CLINICAL PROFILE AND OUTCOMES OF PIGMENT INDUCED NEPHROPATHY : A TERTIARY CARE EXPERIENCE

 

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CLINICAL PROFILE AND OUTCOMES OF PIGMENT INDUCED NEPHROPATHY : A TERTIARY CARE EXPERIENCE

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Sathiyan
Dheivendran
Sathiyan Dheivendran stevejax111@gmail.com GKMC Nephrology chennai India *
Balasubramaniyan Thoppalan sathiyan718@gmail.com GKMC Nephrology chennai India -
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Pigment nephropathy is characterized by a rapid decline in renal function as a consequence of rhabdomyolysis or hemolysis.

This was a retrospective observational study done at our tertiary care centre to analyze the etiology, clinical manifestations, laboratory profile and outcomes in patients with biopsy-proven pigment-induced nephropathy between January 2017 and January 2024. History, clinical examination findings, laboratory investigations and outcomes were documented.

Our study population included 103 patients, out of which 60% were males. The mean follow-up was 12 ± 2.5 months. Mean age was 41.8 ± 14 years. 88% (90) had oliguria and mean serum creatinine at presentation was 6.7 ± 2.5 mg/dL. Rhabdomyolysis was noted in 68% (70) and hemolysis in 32% (33). Etiology of rhabdomyolysis include snake envenomation (11), seizures (7), trauma (24), sepsis (8), pancreatitis (6), drug induced (5), thyroid myopathy (2) and multiple substance abuse (7). Etiology of  hemolysis include rifampicin induced (3), leptospirosis (5), mismatched blood transfusion reaction (3), snake bite (17), sepsis (3) and sickle cell disease (2).The mean duration of hospital stay was 10  ± 2.36 days. 73  patients (71 %) required hemodialysis (HD) during hospital stay and mean number of HD sessions was 10 ± 5. Mortality was 18% (18). On statistical analysis, there was no significant  difference between AKI due to rhabdomyolysis and hemolysis except for high creatine phosphokinase in patients with rhabdomyolysis and Lactate dehydrogenase level in patients with hemolysis. At follow-up, 9% (9) progressed to chronic kidney disease (CKD).

Pigment nephropathy due to rhabdomyolysis and hemolysis is an important cause of dialysis requiring AKI . The prognosis was relatively good and depends on the etiology and complications

Kewords