Recently it has also been reported in the United States. Case: We reported one case of a hypertensive S1P Receptor inhibitor male 44 years old male after consumption of 5 pieces of java barb gallbladders. He got profuse vomiting, decreased urine output and developed edemas at both limbs and the scrotum within 3 days. He was diagnosed as prerenal acute kidney injury. Both his serum creatinine and serum ureum raised to 17,7 mg/dL to 193 mg/dL respectively. Meanwhile, he also developed ischemic acute hepatitis failure, with a ALT: 56 U/L, and AST: 536 U/L. He remained
hypertensive (170/80 mmHg). Renal ultrasound detected no evidence of abnormalities. During admission, patient has been treated conservatively with restricted fluid management, bicarbonate tablet three times a day, amlodipine 10 mg a day, pantoprazole injection 40 mg a day. The urine output is more than Epigenetics Compound Library in vitro 2000 mL/24 hours, no diuretics has been used. The patient did not require dialysis. After 10 days he was discharged from the hospital with a serum creatinine concentration 4,46 mg/dL, ureum 90 mg/dL ALT 17 U/L and AST 42 U/L. After a week discharged his serum creatinine concentration
reached 1,83 mg/dL and his ureum 38 mg/dL. Conclusion: It seems acute kidney injury and acute ischemic hepatic failure after fish gallbladder consumption has an excellent prognosis. We suggested that this is an transient AKI induced by prerenal causes and toxicity of the gall bladder. A renogram and kidney biopsy should be perform and also a toxicological study of the gallbladder should be done. 303 RIGHT INTRA-ATRIAL CATHETER PLACEMENT FOR HAEMODIALYSIS Thymidylate synthase IN THE SETTING OF LIMITED VASCULAR ACCESS M HARFIELD1,3,V MANICKAM1,3, V SRIVASTAVA1,3, G KAN1,3, S YADAV2,3, O ASHRAF2 1Department of Nephrology and 2Department of Cardiothoracic Surgery, The Townsville Hospital, Townsville, Queensland; 3The School of Medicine and Dentistry, James Cook University, Queensland, Australia Background: Intra-atrial catheters are a little known alternative for access in patients
who have limited vascular access options. Case Report: A 55 year old female had been receiving dialysis treatment since 2006 following a diagnosis of end stage renal disease secondary to IgA Nephropathy. Since commencement on dialysis she had experienced multiple vascular access issues, including central venous stenosis and thrombosis of venous catheters and multiple fistulas. She was admitted for the creation of a right brachio-basilic transposition with current access via a right internal jugular (IJ) catheter. One week post-operatively her right IJ catheter thrombosed and was unable to be accessed. Despite numerous attempts at re-wiring and repositioning catheters, establishing vascular access was unsuccessful. The radiology department was not equipped to perform a direct translumbar catheterisation of the inferior vena cava, and an attempt at cannulating the new fistula resulted in haematoma formation.