Genital mycotic infection, urinary tract infection, and those related to osmotic diuresis and volume depletion
are observed with SGLT-2 inhibitors.
Table 1: Etiologies of Acute Kidney Injury in Lymphoma Pre-renal Intravascular volume depletion
Nausea, emesis, diarrhea Hemorrhage Reduced kidney perfusion Vasoconstriction Sepsis Liver disease Medications (diuretics, nonsteroidal anti-inflammatory drugs) Renal Acute tubular necrosis Kidney ischemia Tumour lysis syndrome Medications (acetaminophen, nonsteroidal anti-inflammatory drugs, aminoglycosides) Tubulointerstitial disorders Secondary kidney infiltration Primary kidney lymphoma Glomerular disorders Amyloidosis IgA nephropathy Renovascular disorders Renal vein thrombosis Thrombotic microangiopathy Post-Renal Obstruction Exterior compression (lymphadenopathy, obstructing tumour) Internal obstruction (nephrolithiasis, crystalluria) (*)Adapted from Luciano & Brewster (2014).
9%) has traditionally been used as the priming fluid for extracorporeal circuits, to relieve symptoms of volume depletion
(cramps, hypotension, dizziness) and for reinfusion at the end of HD (Robbins, et al.
Isotonic crystalloid solutions are effective in the treatment of intravascular volume depletion
due to fluid losses.
Pre-renal azotemia is the condition characterized by increased levels of BUN as can occur with volume depletion
Prerenal injury occurs most commonly and results from impaired renal blood flow as a result of volume depletion
, impaired cardiac output, or systemic vasodilation.
Abnormalities of serum sodium concentrations ([Na+]), when measured, were confined to elevated levels consistent with varying degrees of volume depletion
Patients predisposed to acute renal failure include patients with any degree of pre-existing renal insufficiency, diabetes mellitus, age >65, volume depletion
, sepsis, paraproteinemia, or patients receiving known nephrotoxic drugs.
a) Renal acute kidney injury is commonly caused by volume depletion
due to poor oral intake, emesis, and/or diarrhea
In the first 30 days of treatment, there were 13 events among those on canagliflozin (including six strokes, one of which was a fatal ischemic stroke), and one event in placebo patients in the first 30 days of treatment, an imbalance the company said reflected the month-to month variability and was not associated with adverse events related to volume depletion
Risk factors that predispose patients to obstructive renal failure include severe volume depletion
, underlying renal impairment, bolus drug administration and metabolic derangements such as metabolic acidosis or alkalosis.