Online ISSN: 2515-8260

Keywords : Renal Failure


Analysis of Renal Dysfunction in Patients with Liver Cirrhosis: An Institutional Based Study

Jainish Kamlesh Kumar Modi, Alpesh Vadher

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 337-342

Introduction: Liver disease is a common disorder affecting multiple system. It accounts for approximately 2 million deaths every year worldwide and 1 million due to complications of cirrhosis. Current epidemiological trends show that common liver diseases in Asia–Pacific countries are alcohol-related liver diseases, non-alcoholic fatty liver disease (NAFLD), hepatitis B and C, etc. Most of them lead to cirrhosis of liver. Renal dysfunction is one of the most common complications of cirrhosis with high morbidity and mortality.
Materials and Methodology: This study was adopted to be conducted as hospital-based study was carried on 133 cirrhotic patients admitted in the Tertiary care centre. Patients details that includes their demographic data, clinical examination findings and results of laboratory investigations were collected. CTP (Child Pugh) score and MELD (Model for End Stage Liver disease) Score of patients were also briefed. End results for continuous variables were expressed as means and standard deviation. Categorical variables were described as percentages. Significant factors that were associated with the presence of renal dysfunction was analysed using binary logistic regression analysis Bivariate analysis was carried out using pearsons coefficient of correlation. Odds Ratio (OR) was enabled to ascertain the strength of relationship between two variables.
Results: A total of 133 patients were included in this study. Male patients were in majority constituting 85.3% (n=113) of the total population, the rest were females (14.7%). Mean age of patients in the study group was 51.32 years (+ 13.72). The most common aetiology of cirrhosis was found to be alcohol, comprising of about 74.5%. 22 patients had more than 1 aetiology for cirrhosis, the most common of which has combined alcohol and NASH (Non-Alcoholic Steato Hepatitis) related, observed in 9 patients.
Conclusion: The present study has found significant correlation between the severity of liver dysfunction and some parameters of renal dysfunction. However, there is no such significant association was observed between the distribution of various renal parameters among different aetiologies of chronic liver disease.

Acute kidney injury in obstetrics: Varied pathologies and outcomes

Somashekhar HK, Chandrashekhar Shrivastava, Pragyan Paramita Pradhan, Pavan Bhargava Chandramohan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1848-1851

Background: Acute Kidney Injury (AKI) is the sudden loss of renal function. Multiple causes of AKI exist that include those that afflict the general population, and those that are associated with pregnancy. AKI in pregnancy is of particular challenge as there are physiological alterations of renal function in pregnancy. The diagnosis is by abnormalities of renal function tests in addition to the abnormalities reflecting underlying pathologies. Management depends on underlying causes and the prognosis can often be positive.
Material and methods: We present three cases of AKI in pregnancy, their evaluation and management.
Results: The first patient had AKI due to septic abortion and was treated by dialysis. The second patient had AKI due to preeclampsia with severe features and was treated by termination of pregnancy and multiple anti-hypertensives. The third patient had AKI due to hyperemesis gravidarum and was treated aggressively with fluids and anti-emetics.
Conclusion: Early recognition and initiation of appropriate therapy can lead to favourable outcomes in AKI.

Acute kidney injury in obstetrics: Varied pathologies and outcomes.

Somashekhar HK, Chandrashekhar Shrivastava, Pragyan Paramita Pradhan, Pavan Bhargava Chandramohan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1984-1987

Background: Acute Kidney Injury (AKI) is the sudden loss of renal function. Multiple causes of AKI exist that include those that afflict the general population, and those that are associated with pregnancy. AKI in pregnancy is of particular challenge as there are physiological alterations of renal function in pregnancy. The diagnosis is by abnormalities of renal function tests in addition to the abnormalities reflecting underlying pathologies. Management depends on underlying causes and the prognosis can often be positive.
Material and methods: We present three cases of AKI in pregnancy, their evaluation and management.
Results: The first patient had AKI due to septic abortion and was treated by dialysis. The second patient had AKI due to preeclampsia with severe features and was treated by termination of pregnancy and multiple anti-hypertensives. The third patient had AKI due to hyperemesis gravidarum and was treated aggressively with fluids and anti-emetics.
Conclusion: Early recognition and initiation of appropriate therapy can lead to favourable outcomes in AKI.

The Oxidative Effect Of Nlrp3 And Cyp2e1 In Development Of Renal Failure Associated With Hypertension And Diabetes Mellitus Diseases

Alyaa Abdulhadi Salih; Kareem Hamadx Kareem Hamad Ghali2

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 9, Pages 636-644

Renal Failure (RF) is devastating pathology with several causative factors, resulting in dialysis or kidney transplantation needed by end-stage renal disease (ESRD. The progression of RF is closely related to systemic oxidative stress, which causes various complications such as hypertension and diabetic mellitus . The current study was focusing on the oxidative effects of NLRP3 and CYP2E1 gene expression in the pathological development of renal failure disease with hypertension and diabetic mellitus as complications associated diseases. This study involved 100 patients diagnosed clinically and seriologicaly with renal failure 52 males and 48 females, their age from 17 to 80 years . Also the study comprise (18 males and 12 females) healthy volunteers as control group. RNA extracted from blood samples and converted to cDNA which subjected to real-time PCR for detection gene expression . The results detected that Hypertension and diabetic mellitus are the important risk factors that causes and advances renal failure disease . NLRP3 and CYP2E1 have significantly overexpression (1.60 folds and 5.37 folds ) respectively in RF patients compared with healthy group ( p <0.05). However, the expression of NLRP3 and CYP2E1 increase in diabetic mellitus (2.16 and 1.58 ) respectively than hypertension in RF patients with and control group (p<0.05). Diabetic mellitus generate free radical consequently causes ROS, hence elevated expression in oxidative NLRP3 and CYP2E1 genes in diabetic RF patients .

Electrolytes System Disorder And Liver Enzyme Alteration In Adult Men With Hepatocellular Injury

Alzahraa Ibrahim Abdulmajeed; Wafaa Sh. Al – Zuhairi; Ekhlas Abdallah Hassan

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 6, Pages 805-812

Objective: The current study aimed to estimate the magnitude of liver hepatocellular damage in adult men suffering from advanced stages of liver infection considering various important variables (age, BMI, TSB, DSB, GOT, GPT, Na+, K+, Cl-). Background: The main cause of hepatocellular injury is viral hepatitis C. Development of this disease leads to transformation of normal liver tissue into fibroses and nodules (cirrhosis), and it is associated with numerous complications, including gastrointestinal bleeding, ascites, renal function disorder and electrolyte disturbance. Method: The sera of all participants, including 25 patients with VHC and 15 cirrhotic patients, were collected for comparison with 23 control donors (healthy men). The present study was conducted in Baaqubah General Hospital/Diyala. Serum electrolyte concentrations were measured by spectrophotometry assay. Results: significantly decreasing sodium concentration in cirrhotic patients and statistically increasing chloride concentration in patients with liver disease compared with the control (P value < 0. 05). Furthermore, a number of disorders that effect of the liver enzymes levels, Conclusion: The essential decrease in sodium (Na+) concentration was observed in cirrhotic men caused by reduction in renal perfusion. This result is in contrast to that of serum chloride, which increased in patients with liver diseases.