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Related Concept Videos

Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Urinary Tract Calculi VI: Surgical Management01:25

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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Acute Pyelonephritis II: Diagnostic Studies and Management01:28

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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Kidney Transplant I: Introduction01:28

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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Acute Kidney Injury V: Interprofessional Care01:20

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Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
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[Emergency nephrectomies: retrospective monocentric study, about eight cases].

M Secco1, X Tillou, A Desmonts

  • 1Service d'urologie, CHU de Caen, avenue de la Côte-de-Nacre, 14000 Caen, France.

Progres En Urologie : Journal De L'Association Francaise D'Urologie Et De La Societe Francaise D'Urologie
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Emergency nephrectomies are rare, with uncontrolled urinary sepsis being the primary indication. Prompt identification of at-risk patients is crucial for reducing sepsis-related mortality.

Keywords:
EmergencyInfection urinaireNephrectomyNéphrectomieSepsis urinaireUrgenceUrinary infectionUrinary sepsis

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Area of Science:

  • Urology
  • Nephrology
  • Surgical Critical Care

Context:

  • Emergency nephrectomies are infrequent due to advancements in urinary tract infection management and radio-embolization.
  • Limited case series exist, highlighting the need for further clinical data.

Purpose:

  • To evaluate the indications, morbidity, mortality, and outcomes of emergency nephrectomies.
  • To analyze patient characteristics and surgical approaches in emergency nephrectomy cases.

Summary:

  • Eight patients underwent emergency nephrectomy between January 2011 and November 2012.
  • The primary indication was uncontrolled urinary sepsis, with most patients requiring intensive care for multiple-organ failure.
  • All patients survived the procedure, though one required renal dialysis support.

Impact:

  • This study underscores the rarity and critical nature of emergency nephrectomies.
  • Identifying patients at risk for toxic shock is essential for timely intervention and improved survival rates in sepsis cases.