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ePublished: 20 Nov 2015
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J Renal Inj Prev. 2015;4(4): 113-116.
doi: 10.12861/jrip.2015.24
PMID: 26693497
PMCID: PMC4685980
  Abstract View: 1625
  PDF Download: 959

Original Article

Spectrum of glomerular diseases causing acute kidney injury; 25 years experience from a single center

Rubina Naqvi 1 * , Muhammed Mubarak 1, Ejaz Ahmed 1, Fazal Akhtar 1, Sajid Bhatti 1, Anwar Naqvi 1, Adib Rizvi 1

1 Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
*Corresponding author: Prof. Rubina Naqvi, rubinanaqvi@gmail.com

Abstract

Introduction: Acute kidney injury (AKI) is common in nephro-urological practice. Its incidence, prevalence and etiology vary widely, mainly due to variations in the definitions of AKI.

Objectives: We aim to report the spectrum of glomerular diseases presenting as AKI at a kidney referral center in Pakistan. Patients and Methods: An observational cohort of patients identified as having AKI which was defined according to RIFLE criteria, with normal size, non-obstructed kidneys on ultrasonography, along with active urine sediment, edema and new onset hypertension.

Results: From 1990 to 2014, 236 cases of AKI secondary to acute glomerulonephritis (AGN) registered at this institution. Mean age of patients was 27.94± 12.79 years and M:F ratio was 0.77:1. Thirty percent patients revealed crescents on renal biopsy. AGN without crescents was seen in 33.05% of cases. Postinfectious GN was found in 14.4%, lupus nephritis in 8.5% and mesangiocapillary GN in 3.4% cases. Renal replacement therapy (RRT) required in 75.84% patients. Pulse steroids were given in 45.33% cases followed by oral steroids. Pulse cyclophoshphamide was given in 23.7% cases and plasmapheresis was used in 3.38% cases. Complete recovery was seen in 44%, while 11.44% died during acute phase of illness. About 19.49 % developed chronic kidney disease (CKD) and 25.84% were lost to long- term follow-up.

Conclusion: Although glomerular diseases contribute only 4.19 % of total AKI at this center, morbidity associated with illness and its treatment is more marked than other AKI groups. Another notable factor is late referral of these patients to specialized centers resulting in undesirable outcome.

Keywords: Acute kidney injury, Acute glomerulonephritis, Crescentic glomerulonephritis, Renal biopsy, Plasmapheresis

Implication for health policy/practice/research/medical education:

This study may guide the physicians other than nephrologist who should refer the patients with glomerular diseases to subject specialist at an early stage, so that may prevent young patients progressing into chronic kidney disease (CKD).

Please cite this paper as: Naqvi R, Mubarak M, Ahmed E, Akhtar F, Bhatti S, Naqvi A, Rizvi A. Spectrum of glomerular diseases causing acute kidney injury; 25 years experience from a single center. J Renal Inj Prev. 2015;4(4):113-116. DOI: 10.12861/jrip.2015.24

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