterized by a non-specific clinical presentation, making it challenging to diagnose. A thorough approach and a high level of clinical suspicion are essential for accurate diagnosis. The measurement of creatinine levels in peritoneal fluid, serum, and the gradient between them plays a crucial role in achieving a correct diagnosis. In this case report, we present a patient with recurrent ascites and fluctuating elevation of azotemia, who was diagnosed with uroperitoneum through a meticulous diagnostic process. Following surgical intervention, the patient exhibited satisfactory clinical improvement without experiencing further recurrences. [ABSTRACT FROM AUTHOR]

Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Acute renal injury due to collapsing glomerulonephritis is associated with high morbidity and mortality, requiring chronic dialysis, COVID-19 is one of its causes. A 17-year-old male patient presented with a four-month history of edema, foamy urine and reduction in the urine flow; anasarca was observed at physical examination. Laboratory values showed creatinine 4,2 mg/dl; albumin 1,9 gr/dl; cholesterol and triglycerides were high; proteinuria 6,7 gr/24h: leucocyturia and hematuria with negative urine culture. Serologies for HIV, syphilis and hepatitis were negative. Studies for systemic lupus were negative. An antigenic test for SARS-CoV-2 was positive as well as an IgG. Renal Biopsy showed Focal and Segmental Glomerulosclerosis, Collapsing variant. He received corticosteroids and cyclosporine. Creatinine improved; proteinuria remained >3 gr/24 hours. [ABSTRACT FROM AUTHOR]

Copyright of Cogitare Enfermagem is the property of Cogitare Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Dilemas Contemporáneos: Educación, Política y Valores is the property of Dilemas Contemporaneos: Educacion, Politica y Valores and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Habanera de Ciencias Médicas is the property of Universidad de Ciencias Medicas de La Habana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfermería Cuidándote is the property of Colegio Oficial de Enfermeria de Malaga and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The worldwide incidence of acute kidney injury (AKI) in pregnancy is 1.6 to 6.3 per 10,000 pregnancies. In developing countries, maternal mortality due to secondary complications of acute kidney injury is 4 to 5.8%. As it is well known, most cases of acute kidney injury in obstetrics occur during the puerperium, its presentation has been associated with an increase in fetal morbidity and mortality, compared to normoevolutive pregnancies. [ABSTRACT FROM AUTHOR]

BACKGROUND: DRESS syndrome (drug reaction with eosinophilia and systemic symptoms) is associated with exposure to certain drugs. It is potentially fatal (20%), with significant dermatological manifestations and visceral involvement. The main treatment is the immediate withdrawal of the suspected drug, as well as the use of systemic corticosteroids. CLINICAL CASE: A 61-year-old female patient, who, after two weeks of ampicillin consumption, presented a generalized morbilliform skin rash, non-involving soles and palms, and also itchy and painful symmetrical erythematous plaques with lamellar scaling on the face and edema of lips and oral mucosa. Laboratory tests showed leukocytosis with eosinophilia and lymphocytosis as well as impaired kidney and liver function. The histopathological study described hyperkeratosis, spongiosis, and inflammatory infiltrates in the superficial dermis. CONCLUSIONS: DRESS syndrome is a rare and potentially fatal drug reaction, which should be suspected in the presence of a morbilliform rash, fever, hypereosinophilia, as well as visceral involvement, to establish a timely diagnosis and treatment to avoid complications such as multi-organ failure, as well as mortality. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Ciencias Médicas de Pinar del Río is the property of Editorial Ciencias Medicas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Coronavirus disease 2019 (COVID-19) has provoked one of the greatest health crises of our time, which is why risk stratification at the time of hospitalization is essential to identify in good time patients with high morbidity and mortality risk. Dysnatremia as an independent predictor of mortality in patients with COVID-19 has recently become relevant. Objective: To find out if there is an association of dysnatremia with 28-day mortality, and as secondary objectives, its association with hospital stay, invasive mechanical ventilation (IMV) requirement and presence of acute kidney injury (AKI) during hospital stay. Material and methods: Retrospective, descriptive and analytical cohort study. All consecutive patients of 16 years or older of any gender, admitted to a third level hospital from March 1, 2020 to March 2021, who have a diagnosis of COVID- 19 with positive PCR were included. Results: The study included a total of 722 patients. The prevalence of dysnatremia was as follows: 18 patients presented hypernatremia (2.49%) and 153 hyponatremia (21.19%). The presence of hypernatremia once sodium was corrected for glucose was associated with higher mortality (p < 0.05, OR 3.446; 95% CI 1.776-6.688), an increased probability of presenting AKI (p <0.05, OR 2.985; 95% CI 1.718-5.184) and a greater requirement for IMV (p < 0.05, OR 1.945; 95% CI 1.701-5.098). Conclusions: Hypernatremia was associated with higher mortality, higher risk of presenting AKI and the requirement for IMV during hospitalization. [ABSTRACT FROM AUTHOR]

Acetazolamide (ACTZ) is a drug that is used frequently, especially in the treatment of glaucoma. It reduces the secretion of hydrogen in the proximal renal tubule and increases the elimination of bicarbonate and water. Its side effects include nausea, vomiting, abdominal pain, electrolyte imbalances. However, the cases of acute kidney injury (AKI) described are very rare. ACTZ is known to promote the formation of kidney stones due to its effects on urinary pH due to its chronic use, and when excreted in an acidic urinary environment, it can lead to the formation of crystals in the kidney tubules and cause kidney damage. Here we describe a rare case of acute kidney injury that required dialysis secondary to the use of low-dose acetazolamide after cataract surgery. AKI due to acute crystalluria is a potentially severe complication. With the description of this case, we want to emphasize the importance of knowing this rare adverse effect since an early diagnosis that requires high clinical suspicion can avoid complications. [ABSTRACT FROM AUTHOR]

Acute kidney injury is a frequent complication in patients with advanced liver cirrhosis. About 20-50% of patients hospitalized for decompensation of cirrhosis have kidney injury on admission or evolution during hospitalization. The differential diagnosis among the different causes of acute kidney injury is essential and the treatment differs completely among each one. A better prognosis has been observed in patients with parenchymal nephropathy and a poorer prognosis in acute kidney injury-related infections and hepatorenal syndrome. Finally, there are consistent data showing that some urine biomarkers, particularly NGAL (neutrophil gelatinase-associated lipocalin) can be useful in clinical practice for differential diagnosis. Patients with acute kidney injury have a poor short-term prognosis, especially patients with hepatorenal syndrome, so these patients should be selected for liver transplantation, therefore eligible candidates should be identified early and referred for liver transplantation evaluation. [ABSTRACT FROM AUTHOR]

Background: Hyperchloremia has been associated with a greater presence of morbidity and mortality, mainly described in critically ill patients, this may be relative and absolute, which could be reflected in the sodium-chloride difference. Objective: The primary objective was to determine whether the sodium-chloride difference <31 mEq/L measured 24-48 hours after admission is a predictor of 28-day mortality in patients with COVID-19, and as secondary objectives to identify whether it is associated with higher requirement for invasive mechanical ventilation, presence of acute kidney injury and longer hospital stay. Material and methods: Retrospective, descriptive and analytical longitudinal cohort study, was done including all consecutive patients older than 16 years of any gender, admitted to the UMAE from March 1, 2020 to March 2021, which present a diagnosis of COVID-19 with RT-PCR test for SARS-CoV-2 positive. Results: A total of 722 patients were included, the difference sodium-chloride < 31 mEq/L is not associated with an increased risk of death at 28 days (p = 1.172, OR: 1.35; 95%CI, 0.87-2.08) or requirement of mechanical ventilation (p = 0.47, OR: 1.19; 95%CI, 0.76-1.86), but is associated with a higher risk of AKI (p < 0.05, OR: 2.04; 95%CI, 1.33-3.14) and longer hospital stay (p < 0.05). Conclusions: the sodium-chloride difference < 31 mEq/L in the first hours of admission is associated with a higher risk of presenting acute kidney injury during hospital stay in patients with COVID-19, as well as a longer hospital stay. [ABSTRACT FROM AUTHOR]

Introduction: in pediatric age the incidence of acute kidney injury associated with infectious diseases is high. It is considered potentially preventable and presents with high morbidity and mortality. Objective: to characterize pediatric patients with acute kidney injury. Methods: a study was conducted in a hemodialysis center in Angola with a population of 60 pediatric patients evaluated in the period from May 2017 to May 2020. The information was taken from the clinical process of the hospital and the dialysis center. Results: male patients predominated, aged over 10 years. Their etiology was related to malaria and nephrotic syndrome. The main symptoms were neurological and due to volume overload. Conclusions: most of the patients required hemodialysis type renal replacement therapy, with a satisfactory evolution and low mortality. [ABSTRACT FROM AUTHOR]

The cardiorenal syndrome is a complex entity in which a primary heart dysfunction causes kidney injury (Types 1 and 2) and vice versa (Types 3 and 4), being either acute or chronic events, or maybe the result of a systemic disease that involves both organs (Type 5). Approximately 49% of heart failure cases present some grade of kidney dysfunction, significantly increasing morbidity and mortality rates. Its pathogenesis involves a variety of hemodynamic, hormonal and immunological factors that in the majority of cases produce fluid overload; the diagnosis and treatment of such constitutes the disease's management basis. Currently, a clinical based diagnosis is insufficient and the use of biochemical markers, such as natriuretic peptides, or lung and heart ultrasound is required. These tools, along with urinary sodium levels, allow the evaluation of therapy effectiveness. The preferred initial decongestive strategy is based on a continuous infusion of a loop diuretic with a step-up dosing regimen, aiming for a minimal daily urine volume of 3 liters, with the possibility to sequentially add potassium sparing diuretics, thiazide diuretics and carbonic anhydrase inhibitors to reach the diuresis goal, leaving ultrafiltration as a last resource due to its higher rate of complications. Finally, evidence-based therapy should be given to improve quality of life, decrease mortality, and delay the deterioration of kidney and heart function over the long term. [ABSTRACT FROM AUTHOR]

Copyright of Revista Argentina de Cardiología is the property of Sociedad Argentina de Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVE: To demonstrate if in patients with COVID-19 hypoxemia is a risk factor of acute kidney injury. MATERIALS AND METHODS: Cross-sectional, retrospective, descriptive, analytical study was done from May 1st to September 30th, 2020, including patients over 18 years of age admitted to the emergency service of a COVID-19 care medical center with the criteria of a suspected case of COVID-19 plus chest tomography with suggestive images. They were classified by the serum creatinine (SCr) value: Group 1 (G1) without acute kidney injury and group 2 (G2) with acute kidney injury. RESULTS: One hundred and five patients were recruited. G1 included 32 patients (30.5%) and G2 73 (69.5%). Median SCr at admission was 0.7 and 1.0 mg/dL for G1 and G2, respectively (p = 0.05). The median PaO2/FiO2 at admission for G1 was 90 mmHg and for G2 105 mmHg (p = 0.76) without finding association with admission acute kidney injury; arterial oxygen saturation (SatO2) equal or higher than 92% to the moment of admission to the emergency department presented a negative correlation for the development of acute kidney injury (Pearson: -0.537, p = 0.04). CONCLUSIONS: In the initial phase of COVID-19, hypoxemia is not a triggering factor for acute kidney injury; however, SatO2 can be a distracting marker of respiratory stability since persistent hypoxemia would be one more conditioning of acute kidney injury. [ABSTRACT FROM AUTHOR]

Hypouricemia is a biochemical disorder and marker for primary or secondary tubulophaty and other underlying illnesses, defined as a serum uric acid concentration lesser than 2 mg/dL. It occurs in approximately 2% of hospitalized patients and in lesser than 0.5% of general population. Hypouricemia may be caused by decreased uric acid production, uric acid oxidation or decreased renal tubular reabsortion. Differential diagnosis of hypouricemia is usually made by evaluating the fractional excretion of uric acid. Patients with hypouricemia may have an increased incidence of acute kidney injury related to exercise and reduced kidney function. The aim of this paper is to review current concepts related to hypouricemia and emphasize the importance of its evaluation and follow-up. [ABSTRACT FROM AUTHOR]

Introduction: Acute kidney injury is a complication described in patients with SARS-CoV-2 infection that is around 0.5-7% of cases. Objective: evaluate the prognostic value of kidney involvement in patients hospitalized for COVID-19 disease. Methods: A prospective cohort of patients over 18 years with a diagnosis of COVID-19 disease in the period from May to October 2020 was analyzed. All were followed up until hospital discharge or death. Clinical and biochemical parameters, Charlson score, mortality and severity of COVID-19 disease were evaluated. Results: Four hundred twelve patients entered the study, 57% men and mean age 51 ± 16 years. Twenty percent had a Charlson score ≥3, the incidence of acute kidney injury, defined as the increase in serum creatinine 0.3 mg / dl from baseline, was 5.5% (n = 23) and hospital mortality was 2.2% (n = 9). The bivariate and multivariate analysis showed that the male sex [OR= 0.32 (IC 0.12-0.82), p = 0.017], D-dimer> 500 ng/ml [OR= 3.68 (IC 1.23-10.96), p = 0.019], urinary protein/creatinine > 0.20 [OR= 2.43 (CI 1.03-5.74), p = 0.043], and AKI [OR= 10.53 (CI 2.99-37.09), p <0.0001] were predictors of severe COVID-19, defined as respiratory rate >30 x min, oxygen saturation <93% or PO2/FIO2 <300. The univariate analysis of mortality was associated with the development of severe COVID-19 [OR= 68.76 (CI 8.39-563.36), p <0.0001] and acute kidney injury [OR= 45.41 (CI 10.45-197.22), p <0.0001]. Conclusion: Renal involvement is associated with worse evolution and higher mortality in COVID-19. The assessment of renal function and proteinuria are accessible parameters that should be included as risk factors in the initial evaluation of these patients. [ABSTRACT FROM AUTHOR]

Copyright of Acta Medica Colombiana is the property of Acta Medica Colombiana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Toxicología is the property of Asociacion Espanola de Toxicologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfermería Nefrológica is the property of Sociedad Espanola de Enfermeria Nefrologica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Acute kidney injury occurs frequently in patients with sepsis, so identifying risk factors may be useful to avoid this complication. One of factors that have charged interest is the level of chlorine. OBJECTIVE: To determine the association between hyperchloremia and the development of acute renal injury using negative chlorine delta as well as creatinine delta. MATERIALS AND METHODS: Fifty-six patients with sepsis (qSOFA = 2), 28 with chlorine = 110 (when admitted to the emergency room or at 72 h) and 28 with chlorine < 110 were included. The chlorine delta and creatinine delta were analyzed establishing an improvement in the creatinine level with a negative creatinine delta < 0.04 mg/dL. Two groups were established: patients with renal failure and without renal failure. RESULTS: An association was detected between the patients who observed hyperchloremia with the development of renal failure (p = 0.04). We obtained an OR of 7 with a 95%CI of 0.8 to 65. In Pearson's correlation between delta chlorine and delta creatinine negative, a bilateral significance of 0.024 was obtained with an R of -0.3. CONCLUSIONS: Acute renal injury is statistically significant associated with hyperchloremia in patients with sepsis compared with normochloremia. [ABSTRACT FROM AUTHOR]

BACKGROUND: Loxoscelism is a clinical picture resulting from the bite of the spider of the genus Loxosceles, it constitutes an important public health problem in several Latin American countries, including Mexico. CLINICAL CASE: A 31-year-old male patient with diagnosis of loxoscelism, presenting acute myocarditis as an unusual manifestation and multiple organ failure. Despite of an unfavorable prognosis, outcome was good. CONCLUSIONS: Studies are needed to implement diagnostic criteria that require laboratory studies, such as markers of hemolysis and sphingomyelinase D concentrations. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Even though currently the cornerstone of research and treatment of COVID-19 patients has been the respiratory system, it is essential to consider that COVID-19 has multiple extrapulmonary manifestations, some severe enough to be fatal. For this reason this review focuses on three intimately related systems: cadiovascular, renal and hematological systems. SARS-CoV-2 enters cells through angiotensin converting enzyme 2 (ACE2), a key regulator of the renin-angiotensinaldosterone system (RAAS), which has been characterized in multiple cardiovascular and renal diseases. The hyperinflammatory state in COVID-19 leads to microvascular dysfunction, hypercoagulability, arrhythmias, and acute kidney injury. The importance of diverse multisystemic markers should be highlighted, they have been shown to be predictors of severity and highly useful in the management of patients with COVID-19 to avoid future complications related to the disease. [ABSTRACT FROM AUTHOR]

BACKGROUND: Since the beginning of the pandemic caused by the SARS-CoV-2 virus, risk factors have been identified. These can lead to complications in patients with comorbidities, acute renal injury is one of the most important complications of COVID-19. OBJECTIVE: To identify a possible relationship between the indicators of the patient's renal status upon admission and the outcome. MATERIALS AND METHODS: An observational study (retrospective cohort) of patients (series of confirmed cases of COVID-19) who were admitted to the Hospital Central del Estado de Chihuahua, Mexico, from April 1st to October 20th, 2020. A binary logistic regression model was performed. RESULTS: There were included 266 patients. It was found that 82% did not present acute kidney injury on admission, 11.7% were in stage AKIN I, 13.5% AKIN II and 4.5% AKIN III. Patients with COVID-19 without acute renal injury had a higher probability of hospital discharge than those who developed acute renal injury. CONCLUSIONS: Kidney injury influences the prognosis of patients with COVID-19; patients out of range of acute kidney injury based on basal serum creatinine have more probability of being discharged by clinical improvement [ABSTRACT FROM AUTHOR]