• Title/Summary/Keyword: Azotemia

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A Case of Severe Hypercalcemia Causing Acute Kidney Injury: An Unusual Presentation of Acute Lymphoblastic Leukemia

  • Hyun, Hye Sun;Park, Peong Gang;Kim, Jae Choon;Hong, Kyun Taek;Kang, Hyoung Jin;Park, Kyung Duk;Shin, Hee Young;Kang, Hee Gyung;Ha, Il Soo;Cheong, Hae Il
    • Childhood Kidney Diseases
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    • v.21 no.1
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    • pp.21-25
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    • 2017
  • Severe hypercalcemia is rarely encountered in children, even though serum calcium concentrations above 15-16 mg/dL could be life-threatening. We present a patient having severe hypercalcemia and azotemia. A 14-year-old boy with no significant past medical history was referred to our hospital with hypercalcemia and azotemia. Laboratory and imaging studies excluded hyperparathyroidism and solid tumor. Other laboratory findings including a peripheral blood profile were unremarkable. His hypercalcemia was not improved with massive hydration, diuretics, or even hemodialysis, but noticeably reversed with administration of calcitonin. A bone marrow biopsy performed to rule out the possibility of hematological malignancy revealed acute lymphoblastic leukemia. His hypercalcemia and azotemia resolved shortly after initiation of induction chemotherapy. Results in this patient indicate that a hematological malignancy could present with severe hypercalcemia even though blast cells have not appeared in the peripheral blood. Therefore, extensive evaluation to determine the cause of hypercalcemia is necessary. Additionally, appropriate treatment, viz., hydration or administration of calcitonin is important to prevent complications of severe hypercalcemia, including renal failure and nephrocalcinosis.

Dystocia Causing Postrenal Azotemia in a Captive Spotted Hyena (Crocuta Crocuta) (점박이 하이에나에서 신후성 질소혈증을 유발한 난산 증례)

  • Han, Jae-Ik;Kim, Jeong-Ho;Lee, Sook-Jin;Lee, Jong-Won;Han, Sang-Hui;Na, Ki-Jeong;Kim, Ill-Hwa;Kang, Hyun-Gu
    • Journal of Veterinary Clinics
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    • v.27 no.5
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    • pp.614-617
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    • 2010
  • A 3-year-old, female spotted hyena (Crocuta crocuta) was referred with dystocia. The hyena had been in labor for over 5 days, but she failed to expel the infant. The blood biochemistry profiles showed severe azotemia. During caesarian section, we confirmed that the uterus had expanded and contained 1 dead, decayed infant, which compress the urethra, leading to the expansion of the urinary bladder and that the dead fetus was nearly 3 kg in weight (approximately 5% of the maternal weight). Thus, we confirmed that the dystocia caused by oversized fetus and malposture, and the severe azotemia resulted in compression of the urethra by fetus in the hyena. This report is the first to show that the dystocia can induce postrenal azotemia in female spotted hyenas.

Hematological differentiation of bladder rupture and complete/partial urethral obstruction in castrated Hanwoo (Korean indigenous cattle) with urolithiasis

  • Young-Jun Kim;Seung-Min Ha;Ji-Yeong Ku;Ji-Seon Yoon;Jinho Park
    • Journal of Veterinary Science
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    • v.24 no.5
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    • pp.62.1-62.7
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    • 2023
  • This case report describes the hematological and radiological examination of urinary bladder rupture and complete urethral obstruction. associated with urolithiasis in Hanwoo. Hyponatremia, hypochloremia, azotemia, and hyperglycemia were observed in both urethral obstruction and urinary bladder rupture. However, cattle with urethral obstruction showed hyperkalemia and mild hyperglycemia, whereas cattle with bladder rupture showed marked hyperglycemia and normal potassium levels. In ultrasonography, the urethral obstruction showed a dilated bladder with a thick bladder wall. In contrast to previous literature, in this study, severe electrolyte changes such as severe hyponatremia, hypochloremia, and hyperkalemia occurred in a case of complete urethral obstruction.

Application of Extracorporeal Ultrafiltration Therapy Given to a Dog and a Cat with Pulmonary Edema and Renal Failure (폐부종 및 신부전을 동반한 개와 고양이에서 체외초미세여과법을 이용한 치료)

  • Park, Hyung-Jin;Byun, Seok-Young;Choi, Jun-Hyuk;Lee, Jong-Bok;Song, Kun-Ho;Seo, Kyoung-Won
    • Journal of Veterinary Clinics
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    • v.33 no.1
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    • pp.34-38
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    • 2016
  • A 13-year-old castrated male mixed breed dog and a 12-year-old castrated male mixed breed cat were referred to the hospital for the treatment of pulmonary edema and azotemia at the same time. To resolve the pulmonary edema and azotemia, intermittent hemodialysis (HD) was performed using ultrafiltration (UF), and the pulmonary edema, azotemia, other electrolyte and acid-base imbalances were improved. This case study demonstrated that when we encountered pulmonary edema patients with diuretic resistance, severe electrolyte imbalance, and impaired renal function complicated by decongestive therapy using diuretics, UF therapy can be considered a life-saving intervention.

C-ANCA-positive glomerulonephritis associated with subacute infective endocarditis caused by Bartonella infection

  • Kim, Min Jeong;Jang, Ha Nee;Lee, Tae Won;Cho, Hyun Seop;Chang, Se-Ho;Kim, Hyun-Jung
    • Journal of Yeungnam Medical Science
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    • v.34 no.1
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    • pp.140-145
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    • 2017
  • Glomerulonephritis (GN) is sometimes associated with infective endocarditis (IE). Bartonella endocarditis is difficult to diagnose because it is rare and cannot be detected by blood culture. This is the first report of cytoplasmic anti-neutrophil cytoplasmic antibody-positive subacute endocarditis-associated GN caused by Bartonella infection in South Korea. A 67-year-old man was hospitalized due to azotemia. He complained of weight loss and anorexia for 6 months. A diagnosis of IE was made based upon echocardiographic detection of vegetations on the mitral and aortic valves and a Bartonella antibody titer of 1:2,048. Renal histology identified focal crescentic GN. Azotemia and proteinuria improved after doxycycline and rifampin treatment combining with steroid therapy.

Nephrotomy for Removal of Renal Calculi in Two Dog (개에서 신 절개를 통한 신 결석 제거 2례)

  • 김혜진;장화석;송영성;김성미;김순신;최치봉;김휘율
    • Journal of Veterinary Clinics
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    • v.21 no.1
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    • pp.66-71
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    • 2004
  • 2 Cases of nephrotomy for removal of calculi in dog were referred to veterinary teaching hospital of Konkuk University. In case 1, a 5 year-old, castrated male Yorkshire Terrier dog was referred because of intermittent hematuria, pain in urination for one month. Hematologic and chemical examination showed mild increased BUN and CPK. Radiographic findings revealed radiopaque materials in the urinary bladder, urethra, and left kidney. Retrograde hydropropulsion was performed to move the calculi into the bladder, and cystotomy was done to remove calculi. Nephrotomy was performed to removal of the calculi from the left renal pelvis and calyx. After operation renal function were recovered and preserved. In case 2, a 5 year-old, neutral female Schnauzer dog was referred because of persistant vomiting, anorexia, and celialgia for 20 days. Hematologic and chemical examination showed stress leucogram, moderate azotemia, hypercalcemia, hyperphosphatemia, and increased ALP. Radiographic findings revealed enlargement of the left kidney and radiopaque materials in the both of the kidneys. On excretory urography, left kidney was no pyelogram. On ultrasonography, renal tissue was very thin and distended renal pelvis appeared. Nephrectomy of nonfunctional left kidney and nephrotomy for removal of calculi from the right renal pelvis and calyx were done. One week after operation, renal and hepatic functions were recovered. So, in cases of renal calculi, it is necessary that renal calculi are extracted actively as far as the patient's body condition endurable.

Renal Amyloidosis in a Beagle (비글견에서 신장 아밀로이드증 증례)

  • Jung, Joohyun;Jin, Jaebong;Lee, Hyunuk;Choi, Mincheol
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.535-538
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    • 2014
  • An eight-year-old intact male Beagle had anorexia, vomiting, depression for two days. The dog had hypoalbuminenia and mild azotemia on hematologic and clinical chemistry examinations. Severe proteinuria was identified on urinalysis. On abdominal ultrasonographs, there were small amount of ascites and bilateral renomegaly with severe hyperechoic renal cortex and hyperechoic medullary rim sign. Renal biopsy and histopathology revealed renal amyloidosis. The quality of life in this dog was satisfactory with aggressive supportive care for three months. Euthanasia was performed due to deteriorated azotemia and nephrotic syndrome.

Continuous Renal Replacement Therapy of Chronic Kidney Disease with Uncontrolled Azotemia in Six Dogs (개선되지 않는 질소혈증 동반한 만성신부전 환자에서 지속적 신대체 요법의 적용)

  • Han, Sei-Myoung;Kim, Jong-Taek;Lee, Jong-Bok;Seo, Kyoung-Won;Song, Woo-Jin;Ryu, Min-Ok;Hwang, Cheol-Yong;Youn, Hwa-Young
    • Journal of Veterinary Clinics
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    • v.32 no.5
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    • pp.440-444
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    • 2015
  • The purpose of this case report was to present the treatment of continuous renal replacement therapy (CRRT) in dogs with end-stage CKD with uncontrolled uremia. Hemodialysis were carried out 6 patients who failed to improve clinical status with conventional management for CKD. Four dogs with urea reduction ratio (URR) range of 57-72% and 1 dog with URR of 37.3% showed good outcome with decreasing tendency of pre-dialysis Therefore, we suggest that CRRT could be recommended for use in CKD dogs with uncontrolled azotemia or uremia and should be monitor carefully throughout the CRRT.

Hypoadrenocorticism in a 1-Year-Old Korean Shorthair Cat

  • Jung, Hansol;Jeong, Yunho;Kim, Yoonhwan;Choi, Sooyoung;Park, Inchul;Ahn, Jin-Ok
    • Journal of Veterinary Clinics
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    • v.39 no.3
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    • pp.144-148
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    • 2022
  • A one-year-old spayed female Korean Shorthair cat presented to Kangwon National University Veterinary Hospital with vomiting, weight loss, lethargy, loss of appetite, and polyuria that lasted for more than two weeks. The body condition score, blood pressure, heart rate, and body temperature were abnormally low, and the physical examination findings were consistent with moderate dehydration. Hematological and biochemical tests demonstrated mild azotemia and a low Na:K ratio. Additional abdominal ultrasound imaging revealed reduced size of both adrenal glands. The adrenocorticotropic hormone (ACTH) stimulation test showed decreased post-ACTH cortisol and aldosterone levels and increased endogenous ACTH levels, confirming a diagnosis of primary hypoadrenocorticism. The cat was treated with subcutaneous injections of desoxycorticosterone pivalate (DOCP) and oral prednisolone supplementation, and subsequent electrolyte analysis showed a normal Na:K ratio. Clinical symptoms were also improved in response to treatment. Hypoadrenocorticism in cats is a very rare disease, but it should not be excluded as a potential diagnosis in favor of kidney diseases or other conditions, especially when the Na:K ratio is low. In addition, the prognosis for the disease and the response to DOCP treatment should be further evaluated in cats.

Acute Lymphoblastic Leukemia with Bone Marrow Infiltration and Hypoplastic Anemia in a German Shepherd (German Shepherd에서 골수침윤과 재생불량성빈혈을 동반한 급성림프모구성백혈병 1증례)

  • 이창우;신남식;최윤주;정동희;권오경;임채형
    • Journal of Veterinary Clinics
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    • v.17 no.1
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    • pp.247-251
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    • 2000
  • A male German Shepherd dog, $2{\frac{1}{2}}$years of age, was admitted with sudden anemia, weakness, hyperpyrexia, anorexia and lethargy. The patient showed hypoplastic anemia, thrombocytopenia, absolute and relative lymphocytosis, absolute and relative granulocytopenia, hypoalbuminemia, slight hepatic disorder, slight azotemia, hematuria and proteinuria by the screening examination. The bone marrow aspiration smear showed high cellularity, severs infiltration of lymphoblasts and prolymphocytes, and mitotic figures of lymphoid cells. The liver aspiration smear demonstrated infiltration of lymphoblasts. Acute lymphoblastic leukemia was diagnosed as none of the superficial lymph nodes showed enlargement and marked functional disorder of important organs other than the liver was not found. The patient was treated with vincristine, cyclophophamide, predniosolone for chemotherapy and blood transfusion and either ampicillin or cefoperazone for supportive treatment. But the patient did not show marked remission and died 9 days after the start of the chemptherapy. The necropsy was not permitted.

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