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Nephrology, including fluid and electrolytes
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
There is a fall in C3 fraction of complement because of activation of the alternate pathway. Serum IgA and albumin levels are within normal limits. Urine shows granular and red cell casts. Oliguria occurs in severe cases.
Fluid balance and continence care
Published in Barbara Smith, Linda Field, Nursing Care, 2019
Certain abnormalities occur in the production and the elimination of urine: Polyuria: this is the production by the kidneys of abnormally high amounts of urine, sometimes as much as several litres per day. Polyuria is usually associated with diseases such as diabetes mellitus, diabetes insipidus and chronic nephritis (inflammation of the nephrons within the kidney).Oliguria: this is decreased urine output, usually less than 500 mL a day or 30 mL an hour. Oliguria often indicates impaired blood flow to the kidneys or impending renal failure and should be dealt with immediately.Anuria: this is the absence of urine production. Anuria is a serious medical condition that usually follows oliguria. It must be treated immediately in order to prevent death from renal failure. Renal dialysis is used when the kidneys are no longer able to filter blood.
Rift Valley Fever
Published in James H. S. Gear, CRC Handbook of Viral and Rickettsial Hemorrhagic Fevers, 2019
Following the severe liver damage and coincident with its later stages, an increasing renal disorder becomes evident. This is related to fibrin deposition in the glomerular capillaries and degeneration of the proximal tubules. This kidney damage is reflected in decreasing amounts of urine which, on microscopic examination, will show red cells, white cells, and, possibly, casts. The oliguria is followed in severe cases by anuria and complete kidney failure.
Urine N-terminal pro-B-type natriuretic peptide and plasma proenkephalin are promising biomarkers for early diagnosis of cardiorenal syndrome type 1 in acute decompensated heart failure: a prospective, double-center, observational study in real-world
Published in Renal Failure, 2022
Hong-Liang Zhao, Hai-Juan Hu, Xiu-Jie Zhao, Wei-Wei Chi, De-Min Liu, Qian Wang, Wei Cui
This is a prospective, double-center, observational study in a real-world setting. Consecutive hospitalized patients with ADHF [17] from The First Hospital of Hebei Medical University and The Second Hospital of Hebei Medical University were enrolled. ADHF was diagnosed based on the current guidelines criteria [18], showing typical symptoms and/or signs of ADHF and plasma B-type natriuretic peptide (pBNP) >100 pg/mL. AKI was defined according to the KDIGO criteria [5] as an increase in sCr of ≥ 26.5 mol/L (0.3 mg/dL) within 48 h or an increase in SCr by ≥ 50% within 7 d. For the homogeneity and reliability of the sCr tests that we can control and refer to the prior literature [6,19], the lowest value of sCr monitored during hospitalization and follow-up was defined as the baseline. We did not use oliguria for AKI diagnosis because its measurement is inaccurate in non-ICU or no-CCU wards. The inclusion criteria were as follows: (1) age ≥ 18 years; (2) enrollment within 1 h after admission for ADHF; (3) hospital stay time > 48 h. The exclusion criteria included: (1) on dialysis or needing emergency dialysis; (2) cardiogenic shock, acute myocarditis, acute aortic dissection, or concomitant terminal disease; (3) end-stage kidney disease, urinary tract infections or obstruction; (4) autoimmune diseases, sepsis, or surgery within one month; (5) heart or kidney transplantation; (6) exposure to nephrotoxic substances within 1 month (e.g., chemotherapy, radiotherapy, or contrast agents).
Intraabdominal pressure as a marker for physiologic and pathologic processes in pregnancy
Published in Hypertension in Pregnancy, 2022
Kavita Narang, Amy L. Weaver, Ramila A. Mehta, Vesna D. Garovic, Linda M. Szymanski
PreE is a heterogenous disease and can increase both maternal and fetal morbidity and mortality. As previously hypothesized and discussed, IAP appears to be both a cause and result of PreE. Clinical consequences of severely elevated IAP in the setting of PreE may result in ACS. This may present as signs and symptoms of oliguria and multiorgan dysfunction and may warrant more urgent intervention, than in typical PreE patients. There are two case reports (24,32) describing overt ACS in the setting of PreE/HELLP syndrome where the patient presented with oliguria (24) and hepatic rupture (32). Another case report (33) describes unusual presentation of acute renal failure necessitating emergency Cesarean delivery in a twin pregnancy complicated by HELLP syndrome, suggesting a possible undiagnosed ACS. The renal function gradually and spontaneously returned to baseline within 72 hours postpartum.
Clinicopathological characteristics and predictors of poor outcome in anti-glomerular basement membrane disease – a fifteen year single center experience
Published in Renal Failure, 2021
Zafirah Zahir, Asif Sadiq Wani, Narayan Prasad, Manoj Jain
Patients <18 years of age were regarded as children. Microscopic hematuria was defined as at least 5 red cells per high-power field on microscopic examination or positive blood by urine dipstick. Nephrotic syndrome was defined as nephrotic range proteinuria of >3.5 g per 24 h per 1.73 m2 (in children, >40 mg/m2/hr or PCR >2000 mg/g [>200 mg/mmol] or >300 mg/dl or 3 + on urine dipstick) along with hypoalbuminemia and edema [7,8]. Rapidly progressive glomerulonephritis (RPGN) was defined as the rapid loss of renal function within days to weeks, accompanied by nephritic syndrome features (proteinuria, glomerular hematuria and often oliguria) [9]. Oliguria was defined as urinary output of <400 mL/24 h while anuria was defined as urinary output of <100 mL/24 h. Advanced renal failure at presentation was defined as serum creatinine >5.7 mg/dl, in accordance with a few previous studies [4]. Dialysis-dependent renal failure was defined as the need to dialyze the patient within 72 h of admission to the hospital [6]. A diagnosis of pulmonary hemorrhage was rendered in patients with overt hemoptysis and/or pulmonary interstitial opacities on computed tomography (CT) chest and/or bronchoalveolar lavage showing alveolar hemorrhage [10].