Nephrology


        

Case Discussion

Chronic kidney failure   Posted By maged    Date : 01-May-10   08:59 AM     Reply

please help in diagnosing my case complaning of fever and generalised body weakness for 2 weeks and getting worse on day of admission . kdeveloped hperventailation and cramp in A & E. oted severe renal failure and metabolic acidosis . admitted for intesive care and was trdeated as liptospirosis in view iof elevated muscle enzyme, equivocal loptospirosis seology. He is a veternary student. He was supprted with acute heamodialysis annd given antibiotcs. Renal biopsy was performed. the diagnosis was renal failure with lepotospirosis. the biospsy is suboptimal the features are of an advanced renal disease with diffuse glomerulsclerosis (In 6 out of 7 glmeruli) associated with severe chronic tubulointerstitial damage involoving abvout 80-90% of the biospsy tissue . there is also hypertensive vascular changes. There is no evidence of immune-complex mediated glomerulonephritis. Summary of renal biopsy diffuse sclerosisng glomerulonephritis.

Creatinin when admitted

1900umol/L (after tow times hemodialysis creatinin became 600 umol/L then hemodialysis was stop. creatinin after 6 month was 1500 umol/L(hemodialysis was done for one month and the creatinin became to 900 umol/L. (afer that the hemodialysis was stop for one month) the creatinin now is 700 umol/L.


Replies to the above case discussion :

Re : Chronic kidney failure - Dr. Sree Bhushan Raju 03-May-10    01:15 AM

Re :Chronic kidney failure - Anil Kumar Saxena, MD; FRCP 05-May-10    07:14 AM




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