Association of Acute Kidney Injury with Ammonia Poisoning: A Case Report.

Ammonia may cause poisoning due to inhalation or ingestion. Renal involvement in ammonia poisoning has been reported only once. A 30-year-old male working in an ice factory was accidentally exposed to liquid ammonia from a leaking hose, following which he had burns over his face and neck and severe abdominal pain. On day 2, he had deranged renal function, which was progressive. He was referred to us due to persistent renal dysfunction. A kidney biopsy was performed due to slow recovery of renal failure, which was suggestive of acute tubular necrosis. He was managed conservatively and showed gradual improvement over 12 days of his hospital stay. Renal functions normalized after 14 days of discharge. This case highlights the occurrence of renal involvement in ammonia poisoning.

Fatal allograft mucormycosis complicating severe COVID-19 infection and bacterial pyelonephritis.

We herein present a case of live related kidney transplant recipient who initially developed severe coronavirus (COVID-19) disease associated with E.coli related pyelonephritis and graft dysfunction, who improved over one week only to deteriorate in the second week, with fever, oligoanuria and refractory shock. A postmortem allograft biopsy revealed angioinvasive mucormycosis. With the resurgence of mucormycosis during the COVID-19 pandemic, the transplant team should add allograft mucormycosis as a rare differential for severe graft dysfunction and oligoanuria in the COVID-19-infected kidney transplant recipient.

Development and Validation of a Novel Food-frequency Questionnaire for Hemodialysis Patients in Lucknow, India.

INTRODUCTION: Food-frequency questionnaire (FFQ) is a preferred tool for longitudinal dietary assessment and has been recently validated in patients on hemodialysis in other countries. As dietary habits vary vastly across regions, this study was planned to develop and validate a novel dialysis FFQ in northern India. MATERIALS AND METHODS: Dietary recall data from patients on hemodialysis available from the previous year were used for identifying food items for inclusion in the FFQ. A nutrient database was created to estimate energy, protein, calcium, phosphorus, and potassium content of the foods included in the food list. The FFQ was validated against a 2-day dietary recall method (one predialysis, one on the dialysis day) in patients on maintenance hemodialysis in a tertiary care hospital in Lucknow, northern India. RESULTS: Dietary recall data from 78 patients on hemodialysis were used for the generation of the FFQ. A total of 84 patients completed the validation study. All the nutrients measured by the FFQ correlated significantly with the means of the 2-day dietary record (r values 0.31-0.76) both in crude- and energy-adjusted intakes. De-attenuation further improved the correlation (0.35-0.80). Bland-Altman plots showed higher estimates by FFQ than by dietary recall. Cross-classification analysis showed correct classification in the exact or adjacent quintile (average 60%) by both methods and 2% gross misclassification. Weighted kappa showed fair agreement for energy intake and slight agreement for others. CONCLUSION: This novel semiquantitative FFQ is a valid tool for measuring energy and nutrient intakes in hemodialysis patients.