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J Nephropathol. 2012;1(3): 155-159.
doi: 10.5812/nephropathol.8111
PMID: 24475407
PMCID: PMC3886153
Scopus ID: 84874826312
  Abstract View: 2677
  PDF Download: 1303

Commentary

Mucormycosis and acute kidney injury

Krishan L Gupta 1 * , Aakriti Gupta 2

1 Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
2 Yale University School of Medicine, New Haven CT, USA.
*Corresponding author: Prof. Krishan L. Gupta, Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Telephone:+91-172-(O)-2100070 ,Fax:+91-172-2749911/2744401. klgupta@hotmail.com

Abstract

Mucormycosis, although said to be less common than candidiasis and aspergillosis is becoming increasingly associated with many co-morbid conditions and immunosuppression. Renal involvement, rarely reported previously, has also been documented with increasing frequency in recent times in both diseased as well as apparently healthy individuals. The kidneys may be involved in disseminated disease or have an isolated involvement for unexplained reasons. The manifestations are very serious particularly in patients with bilateral renal mucormycosis who often develop acute kidney injury and usually have a fatal outcome. The diagnosis of the renal mucormycosis is based on renal histology sections of renal biopsy or nephrectomised kidneys. Imaging with computerised tomography with contrast is of tremendous help in early identification of these cases before histological diagnosis. Once diagnosis is established, prompt treatment with antifungal medication, including Amphotericin-B (and its lipid formulations) and posaconazole, and removal of infected tissue is necessary to save from otherwise fatal infection.
Keywords: Mucorales, Renal mucormycosis, Acute kidney injury

Implication for health policy/practice/research/medical education:

Renal mucormycosis is often seen in patients with immunocompromised status. The disease may manifest with serious renal manifestations including flank pain, hematuria, pyuria and acute kidney injury particularly in patients having bilateral renal involvement with nearly universal fatal outcome. Hence an early diagnosis is very important with awareness of its manifestations, imaging and renal histology. Appropriate antifungal therapy with nephrectomy can save many patients with renal mucormycosis.

Please cite this paper as: Gupta KL, Gupta A. Mucormycosis and Acute Kidney Injury. J Nephropathology. 2012; 1(3): 155-159. DOI: 10.5812/nephropathol.8111

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ePublished: 01 Oct 2012
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