Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:1.6.5.4 (SOR)
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The changing trend of today's ARF in Thailand had led to requirement of epidemiologic data for management and planning. Retrospective review of adult inpatient records for 5 years of Ramathibodi Hospital was performed. Normal initial serum creatinine rising to double its value within one week and/or oliguria were the inclusion criteria. Data from another 3 university hospitals were used for comparison. AFR is the second most common renal disease at Ramathibodi Hospital with sepsis as the major underlying etiology. Among 396 cases of ARF, 194 were non-oliguric, 150 oliguric and 52 anuric. Non-oliguric cases needed lesser dialysis and had lower mortality. The number of AFR patients from 4 university hospitals varied from 0.14 to 0.18 per cent of hospital admission. If we consider the incidence of AFR in general hospital admission to be 0.1 per cent and the average hospital admission/year of Thailand was 3.25 million, there will be 3,250 cases/year or 55 cases/million/population year. If 4 dialyses/case was considered, 220 dialyses/ year/million population was required. We suggested that the hospitals of the province with population above 1 million should have a hemodialysis unit for both their local service and referral cases and all provincial hospitals should develop at least a peritoneal dialysis facility for increasing cases in ARF.
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PMID:Acute renal failure (ARF) in Thailand. Retrospective analysis in a medical center. 927 69

Several interventions may reduce the risk of contrast nephropathy for high-risk patients; however, most evidence uses surrogate markers for clinically relevant outcomes. Because dehydration is a risk factor for developing contrast nephropathy, periprocedural hydration is routinely recommended (strength of recommendation [SOR]: C, expert opinion). Single studies have suggested that isotonic saline is associated with less risk than half-normal saline, and hydration with fluids containing sodium bicarbonate is more efficacious than those containing isotonic saline (SOR: B, single randomized controlled trial [RCT]). Oral acetylcysteine lowers the risk of postcontrast elevations in creatinine if taken more than 24 hours before contrast administration (SOR: A, RCTs). Acetylcysteine's low cost and favorable side effect profile make it an appealing option. Hypo-osmolar contrast media are less likely to induce contrast nephropathy than hyper-osmolar media (SOR: A, RCTs). Finally, hemofiltration might be considered for patients with extremely high risk of developing contrast nephropathy (SOR: B, single RCT).
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PMID:Clinical inquiries. What interventions reduce the risk of contrast nephropathy for high-risk patients? 1583 30