Protected: Leptospirosis and kidneys: a clinical case

Abstract

We describe here the case of a young patient, employed in agriculture, who entered the emergency room with fever, headache, hematuria and a worsening of renal function; we diagnosed leptospirosis with renal involvement. As the patient lamented very generic symptoms, the anamnesis was fundamental in leading us to suspect an infection, execute the right laboratory analysis, and correctly diagnose a pathology which is currently very rare in Italy.

Keywords: case report, leptospirosis, AKI

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The management of antibiotic therapy in critically ill patients with AKI: between underdosing and toxicity

Abstract

Changes in microbiology and dialysis techniques in intensive care have made the use of antibiotics on nephropathic patients more complex. Several recent studies have modified our knowledge about the use of antibiotics in the care of critically ill patients, highlighting the frequency of their inappropriate use: both underdosing, risking low efficacy, and overdosing, with an increase in toxicity. Kidneys, organs devoted to excretion and metabolism, are a potential target of pharmacological toxicity. Extracorporeal replacement therapy is also a possible drug elimination route. What we call nefropharmacology represents a complex, tangled and rapidly evolving subject of multi-specialist interest. We have reviewed here most of the recent literature dealing with the appropriateness of antibiotic use, focusing on the most interesting contributions from a nephrological perspective.

Keywords: AKI, antibiotics, CRRT, pharmacokinetic

Sorry, this entry is only available in Italian.

A cause of acute renal dysfunction: a giant bladder diverticulum

Abstract

We describe the case of a previously 77-year-old man who accessed in our Nephrology Unit for acute kidney injury (AKI) on chronic kidney disease (CKD), gastric discomfort and vague urinary symptoms with apparently preserved diuresis and suspected “ascites”. Physical examination confirmed the presence of abdominal effusion, even though ultrasound abdominal examination revealed the presence of a giant diverticular urinary bladder with bilateral hydronephrosis. We discuss the diagnostic and therapeutic approach of these rare complications by briefly reviewing the technical aspects and the possible consequences.

 

KEY WORDS: Bladder diverticulum, obstructive nephropathy, AKI

Sorry, this entry is only available in Italian.