An auspicious triumph of recovery from dialysis-requiring acute kidney injury in COVID-19 in a patient with chronic kidney disease, α-1 antitrypsin deficiency, and liver transplant: A case report.

We report a unique case of an immunosuppressed 67-year-old female with homozygous Z-allele mutation A1AT deficiency and liver transplant with baseline chronic kidney disease (CKD) stage IIIa with creatinine of 1 mg/dL and glomerular filtration rate (GFR) of 49 mL/min/1.73m2 ~ 6 months before the presentation. She presented with COVID-19 mediated hypoxic respiratory failure complicated by AKI requiring provisional renal replacement therapy with recovery of kidney function with a new baseline of creatinine of 1.6 - 1.8 mg/dL with GFR of 31 mL/min/1.73m2.

Acute Kidney Injury From Biopsy-Proven Renal Oxalosis From Excessive Intake of Vitamin C Leading to End-Stage Kidney Disease.

We are presenting a case of a 55-year-old Caucasian female who presented with acute kidney injury requiring hemodialysis. Her native kidney biopsy showed extensive crystals in both the cortex and medulla, morphologically consistent with calcium oxalate crystals. The etiology was attributed to vitamin C-induced kidney hyperoxaluria. She has remained hemodialysis dependent for more than three months since the initial presentation, establishing a diagnosis of end-stage kidney disease.

A Case Report of Malfunctioning Peritoneal Dialysis Catheter in a Patient With Diverticulitis With a Phlegmon.

We are presenting a case of 59-year-old female with advanced chronic kidney disease where her peritoneal dialysis (PD) catheter was complicated and malfunctioned by its entanglement within a phlegmon from diverticulitis. It needed removal of PD catheter and eventually sigmoid colectomy. We reviewed the literature regarding the risk of peritonitis in patients with asymptomatic diverticulosis and in symptomatic patients with diverticulitis.

Evaluating a Living Donor With Rheumatoid Arthritis for a Recipient With End-Stage Renal Disease From Antineutrophil Cytoplasmic Antibodies Associated Vasculitis.

A 60-year-old Caucasian female with sero-positive rheumatoid arthritis (RA) was evaluated as a potential kidney donor for her brother-in-law with end-stage kidney disease (ESKD) secondary to c-antineutrophil cytoplasmic antibody (c-ANCA) associated vasculitis (AAV) and membranous nephropathy (MN). With little to no data supporting or contradicting this unique scenario, in addition to the varying viewpoints expressed by the different specialists, our multidisciplinary transplant committee encountered a difficult decision of whether to approve a candidate with RA for a living kidney donation or not. As a result, we carried out a careful literature review addressing aspects of recipients' outcomes following kidney transplants from a living donor with RA, especially when the recipient has AAV, living donor's short- and long-term outcomes post kidney donation, renal disease in AAV and RA, and maintenance of disease remission.

A Case of Cefepime-Induced Neurotoxicity: Renal Function Missing in Action.

Cefepime is a renally excreted, fourth-generation cephalosporin used in the treatment of severe abdominal, skin, soft tissue, and urinary tract infections due to its broad-spectrum coverage. Cefepime-induced neurotoxicity is a rare but serious side effect that has increased in recent years likely due to increased antibiotic use, increased drug resistance, and increased symptom recognition. While decreased glomerular filtration rate is an important risk factor for developing elevated serum cefepime levels, recent literature has suggested that a significant proportion of patients with normal renal function can also develop neurotoxicity from cefepime. Here, we present a case of cefepime-induced neurotoxicity to demonstrate the importance of monitoring mental status changes in all patients being treated with cefepime.

A case of severe metabolic acidosis during pregnancy.

Renal tubular acidosis (RTA) is a disorder that impairs renal acid-base regulation leading to normal anion gap metabolic acidosis. It is rare to encounter this entity during pregnancy. Pregnancy can worsen renal tubular acidosis (RTA) due to the physiological changes that happen during pregnancy. Teamwork including nephrologist and obstetrician is very important to identify and properly manage pregnant women with RTA to ensure smooth pregnancy and prevent complications.

Native kidney BK nephropathy: A case report.

BK virus nephropathy (BKN) is uncommonly reported in native kidneys; mostly reported in bone marrow transplant patients. This case report represents an interesting clinical scenario of biopsy-proven BKN in native kidneys, in the presence of more than one million copies/mL of BK virus in serum.

Membranous or membranous-like GN: A case report of massive proteinuria, positive serum with negative PLA2R on biopsy.

This case report represents primary membranous glomerulonephritis (MGN) with positive serum anti-PLA2R antibodies, 2+ positivity for IgG4 on immunofluorescence with routine fresh-frozen sections and negative PLA2R stain on biopsy. He was treated as primary MGN based on positive serum PLA2R and the absence of clinical symptoms or signs suggestive of any secondary MGN.

A case of hypothermia on CRRT.

A 64-year-old Asian man, with past medical history of hypertension, hypothyroidism, and hyperlipidemia, presented with 3 days history of fever associated with cough and worsening shortness of breath. Subsequent clinical course was complicated by acute lung injury leading to acute respiratory distress syndrome requiring positive pressure ventilation, septic shock requiring inotropic support, and acute kidney injury requiring continuous renal replacement therapy (CRRT). On day 3 of CRRT, the patient developed significant hypothermia (temporal temperature 27.5°C), which was successfully managed. Continuous renal replacement therapy was subsequently discontinued as renal function recovered and the patient was discharged home after a prolonged hospital stay. He currently remains off dialysis and is being followed as an outpatient for chronic kidney disease. In this article, we examine various aspects of pathophysiology and management of hypothermia on CRRT and review relevant literature in this field.

The influence of occupational stress factors on nicotine dependence among students of health and nonhealth care professional colleges.

OBJECTIVES: To study the relationship between perceived job stress measured using Effort-Reward Imbalance (ERI) scale and nicotine dependence using Fagerström Test for Nicotine Dependence (FTND) scale among students of health and nonhealth care professional colleges. MATERIALS AND METHODS: A descriptive cross-sectional study was carried on convenient sample of 408 health and nonhealth care professional who were current smokers. Nicotine dependence was measured using the FTND. The extent of the stress factors experienced at work was assessed using the ERI. Chi-square test and logistic regression were used for the statistical analysis. RESULTS: Occupational stress factors are actually associated with higher levels of nicotine dependence (odds ratio = 4.523). The degree of nicotine dependence and stress imbalance was found to be more among health care professional students as compared to nonhealth care professional students (P < 0.05). Being religious was found to have a significant effect in reducing nicotine dependence. CONCLUSION: Being religious, having low occupational stress and being nonhealth care professional have a significant effect on the prevention of nicotine dependence.