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2015 ; 4
(4
): 113-6
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Spectrum of glomerular diseases causing acute kidney injury; 25 years experience
from a single center
#MMPMID26693497
Naqvi R
; Mubarak M
; Ahmed E
; Akhtar F
; Bhatti S
; Naqvi A
; Rizvi A
J Renal Inj Prev
2015[]; 4
(4
): 113-6
PMID26693497
show ga
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.