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Kamal F, Snook L, Saikumar JH. Rhabdomyolysis-Associated Acute Kidney Injury With Normal Creatine Phosphokinase. Am J Med Sci 2018; 355:84-87. [DOI: 10.1016/j.amjms.2017.04.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 04/14/2017] [Accepted: 04/18/2017] [Indexed: 10/19/2022]
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Sönmez MG, Göğer YE, Ecer G, Atıcı A, Özkent MS, Öztürk A. Effects of urine alkalinization with sodium bicarbonate orally on lower urinary tract symptoms in female patients: a pilot study. Int Urogynecol J 2017; 29:1029-1033. [PMID: 28975365 DOI: 10.1007/s00192-017-3492-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 09/13/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND HYPOTHESIS In this study, we planned to explore the effects of sodium bicarbonate orally (NaHCO3) treatment on female patients with lower urinary tract symptoms (LUTS) who have acidic urine pH values (<6). METHODS NaHCO3 was given orally to 33 female patients for 4 weeks at a dose of 2 × 4 g/day. Laboratory values, bladder diary, the Patient Perception of Bladder Condition Score (PPBC), Patient Perception of Intensity of Urgency Scale (PPIUS), Overactive Bladder-Validated 8-question Awareness tool (OAB-V8), Pelvic Pain and Urgency & Frequency Patient Symptom Scale tests (PUFSS), and the King's Health Questionnaire (KHQ) scores before and after treatment were compared. RESULTS A significant increase was detected in urine pH values measured after treatment (5.31 ± 0.52 to 7.2 ± 0.66, p < 0.001), but not in blood pH values (7.369 ± 0.33 to 7.384 ± 0.28, p = 0.14). After treatment, a significant decrease was detected in daily frequency, nocturia, urgency, and urge incontinence prevalence (p < 0.001,p = 0.003, p < 0.001, p = 0.002, respectively) and PPBC, PPIUS, PUFSS, and OAB-V8 symptom scores (p = 0.004, p = 0.002, p < 0.001, p < 0.001, respectively). A significant decrease was detected in all KHQ subunit scores. CONCLUSION Urine alkalinization with NaHCO3 orally in female patients with LUTS and acidic urine pH has a significant level of positive effects on symptoms and symptom scores. Our results show that this new treatment modality-which is inexpensive, easy to use, and has a low side-effect profile is effective in this chronic patient group.
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Affiliation(s)
- Mehmet Giray Sönmez
- Department of Urology, Meram Medical Faculty, Necmettin Erbakan University, 42080, Konya, Turkey.
| | - Yunus Emre Göğer
- Department of Urology, Meram Medical Faculty, Necmettin Erbakan University, 42080, Konya, Turkey
| | - Gökhan Ecer
- Department of Urology, Meram Medical Faculty, Necmettin Erbakan University, 42080, Konya, Turkey
| | - Ahmet Atıcı
- Department of Urology, Meram Medical Faculty, Necmettin Erbakan University, 42080, Konya, Turkey
| | - Mehmet Serkan Özkent
- Department of Urology, Meram Medical Faculty, Necmettin Erbakan University, 42080, Konya, Turkey
| | - Ahmet Öztürk
- Department of Urology, Meram Medical Faculty, Necmettin Erbakan University, 42080, Konya, Turkey
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Hashemi B, Safari S, Hosseini M, Yousefifard M, Erfani E, Baratloo A, Rahmati F, Motamedi M, Forouzanfar MM, Najafi I. A Systematic Review of Iranian Experiences in Seismo-Nephrology. ARCHIVES OF TRAUMA RESEARCH 2016; 5:e28796. [PMID: 27703959 PMCID: PMC5038155 DOI: 10.5812/atr.28796] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 06/18/2015] [Accepted: 07/15/2015] [Indexed: 11/24/2022]
Abstract
Context Crush syndrome and its potentially life-threatening complications, such as acute kidney injury (AKI), are one of the most important medical problems of disaster victims. However, today, many unanswered questions abound about the potential risk factors of crush syndrome, predictive factors of AKI, proper amount of prophylactic hydration therapy, type of fluid, time of continuing fluid, intravenous versus oral hydration, etc. Therefore, this study was designed to review the findings on Iranian nephrologist experiences in diagnosis and management of traumatic rhabdomyolysis following the last two strong earthquakes of Bam (2003) and Manjil-Rudbar (1990). Evidence Acquisition The study was conducted according to the MOOSE reporting guideline. A literature review was conducted on the nephrologic aspects of earthquakes in Iran. Relevant articles were identified through a comprehensive search of online databases until 2014. The search was limited to articles studying the Iranian population published in English and Persian languages. The validated combination of MeSH terms and key words was used. In addition, a manual search was run among the references of all articles that met the entrance criteria and previous reviews. Only cohort, case-control, and cross-sectional studies were enrolled. Two reviewers independently reviewed the eligible studies, and another reviewer contributed in case of a disagreement. Basic information from each study was evaluated from the aspects of purpose and design, year of publication, methodology, main population, and source of data. The quality of the included studies was assessed using methods guide for effectiveness and comparative effectiveness reviews. Two reviewers independently rated each paper as “good”, “fair”, or “poor”. Results A total of 1256 non-duplicate articles were identified, but only 35 potentially relevant papers were screened. Finally, 21 articles were found eligible and studied in details. In addition, one unpublished report was included. In the quality assessment, two articles had poor quality, and thus only 20 were finally included in the systematic review. No publication bias (coefficient = −2.28; 95% Confidence interval: −6.17 - 1.78; P = 0.26) was observed among the included studies. Conclusions A few eligible articles on seismo-nephrology were found in Iran, and a limited number of current articles had poor or fair quality. As expected, the chaotic situation after mass disasters and the lack of documentation led to the loss of much important data on the diagnosis and management of victims. Lessons learned from the current researches can be used as a valuable guide for future studies.
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Affiliation(s)
- Behrooz Hashemi
- Department of Emergency Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Saeed Safari
- Department of Emergency Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Mostafa Hosseini
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Mahmoud Yousefifard
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Elham Erfani
- Department of Emergency Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Alireza Baratloo
- Department of Emergency Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Farhad Rahmati
- Department of Emergency Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Maryam Motamedi
- Department of Emergency Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | | | - Iraj Najafi
- Shafa Continuous Ambulatory Peritoneal Dialysis Research Center, Dialysis and Transplant Patients Association (DATPA), Tehran, IR Iran
- Department of Internal Medicine, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Iraj Najafi, Department of Internal Medicine, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2122721155, E-mail:
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Efficacy of urine alkalinization by oral administration of sodium bicarbonate: a prospective open-label trial. Am J Emerg Med 2013; 31:1703-6. [DOI: 10.1016/j.ajem.2013.08.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Revised: 08/13/2013] [Accepted: 08/15/2013] [Indexed: 11/19/2022] Open
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Talaie H, Emam-Hadi M, Panahandeh R, Hassanian-Moghaddam H, Abdollahi M. On the mechanisms underlying poisoning-induced rhabdomyolysis and acute renal failure. Toxicol Mech Methods 2012; 18:585-8. [PMID: 20020858 DOI: 10.1080/15376510802232167] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
ABSTRACT The clinical syndrome of rhabdomyolysis is caused by injury of skeletal muscles resulting in release of intracellular muscle constituents. Drug poisoning is one of the causes of severe rhabdomyolysis. Severe electrolyte disorders and acute renal failure may occur in rhabdomyolysis, leading to life-threatening situations. Early initiation of renal replacement therapy can help improve outcome. In the present retrospective study, medical records of 181 patients suspected of rhabdomyolysis from Loghman-Hakim Hospital in the period of 2004 to 2005 were reviewed. A creatinine phosphokinase (CPK) value of greater than five times normal (>/=975 IU/L) was the basis for confirmation of a rhabdomyolysis diagnosis. An increased serum creatinine level of more than 30% was the basis for acute renal failure diagnosis. Out of 156 patients, 100 were male with an age range of 13 to 78 years. One hundred and two (92%) patients had CPK >975 U/L, and 36 patients (28.6%) had a 30% or more increase in their creatinine level during their admission days. Mean fluid intake was the same in patients with renal failure and those without renal failure. In 8.3% of the cases, multiple drug poisoning was observed. The most common compound overdose associated with rhabdomyolysis was opium. It is concluded that fluid therapy alone is not adequate in the management of acute renal failure in rhabdomyolysis. Therefore, other etiological factors are involved that remain to be elucidated by further studies.
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Affiliation(s)
- Haleh Talaie
- Toxicological Research Center, Loghman-Hakim Hospital, School of Medicine, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
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Iraj N, Saeed S, Mostafa H, Houshang S, Ali S, Farin RF, Shiva S, Ahmad M, Samimagham H, Pourfarziani V, Shahnaz A, Shahrzad O, Behrooz B. Prophylactic fluid therapy in crushed victims of Bam earthquake. Am J Emerg Med 2010; 29:738-42. [PMID: 20825890 DOI: 10.1016/j.ajem.2010.02.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2009] [Revised: 01/16/2010] [Accepted: 02/17/2010] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Acute kidney injury (AKI) is a severe and preventable problem of crushed earthquake victims. Early hydration therapy started before fully removing earthquake rubbles has been claimed to play a decisive role in AKI prevention, which saves the necessity of later dialysis. However, the extent, quality, and appropriateness of its know-how are controversial. METHODS Processing clinical and paraclinical data gathered from Bam earthquake victims older than 15 years, we tried to determine correlations between the time of being under the rubbles (TUR), the level of serum creatine phosphokinase (CPK), the delayed onset of fluid therapy (DFT), and finally the volume of intravenous fluid received per day (VFR) with the formation of AKI and the need for dialysis. RESULTS There is a direct and significant relation between the intensity of the trauma (TUR and CPK) and DFT with the occurrence of AKI and need for dialysis (P < .001). However, as the VFR increases, the occurrence of AKI and the need for dialysis significantly decrease (P = .005). Based on multivariate analysis, the occurrence of AKI and the need for dialysis are primarily affected by CPK, TUR, and VFR; and DFT has been dropped out. The analysis showed the preventive role of VFR more than 6 L in severe rhabdomyolysis patients and of at least 3 L in moderate ones in development of AKI and dialysis. CONCLUSIONS In the severely rhabdomyolized patients (CPK ≥ 15,000), higher volumes of prophylactic fluid (VFR >6 L) are required, whereas in less-traumatized patients, lower volumes (3-6 L) would be effective.
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Affiliation(s)
- Najafi Iraj
- Urology Research Center, Tehran, Iran; Department of Nephrology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Greenstein SM, Moore N, McDonough P, Schechner R, Tellis V. Excellent outcome using “impaired” standard criteria donors with elevated serum creatinine. Clin Transplant 2008; 22:630-3. [DOI: 10.1111/j.1399-0012.2008.00835.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Affiliation(s)
- Thomas James
- Department of Anesthesia, University of Cincinnati Medical Center, Cincinnati, Ohio 45267-0764, USA
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Thomusch O, Gerstenkorn C, Boehm J, Arldt T, Hopt U, Pisarski P. Successful transplantation of kidneys from a donor with myoglobinuric acute renal failure. Am J Transplant 2006; 6:2500-1. [PMID: 16827784 DOI: 10.1111/j.1600-6143.2006.01462.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The shortage of donor organs is reflected in the growing number of patients on the waiting list for kidney transplantation worldwide. It seems to be sensible to expand the scarce donor pool by the cautious use of extended donor criteria. Kidneys from a 21-year-old deceased donor road traffic accident victim who suffered acute renal failure (ARF) due to myolysis were transplanted. Both transplantations were successful after an initial period of delayed graft function. Therefore, kidneys from deceased donors with ARF should not be excluded for transplantation in general.
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Affiliation(s)
- O Thomusch
- Department of General and Visceral Surgery, Albert-Ludwig University, Freiburg, Germany.
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