ABSTRACT
BACKGROUND: ROLE OF HEMOADSORBTION IN GRAM NEGATIVE SEPSIS AIM OF THE STUDY: TO SEE THE EFFICACY OF NOVEL ALTECO LPS ADSORBER IN A PATIENT WITH SEVERE GRAM NEGATIVE SEPTIC SHOCK METHODS: ALTECO LPS ADSORBER WAS USED IN A POST RENAL TRANSPLANT RECIPIENT WITH SEVERE SEPTIC SHOCK WITH ACTIVE COVID 19 INFECTION GRAM NEGATIVE SEPSIS ALONG WITH RENAL REPLACEMENT THERAPY USING PMMA FILTER. RESULT(S): SIGNIFICANT IMPROVEMENT IN HEMODYNAMICS, DECREASED VASOPRESSOR REQIUREMENT, RAPILDLY RECOVERED FROM SEPSIS AND SHOCK CONCLUSION(S): This case report highlights the efficacy of a new adsorptive therapy for the clearance of endotoxins in septic shock caused Gram negative bacterial infection. Early application of an endotoxin adsorber showed a reduction of vasopressor requirements, elevation of blood pressure, and a decrease in inflammatory markers. Endotoxin elimination has a significant effect on the ICU length of stay or ICU mortality.
ABSTRACT
BACKGROUND: Covid 19 is relatively a new disease with varied presentations which can affect multiple organs including kidney. AKI is quite commonly associated with covid-19 infection. However, a lot of research is still needed in understanding of the pathophysiology associated. AIM OF THE STUDY: To study the histological patterns of covid-associated AKI. METHOD(S): This is a retrospective longitudinal study. 109 patients developing AKI after covid -19 infection have been identified. AKI was defined as per KDIGO criteria. Evaluation of AKI was done with routine analysis, and causes other than covid infection were ruled out. Renal biopsy was done, and core specimens were sent for light microscopy and immunofluorescence. RESULT(S): Patients varied from 2 to 76 years. The duration between Covid infection and AKI ranged from 2 weeks to 6 months. Out of 109 patients, 27 (24.7%) showed acute tubular injury, 26 (23.8) showed ATIN, 11 (10%) showed IRGN, 8 (7%) showed crescentic GN, 4 (3.6%) showed chronic TIN,6 (5.5%) showed TMA, 3 (2.75%) showed Ig A nephropathy and Granulomatous TIN each. FSGS and cast nephropathy were seen in 4 (3.6%) patients each. Lupus nephritis, MCD, and Papillary necrosis were seen in one patient each. Rest of the patients, i.e., 10 (9.1%), showed features of background disease. CONCLUSION(S): AKI followed by covid 19 has a variety of pathologic mechanisms. Studying the patterns and their further follow-up will be beneficial since there is very limited data.