Background: Drug-induced acute kidney injury is a common situation in clinical practice. Many treatments are involved and they are even more aggressive when associated with a predisposing factor such as diabetes. We a...Background: Drug-induced acute kidney injury is a common situation in clinical practice. Many treatments are involved and they are even more aggressive when associated with a predisposing factor such as diabetes. We aimed to investigate clinical features of acute drug-induced kidney injury in diabetics in order to clarify renal prognosis. Methods: This was a descriptive and analytical retrospective study including diabetics who presented drug-induced acute kidney injury, conducted in our department during the period from 1986 to 2015. Acute kidney injury was classified according to Kidney Disease Improving Global Outcomes criteria. We analyzed medical records of patients. Results: 31 patients were included with mean age of 65.41 years and gender ratio M/F at 0.93. Diabetes was type 2 in 97% of cases. Mean previous creatinine clearance was 39.33 ml/min/1.73 m<sup>2</sup>. Drugs involved were blockers of renin-angiotensin system (35%), aminoglycosides (16%), non-steroidal anti-inflammatory (16%), diuretics (13%), lipid-lowering agents (10%), rifampicin (6%) and ifosfamide (3%). Extracellular dehydration was present in nine cases (29%). Main drug combinations were with diuretics in 16 cases (52%) and with ACE inhibitor or ARB in eight cases (26%). Oligo anuria was observed in 5 cases (16%). Proteinuria with urine strips was objectified in 25 cases (81%). Acute kidney injury was grade 3 in 24 cases (77%), grade 2 in three cases (10%) and grade 1 in four cases (13%). Renal survival at 102 months was 57%. Identified renal prognosis factors were serum phosphorus >1.47 mmol/l (p = 0.01), proteinuria at urine strips (p = 0.042), dehydration (p = 0.013), oral antidiabetic treatment (p = 0.038), intravenous rehydration (p = 0.021) and insulin (p = 0.006). Conclusion: Drug-induced acute kidney injury is potentially serious in diabetics. Prevention is essential to improve the prognosis of this renal damage.展开更多
It’s a retrospective study whose aim was to evaluate the incidence and the mortality in a popula-tion including 329 patients who received first kidney transplants from a living donor in 269 cases and cadaveric donor ...It’s a retrospective study whose aim was to evaluate the incidence and the mortality in a popula-tion including 329 patients who received first kidney transplants from a living donor in 269 cases and cadaveric donor in 60 cases at Internal Medicine A department between June 1986 and December 2003. Aetiologies of mortality in our kidney transplant recipients were determined. There were 157 males and 75 females having an average age of 30.8 years. After a period of follow-up of 5.64 years, 51 patients (21.98%) died. Aetiologies of mortality were multiple and were known in approximately 98% of cases. Infections were observed in 25 cases. Cancer was observed in 7 cases (13.72%). Patient survival was not affected by gender, donor age or cause of donor death. Infections represent the major cause of mortality in our patients even many years after kidney transplantation. The maximum of death occurred in the 8th year after kidney transplantation.展开更多
The sarcoidosis is a systemic granulomatosis affecting most frequently the lungs and the mediastinum. An acute renal failure reveals exceptionally this disease. It’s a retrospective study implicating 13 cases of sarc...The sarcoidosis is a systemic granulomatosis affecting most frequently the lungs and the mediastinum. An acute renal failure reveals exceptionally this disease. It’s a retrospective study implicating 13 cases of sarcoidosis complicated of acute renal failure. The aim of this study is to determine epidemiological, clinical, biological and histological profile in these cases and the interest of considering sarcoidosis diagnosis in case of unexplained renal failure. Extra-renal complications, therapeutic modalities and the outcome were determined in all patients. Our series involved 13 women with an average age of 41 years. Biological investigations showed an abnormal normocalcemia in 8 cases, a hypercalcemia in 5 cases, a hypercalciuria in 11 cases and polyclonal hypergammaglobulinemia in 7 cases. An acute renal failure was found in all patients with a median creatinin of 540 umol/L. The renal echography was normal in all patients. The kidney biopsy performed in all patients showed tubulo-interstitial nephritis. The extra-renal signs were: pulmonary interstitial syndrome in 5 cases, a sicca syndrome in 4 cases, mediastinal lymphadenopathy in 2 cases, a lymphocytic alveolitis in 3 cases, an anterior granulomatous uveitis in 3 cases and a polyarthritis in 6 cases. Six patients benefited from hemodialysis. The treatment consisted of corticosteroid in all cases. The follow up was marked by complete resolution of clinical and biological signs. The diagnosis of renal sarcoidosis should be made rapidly in order to avoid end stage renal failure.展开更多
文摘Background: Drug-induced acute kidney injury is a common situation in clinical practice. Many treatments are involved and they are even more aggressive when associated with a predisposing factor such as diabetes. We aimed to investigate clinical features of acute drug-induced kidney injury in diabetics in order to clarify renal prognosis. Methods: This was a descriptive and analytical retrospective study including diabetics who presented drug-induced acute kidney injury, conducted in our department during the period from 1986 to 2015. Acute kidney injury was classified according to Kidney Disease Improving Global Outcomes criteria. We analyzed medical records of patients. Results: 31 patients were included with mean age of 65.41 years and gender ratio M/F at 0.93. Diabetes was type 2 in 97% of cases. Mean previous creatinine clearance was 39.33 ml/min/1.73 m<sup>2</sup>. Drugs involved were blockers of renin-angiotensin system (35%), aminoglycosides (16%), non-steroidal anti-inflammatory (16%), diuretics (13%), lipid-lowering agents (10%), rifampicin (6%) and ifosfamide (3%). Extracellular dehydration was present in nine cases (29%). Main drug combinations were with diuretics in 16 cases (52%) and with ACE inhibitor or ARB in eight cases (26%). Oligo anuria was observed in 5 cases (16%). Proteinuria with urine strips was objectified in 25 cases (81%). Acute kidney injury was grade 3 in 24 cases (77%), grade 2 in three cases (10%) and grade 1 in four cases (13%). Renal survival at 102 months was 57%. Identified renal prognosis factors were serum phosphorus >1.47 mmol/l (p = 0.01), proteinuria at urine strips (p = 0.042), dehydration (p = 0.013), oral antidiabetic treatment (p = 0.038), intravenous rehydration (p = 0.021) and insulin (p = 0.006). Conclusion: Drug-induced acute kidney injury is potentially serious in diabetics. Prevention is essential to improve the prognosis of this renal damage.
文摘It’s a retrospective study whose aim was to evaluate the incidence and the mortality in a popula-tion including 329 patients who received first kidney transplants from a living donor in 269 cases and cadaveric donor in 60 cases at Internal Medicine A department between June 1986 and December 2003. Aetiologies of mortality in our kidney transplant recipients were determined. There were 157 males and 75 females having an average age of 30.8 years. After a period of follow-up of 5.64 years, 51 patients (21.98%) died. Aetiologies of mortality were multiple and were known in approximately 98% of cases. Infections were observed in 25 cases. Cancer was observed in 7 cases (13.72%). Patient survival was not affected by gender, donor age or cause of donor death. Infections represent the major cause of mortality in our patients even many years after kidney transplantation. The maximum of death occurred in the 8th year after kidney transplantation.
文摘The sarcoidosis is a systemic granulomatosis affecting most frequently the lungs and the mediastinum. An acute renal failure reveals exceptionally this disease. It’s a retrospective study implicating 13 cases of sarcoidosis complicated of acute renal failure. The aim of this study is to determine epidemiological, clinical, biological and histological profile in these cases and the interest of considering sarcoidosis diagnosis in case of unexplained renal failure. Extra-renal complications, therapeutic modalities and the outcome were determined in all patients. Our series involved 13 women with an average age of 41 years. Biological investigations showed an abnormal normocalcemia in 8 cases, a hypercalcemia in 5 cases, a hypercalciuria in 11 cases and polyclonal hypergammaglobulinemia in 7 cases. An acute renal failure was found in all patients with a median creatinin of 540 umol/L. The renal echography was normal in all patients. The kidney biopsy performed in all patients showed tubulo-interstitial nephritis. The extra-renal signs were: pulmonary interstitial syndrome in 5 cases, a sicca syndrome in 4 cases, mediastinal lymphadenopathy in 2 cases, a lymphocytic alveolitis in 3 cases, an anterior granulomatous uveitis in 3 cases and a polyarthritis in 6 cases. Six patients benefited from hemodialysis. The treatment consisted of corticosteroid in all cases. The follow up was marked by complete resolution of clinical and biological signs. The diagnosis of renal sarcoidosis should be made rapidly in order to avoid end stage renal failure.
