September 2017

Original Article

Changes in renal functions of sickle cell anemia patients during and after painful crisis

Can Huzmeli1, Edip Uçar1, Ali Borazan2, Hasan Kaya3

1Departmment of Internal Medicine, 2Department of Nephrology, 3Department of Hematology, Mustafa Kemal University, Hatay, Turkey

DOI: 10.4328/AEMED.119

Abstract

Aim: We aimed to investigate glomerular filtration rate (GFR) observed dur- ing the painful crisis and 15 days after the painful crisis of sickle cell anemia (SCA) patients. Material and Method: A total of 38 patients with SCA were included in the study. 25 of these patients were male, and 13 were female. The amount of creatinine and albumin in urine in 24 hours and serum creati- nine level were determined during and after 15 days from SCA painful crisis. In the patients, the creatinine clearance was measured during and after 15 days from SCA painful crisis. Results: In SCA patients, the average creatinine clearance during the painful crisis was determined as 136.0 ± 80.0 mL / min, after 15 days from the painful crisis, the average creatinine clearance was determined as 124,8 ± 53,4 ml/min (44,9-238,3). In SCA patients, there was no significant difference between the creatinine clearance calculated during the painful crisis and 15 days after the painful crisis (p>0,05). In SCA patients, during the crisis, the amount of albuminuria was 199.5 ± 408.3 mg/ day (2.6-1943) while it was determined 167.0 ± 399.7 mg/day (5.7-1944.9) after 15 days of the crisis. There was no statistically significant difference between albuminuria during and 15 days after the crisis. Discussion: In SCA patients, there was no significant difference between the creatinine clear- ances calculated during and 15 days after the SCA painful crisis. SCA pa- tients were found to have decreased albuminuria 15 days after the crisis.

Keywords

Sickle Cell Anemia; Crisis; Creatinine Clearance

Corresponding Author: Can Hüzmeli, Department of Internal Medicine, Faculty of Medicine, Mustafa Kemal University, 31100, Hatay, Turkey. GSM: +905067159443 E-Mail: chuzmeli@hotmail.com

How to cite this article: Changes in renal functions of sickle cell anemia patients during and after painful crisis. Huzmeli C, Uçar E, Borazan A, Kaya H. J Ann Eu Med 2017;5(3): 64-7.

Early period effect of the massive pleural effusion drainage on hemodynamic and pulmonary functions

Ömer Faruk Demir, Ömer Önal

Department of Thoracic Surgery, Faculty of Medicine, University of Erciyes, Kayseri, Turkey

DOI: 10.4328/AEMED.118

Abstract

Aim: The objective of our study was to put forth the acute changes in he- modynamic and pulmonary functions following massive pleural effusion via thoracoscopy. Material and Method: A total of 20 patients who underwent thoracoscopy due to massive pleural effusion between January 2012 and January 2013 were included in our study. Partial oxygen pressure, partial car- bondioxide pressure, respiratory rate, pulse rate, systolic and diastolic blood pressures of the patients were measured one day before and one day after pleural effusions drainage. The central venous pressure, pulmonary capillar- ies wedge pressure and pulmonary artery pressure values of the patients were measured via Swan Ganz catheter before and after pleural effusion drainage. Results: The average amount of pleural effusion drainage was 2205±734 cc. A statistically significant changes were observed in the re- spiratory rate, systolic blood pressure, partial oxygen pressure, pulmonary artery pressure, central venous pressure, and pulmonary capillaries wedge pressure with pleural effusion drainage (p < 0.05). No statistically signifi- cant changes were observed in diastolic blood pressure, partial carbondiox- ide pressure, and pulse rate (p >0.05). Discussion: Massive pleural effusion drainage is ineffective at the early stage on diastolic blood pressure, partial carbondioxide pressure, and pulse rate.

Keywords

Hemodynamic; Pleural Effusion; Pulmonary Function

Corresponding Author: Omer Faruk Demir, Department of Thoracic Surgery, Erciyes University Medical Faculty, 38039, Kayseri, Turkey. T.: +903522076666 GSM: +905302935204 F.: +90 3524375273 E-Mail: ofdemir@erciyes.edu.tr

How to cite this article: Early Perİod Effect of the Massıve Pleural Effusion Draınage on Hemodynamıc and Pulmonary Functıons. Demir ÖF. J Ann Eu Med 2017;5(3): 60-3.

Spectrum and outcome of acute kidney injury: A tertiary care centre experience from north india

H.K. Aggarwal1, Deepak Jain2, Ajit Singh3, R K Yadav4, Promil Jain5

1Head Department of Medicine III and Division of Nephrology, Pt. B.D. Sharma University of Health Sciences, Rohtak, Haryana, 2Department of Medicine and Division of Nephrology, Pt. B.D. Sharma University of Health Sciences, Rohtak, Haryana, 3Department of Medicine, Pt. B.D. Sharma University of Health Sciences, Rohtak, Haryana, 4Department of Nephrology, AIIMS, New Delhi, 5Department of Pathology Pt. B.D. Sharma University of Health Sciences, Rohtak, Haryana

 

DOI: 10.4328/AEMED.114

Abstract

Aim: Acute kidney injury (AKI) is usually marked by a rise in serum creatinine concentration or by azotemia (a rise in blood urea nitrogen concentration). Prerenal AKI represents the most common form of kidney injury and often leads to intrinsic AKI if it is not promptly corrected. Approximately 95% of consultations with nephrologists are related to AKI. The present study was designed to find the spectrum and outcomes of acute kidney injury requiring hemodialysis in a tertiary care hospital. Only a few small studies are available from the Indian population; hence, there was a need for a large cohort prospective study. Material and Method: A total of 2777 in-house patients in the medicine, surgery, and obstetrical wards of PGIMS Rohtak were screened for AKI as per KDIGO guidelines. The study was prospective, conducted from 1 April 2015 to 31 December 2016. All the AKI patients were followed for 3 months after discharge from hospital and their various spectrum and outcomes were analysed. Results: Out of a total of 112 AKI patients, the mean age was 35.21±16.85 years; 51.78% were fe- male. 94 had community-acquired AKI, while 18 had hospital-acquired AKI. 60 patients were hemodialysed; of these 50 were oliguric and 10 were nonoliguric. Mortality was higher in oliguric patients as compared to nonoliguric. The majority of patients (53.33%) were from the medical specialty, in which sepsis and gastroenteritis with hypovolemia were the main causes. Obstetrical and gynecological cases constituted 26.66%, of which the leading cause was eclampsia. Surgical cases were 13.33%. Regarding the final outcome for the AKI patients, 59.82% patients recovered with normal renal function, 21.42% patients died, and 18.75 patients developed CKD. Out of the 60 patients requiring hemodialysis, 21 patients recovered with normal renal function, 20 patients died within 3 months, and 19 patients developed CKD. Of those, 8 required maintaining hemodialysis. Discussion: AKI is associated with high mortality and morbidity in the community if not managed promptly. Sepsis and hypovolumia were the most common causes of AKI in the present study. There should be a low threshold for early diagnosis and management of AKI in critically ill patients. Renal replacement therapy such as hemodialysis should be started early once indicated.

Keywords

Acute Kidney Injury; Hemodialysis; Renal Replacement Therapy; Creatinine

Corresponding Author: Deepak Jain, Department of Medicine, Pt. B.D. Sharma University of Health Sciences, Rohtak-124001, Haryana, India. T.: +91-9416147887 E-Mail:jaindeepakdr@gmail.com

How to cite this article: Aggarwal H.K., Jain D, Singh A, Yadav RK, Jain P. Spectrum and Outcome of Acute Kidney Injury: A Tertiary Care Centre Experience From North India. J Ann Eu Med 2017;5(3): 53-9.