Renal failure, acute definition

Bellomo R, Ronco C, Kellum JA, et al. Acute renal failure—definition, outcome measures, animal models, fluid therapy and information technology needs the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 2004 8 R204-R212. 

Several reports identified nonlethal effects in humans acutely exposed to arsine. These reports, however, lacked definitive exposure data but verified hematologic disorders leading to renal failure as critical effects of arsine exposure. Bulmer et al. (1940) (as cited in Elkins 1959) reconstructed an exposure incident at a gold extraction facility and estimated that subchronic (up to 8 mon) exposure to 0.12 ppm arsine resulted in jaundice and anemia (see Section 2.2.1). The lack of definitive exposure data for humans necessitates the use of animal data for quantitative estimation of AEGL values. Derivation of AEGL-2 values based upon limited human data (Flury and Zernik 1931) was considered but rejected because the data were poorly documented and inconsistent with other data showing lethality at lower cumulative exposures. 

CDC Case Definition A mosquito-borne viral illness characterized by acute onset and constitutional symptoms followed by a brief remission and a recurrence of fever, hepatitis, albuminuria, and symptoms and, in some instances, renal failure, shock, and generalized hemorrhages. Laboratory criteria for diagnosis is (1) fourfold or greater rise in yellow fever antibody titer in a patient who has no history of recent yellow fever vaccination and cross-reactions to other flaviviruses have been excluded or (2) demonstration of yellow fever virus, antigen, or genome in tissue, blood, or other body fluid. 

Definition of Exercise-Induced Acute Renal Failure (ALPE)... 

In addition to ALPE, mild acute renal failure, including dehydration, acute pyelonephritis, and renal pelvic tumors, is visualized as wedge-shaped contrast enhancement [15]. However, acute pyelonephritis and renal pelvic tumors are visualized as unilateral lesions, whereas ALPE is visualized as a bilateral lesion therefore, differentiation is possible. For a definitive diagnosis, the presence of patchy contrast enhancement must be demonstrated when the serum creatinine level is in the range from 1.2 to 3.5 mg/dl. However, as described above, a definitive diagnosis is not always necessary in clinical practice. 

Mehta RL, Chertow GM. Acute renal failure definitions and classification time for change J Am Soc Nephrol 2003 14 2178-87. 

This region has two major referral hospitals for treating those people in renal failure. It is our opinion that in the majority of toxin induced acute renal failure unknown toxin is by far the commonest etiological agent In a minority of cases the definite agent is know. One of these is potassium dichromate. The excellent work done by Wood et al [3] in describing the extent of the toxicity of potassium dichromate has been of great educational value. 

Urinary tract Scleroderma renal crisis (SRC) is one of the most feared complications of systemic sclerosis (SSc). It is characterised by acute renal failure usually accompanied by malignant hypertension. SRC has been associated with the use of CS in retrospective studies. An evidence-based systematic review was done by Canadian researchers [27 ]. They identified 26 prospective studies which included a total of 500 (81% women) SSc pafients, in which CS were administered as a new indication. The objective was to ascertain the risk of SRC in newly treated patients. Ten definite SRC cases were reported among the 500 patients, equivalent to a rate of 2%, out of which, eight had received pulse CS tiierapy (initial doses greater than 30 mg per day of prednisone equivalent), two medium doses of CS (initial doses between 16 and 30 mg per day of prednisone equivalent) and none low-dose CS. Considering only the 11 studies limited to early diffuse SSc patients, they identified nine definite SRC cases in 226 patients, which is equivalent to a rate of 4%. This study provides additional support for the association between CS and SRC previously reported in retrospective studies but does not eliminate the possibility that the association may be due to confounding by disease severity or by co-intervention. 

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