ABSTRACT
Aims: Acute kidney injury [AKI] is characterized by a reversible increase in the blood concentration of creatinine and nitrogenous waste products and by the inability of the kidney to regulate fluid and electrolyte homeostasis appropriately. Hyperuricemia is a feature of several pathologies and requires an appropriate and often early treatment, owing to the severe consequences that it may cause. A rapid and massive raise of uric acid, mainly damage the kidney.. Rasburicase, compared to allopurinol, results in more rapid reduction of uric acid and prevent its accumulation in patients with hematologic malignancy with hyperuricemia and AKI.
Methods: We evaluated the efficacy of rasburicase [0.15 mg/kg] administered as single dose in 15 patient with AKI in sheikh hospital, Mashhad University of medical Sciences. Beside conventional therapy, infusion of Rasburicase in 50cc normal saline in30 minute intravenously was done and all adverse reaction was treated. Before injection of Rasburicase and 1st, 3nd and 7rd day after it urea, creatinine, uric acid and urine output were determined and compared.
Results: Within first 24 hour, the levels of serum uric acid in all patients decreased dramatically. there was a significant improvement in estimated GFR and urine output. Urea and creatinine level decreased from Day 0 to Day 7 but there was no difference between creatinine before treatment and 1st day.
Conclusion: Rasburicase is effective for management of hyperuricemia and uremia in AKI Patients.
ABSTRACT
With attention to association of right atrial pressure to renal venous hypertension, we try to review renal function indices changing due to congenital heart disease as base of right atrial pressure and cyanosis condition. Forty five children without preexisting renal disease, diagnosed as pulmonary hypertension due to congenital heart disease with or without cyanosis entered to this study their renal function indices besides to their right atrial pressure measured by angiographic documents .The effects of right atrial pressure and cyanosis on renal function indices evaluated by appropriate statistical methods. Right atrial pressure is not a common problem but it is more frequent in cyanotic than acyanotic patients. In addition significant proteinuria occurs in cyanotic patients with high right atrial pressure [above 5 mmHg]. There is not any difference between renal function as glomerular filtration rate or creatinine in either groups of cyantic or acyanotic with a high or normal right atrial pressure. In cyanotic congenital heart disease patients who have pulmonary hypertension measuring of right atrial pressure seems essential; in high risk group including those with high right atrial pressure and cyanosis, significant proteinuria may happen in up to 30% of cases independent of age or gender