Incidence and outcome of acute kidney injury in type 2 diabetes patients in a tertiary care hospital-A prospective study

Introduction: Acute kidney injury (AKI) is currently defined by the Kidney Diseases: Improving Global Outcomes (KDIGO) clinical practice guidelines workgroup as a rise of serum creatinine at least 0.3mg/dl from baseline within 48 hours or at least 50% higher from baseline within one week or a reduction in urine output to less than 0.5ml/kg per hour for longer than 6 hours (KDIGO, 2012). Materials and Methods: A prospective study was conducted on Type 2 diabetic patients with acute kidney injury irrespective of age and gender at Department of General Medicine, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamilnadu from January 2019 to December 2019 (1 year). Type 2 diabetic patients 30 years or above, irrespective of gender, diagnosed to have acute kidney injury using KDIGO criteria, admitted o ICU or wards under the Department of General Medicine, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamilnadu. Results: The study was conducted in a total of 75 diabetic patients who developed acute kidney injury. There were 47 males and 28 females. The aetiology and outcome of acute kidney injury in the above patients were found out. Blood urea, serum creatinine, serum electrolytes, fasting and post-prandial blood sugar, WBC count, platelet count and haemoglobin were included as the baseline parameters. Conclusion: Infection was the most common cause of AKI in Type 2diabetes patients in our study. Among drug induced renal failure patients, NSAIDS were noted to be most common cause. Age >60 and male gender were prevalent in the majority of AKI patients. About 52.66% of the total patients recovered to normal renal function, 13.3% recovered partially, with 14% of the total patients progressed for maintenance hemodialysis. Crude mortality rate among patients with AKI in the study group was 20%

A prospective study of pattern of serum lipid profile of type 2 diabetes patients in a tertiary care hospital

Introduction: Diabetes is characterized by chronic hyperglycemia and disturbances of carbohydrate, lipid and protein metabolism. Dyslipidemia is one of the major risk factor for cardiovascular disease in Type 2 Diabetes mellitus, characterized by elevated Total cholesterol (TC), Triglycerides (TG), Low density lipoprotein (LDL) and decreased High density lipoprotein (HDL). Because detection and treatment of dyslipidemia is one means of reducing Cardiovascular Disease (CVD) risk, determination of serum lipid levels in people with diabetes is now considered a standard of care. Materials and Methods: A total of 200 with type 2 diabetes mellitus irrespective of duration of diabetes in the age group of 36-75 years formed the study subjects. A prestructural proforma will be used to collect baseline date detailed clinical history with clinical examination and relevant investigation will be done on participating individuals. Results: During our study we randomly selected 200 Diabetes mellitus-type-2 patients visiting OPD or admitted in the department of Medicine at our institution. Out of 200 DM patients, 60 were Males and 40 were Females. The Mean age of patients in our study was 57.29 +56.55 mg/dl and mean PPBS was 252 +73.76 mg/dl. Conclusion: This study shows significant increasing levels of TG, TC, LDl-C, and Vdl-C and significant decrease in level of HDL-C has the severity of diabetes

Unusual cause of crystalline nephropathy

Adenine phosphoribosyltransferase deficiency is a rare, inherited autosomal recessive disease presenting with 2,8-dihydroxyadenine (DHA) urolithiasis, DHA nephropathy, and chronic kidney disease. The presence of DHA crystals in urine and renal biopsy is pathognomonic of the disease. We report a 23-year-old female with acute renal failure and nephrotic proteinuria. Urinalysis showed reddish brown, round crystals with dark outline, and central spicules consistent with 2,8-DHA crystals. Renal biopsy showed membranous nephropathy and 2,8-DHA nephropathy. Our patient improved with liberal fluid intake, restriction of high adenine content foods, and oral xanthine dehydrogenase inhibitor febuxostat. Early diagnosis and initiation of treatment prevent renal complications