5 AP24534 Approaches Described

Patients Selleck AP24534 presenting in our setting with renal failure who were HIV positive were more likely to be black. The only other study showing 99% of the patients presenting with AKI to be black was the study by Rao et al. [14]. The studies by Wyatt, Ibrahim and Franceschini each showed the percentage of black patients with AKI to be 54.5, 55 and 61%, respectively [6, 8, 9]. The racial predominance is different to that of other countries, which might be due to epidemiological factors and the spread of HIV. The majority race in South Africa is black and the predominance of black patients that are HIV positive presenting with renal failure is evident. When the aetiology of renal failure was reviewed, the commonest cause of renal failure was sepsis (60%) followed by volume depletion and haemodynamic instability in HIV-infected patients. Urological obstruction was the least common cause of renal failure (4%). Sepsis was also the predominant aetiology UNC2881 of renal failure in other studies. Rao et al. [14] reported that sepsis was the commonest aetiology, occurring in 52% of hospitalized patients. Sepsis was the most frequent cause of AKI in the retrospective review by Peraldi et al. [15], accounting for 75% of cases. Other studies showed that sepsis was less common; however, these included ambulatory and not hospitalized patients [9]. Acute kidney injury patients presented in a hypotensive state more frequently (in 19%), compared with AOCKD (10%) and CKD (0%) patients, with a mean BP of 108 (��33)/69 (��17) mmHg. The definition of AKI could misclassify some patients with non-resolving AKI as AOCKD. Hyponatraemia was common among all three groups, but most severe in the AKI patients. The study by Agarwal et al. [16] reported the incidence of hyponatraemia in HIV-infected patients as 30�C60%. The common causes of hyponatraemia were diarrhoea and vomiting. HIV-positive CKD patients presented with more severe hyperkalaemia and acidosis, probably secondary to renal failure or concomitant drugs such as trimethoprim-sulphamethoxazole. Mineralocorticoid STI571 deficiency could also account for the hyperkalaemia and hyponatraemia, but was not proven in this study. CKD patients were also appropriately more hypocalcaemic and hyperphosphataemic than other patients, in keeping with chronicity. The mean CD4 count of the whole group was 135 cells/?L (range 1�C579 cells/?L), with 63% of patients with AKI with CD4 counts