Case Of Acute Renal Failure Research Articles

Giant bladder stone: A case report

Giant bladder stones are rare in younger patients. Herein, we report a case of acute renal failure in a 31-year-old male with a giant bladder stone. The patient presented with lower urinary tract symptoms and urinary retention with milky-white urine. An emergency suprapubic cystotomy was performed and an 11-cm oval, solid stone was removed. Post-operative creatinine levels progressively decreased to normal and the patient exhibited smooth urination and good recovery at follow-up. A comprehensive physical examination and thorough investigation of the patient's medical history are required during clinical evaluation, diagnosis and treatment, thus preventing misdiagnoses and ensuring prompt treatment.

Obstructive uropathy associated with a Retzius space hematoma following postpartum pulmonary embolism

Background: To report on a case of acute renal failure associated with a Retzius space hematoma that had been extended to retroperitoneal space, following pulmonary embolism treatment in the postpartum period. Case report: A 30-year-old woman was transferred to the hospital for syncope on the first postoperative day following cesarean section. There were no active vaginal bleeding or intra-abdominal bleeding. On diagnosis of pulmonary embolism, she was treated with extracorporeal membrane oxygenation with heparinization. On day 4, ultrasonography showed newly developed hematoma at the anterior side of the uterus, and transarterial embolization was performed. On day 5, she developed acute kidney injury but there were no increase in size of the hematoma on ultrasonography. She recovered after 3 days of renal replacement therapy. However, on day 10, she showed tachycardia and increased serum creatinine. Computed tomography revealed not only a 15-cm hematoma anterior to the uterus, but also another 17-cm hematoma in the retroperitoneal space under the left kidney. Exploratory laparotomy was performed for obstructive uropathy and hematomas were evacuated. The patient’s vital sign stabilized one day following surgery. Conclusion: When treating postpartum patients with pulmonary embolism, physicians should be aware of the possibility of a concealed hemorrhage in the Retzius space and of subsequent kidney injury.

Outcome of Acute Renal Failure in Neonates and Its Associating Factors

Objective:To identify various predisposing causes and immediate consequences in new-borns presenting with acute renal failure. Study design: The study design was case series. Place & duration:In the Pediatric department of Shifa International Hospital, Islamabad for one-year duration from September 2020 to August 2021. Material and Methods:A total of 1300 cases were assessed for acute renal failure (ARF)and 98 established cases of ARF being included in the research. The neonates (0-28 days old) who met the criteria for ARF, i.e., anuria/oliguria plus a serum creatinine level more than 1.5 mg/dl, were included in this research. The patient's relevant medical history, physical examination, and laboratory tests were recorded on a separate proforma after given informed permission for the procedure. Each patient's outcome was precisely documented. The statistical software for social sciences was used to examine the data (SPSS20.0). A p-value of less than < 0.05 was considered significant. Results:A total of 98 cases (7.5 percent) were studied, with 68 (69.4 percent) males and 30 (30.6 percent) females. The ratio of males to females was 1.6:1. According to the study results, the mean age was 9.85± 7.20 days and the mean weight was 2.54± 0.65 kg. The majority of the infants were delivered at a hospital (73.5 percent). The most prevalent ARF symptoms in our neonates were birth asphyxia (30.6%), sepsis (24.5%), respiratory distress syndrome (RDS) (11.2%), and dehydration (9.2%), bleeding in (4.1 percent) and meconium aspiration in 3(3.1 percent). CCF and neurogenic bladder were both present in two patients. In 4 individuals, obstructive uropathy was found, including 2 cases of urethral valve (PUV) blockage and 2 cases of pelvic ureteric junction obstruction (PUJO). Neonates with ARF had a 28.5 percent overall death rate (28 cases). Conclusion:When it comes to neonates in critical care, acute renal failure is a frequent concern to observe. More than one predisposing factor for acute renal failure was present in the majority of the patients. Preventing acute renal failure in infants may be accomplished by early identification of risk factors and prompt treatment of underlying diseases. Keywords:Renal failure, Sepsis, Birth asphyxia, Neonates

Thrombotic thrombocytopenic purpura in pregnancy. Giving birth or not giving birth, that is the question

Introduction. Pregnancy is one of the most frequent triggers of congenital and acquired forms of thrombotic thrombocytopenic purpura (TTP).Aim — to develop tactics for the treatment of pregnant women with TTP.Results. TTP was associated with pregnancy in 55.5 % of all cases of TTP in women. In 5 pregnancies in which the diagnosis of TTP was known before pregnancy, or established in the early stages, TTP was treated throughout the pregnancy. In the congenital form, plasma transfusions were performed once every two weeks until the 20th week of pregnancy, or weekly, if thrombocytopenia < 150 × 109 /L persisted. Plasma transfusions were performed weekly after the 20th week with the goal of achieving clinical remission. With acquired TTP, glucocorticosteroids and plasma exchanges were used as treatment, in 1 case — rituximab, with the aim of achieving a clinical remission and an ADAMTS13 activity > 20 %. In this group of pregnant women, 1 caesarean section was performed and there were 4 cases of vaginal deliveries, with a total of 5 children being born with an average Apgar score of 7.5. In 7 pregnancies in which TTP fi rst manifested late, leading to a delayed diagnosis, preventive and curative measures were not carried out before delivery. In this group there were 2 abortions of pregnancy, 5 surgical deliveries, 3 cases of preeclampsia, 3 acute cerebral circulatory disorders, 1 intraabdominal bleeding, 1 case of acute renal failure, with two women undergoing mechanical ventilation. There was 1 case of antenatal fetal death, with a total of 4 children being born, who were assessed on the Apgar scale with an average of 5 points.Conclusion. Timely diagnosis as well as ongoing therapeutic and preventive measures help to avoid complications during childbirth in pregnant women with TTP.

Clinical analysis of 34 cases of acute fatty liver of pregnancy

Objective: To analyze the characteristics, diagnosis and prognosis of acute fatty liver of pregnancy (AFLP), and to guide the management of AFLP patients. Methods: The clinical data of 34 AFLP patients admitted to Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2009 to December 2019 were retrospectively analyzed. The general situation, diagnostic characteristics, treatment and maternal and neonatal prognosis of the AFLP patients were collected and analyzed. Results: The incidence of AFLP in our hospital was 0.022% (34/152 383). The age of onset was (30.6±4.9) years old, and the gestational age was (35.3±2.4) weeks. Most of the first symptom was gastrointestinal symptoms of unknown cause in the third trimester of pregnancy (53%, 18/34), accompanied by different degrees of elevated liver enzymes. Cesarean section was performed in 97% (33/34) of patients for termination of pregnancy. Only one pregnant woman was diagnosed prenatal and delivered vaginally, and the prognosis of both mother and infant was good. Five cases were transferred to intensive care unit, including 2 cases of acute renal failure, 1 case of gastrointestinal bleeding and 2 cases of disseminated intravascular coagulation. There was no maternal death. Severe asphyxia occurred in 2 neonates. Conclusions: Attention should be paid to the digestive tract symptoms during the third trimester of pregnancy and the diversity of clinical manifestations of AFLP for early detection. Once AFLP is diagnosed, pregnancy should be terminated as soon as possible to improve maternal and infant outcomes.

402 A case of acute renal failure from bilateral ureteral obstruction due to endometriosis

Introduction: Endometriosis is common in women of reproductive age with an incidence of 15%. Ureteral endometriosis is a rare (1%-5%) form of urinary tract endometriosis. Case history: A 42-year-old nulliparous woman attended to her general practitioner for severe headache, vague back pain, nausea and vomiting. Investigations revealed high blood pressure, serum creatinine 3,5mmol/l, normal blood count. Abdominal ultrasound and MRI showed bilateral hydronephrosis with dilated ureters. A double J ureteric catheter was placed on right kidney and a nephrostomy on the left. Gynaecologic consultation was undertaken with the only finding being a slight non-tender non-nodular thickening of the left paracervical tissues. Normal tumor markers. Patient underwent an exploratory laparotomy by a multidisciplinary team. Intraoperatively, no ovarian endometrioma or other lesion was identified. Both ureters were dilated with thick muscular wall. Dissection of the ureteral canal after mobilization of the bladder revealed a thick fibrous tissue at the level of the uterosacral ligaments, which completely encased the ureters. Both ureters were cut below the pelvic brim at the level of the fibrous tissue and were reimplanted in the bladder with a bladder hitch procedure over double J ureteric catheter. Uneventful post-operative course. Histology confirmed the presence of endometriosis on the peritoneal tissue that was removed. Discussion: Ureteral endometriosis can present with non-specific symptoms for example dysmenorrhea, dyspareunia, pelvic pain, infertility, altered urinary function and rarely haematuria. Progressive obstruction of the ureters may ultimately lead to hypertension and acute renal failure. Ureteral obstruction is mostly associated with an endometriotic nodule. In our case, the presence of thick fibrotic peritoneal tissue surrounding the ureters was probably the mechanism that led to ureteric dilatation. Surgical management aims to free the ureter from all endometriotic tissue, and restore normal function.

A Successful Rescue Case of Lactic Acidosis and Acute Renal Failure Caused by Excessive Dose of Metformin

A Successful Rescue Case of Lactic Acidosis and Acute Renal Failure Caused by Excessive Dose of Metformin

LncRNA ROR and miR-125b Predict the Prognosis in Heart Failure Combined Acute Renal Failure.

Objective To elucidate the correlation between expression levels of long noncoding RNA (lncRNA) ROR and microRNA-125b (miR-125b) with the prognosis in heart failure (HF) patients combined acute renal failure (ARF). Methods HF patients combined ARF (n = 90) and healthy controls (n = 90) in the same period were included in our hospital from April 2016 to December 2018. Every subject was followed up for 24 months. Serum levels of lncRNA ROR and miR-125b were detected, and their expression correlation was analyzed by Pearson correlation test. Receiver operating characteristic (ROC) curves were depicted for assessing the sensitivity and specificity of lncRNA ROR and miR-125b in diagnosing HF combined ARF. Results lncRNA ROR was upregulated in serum of HF patients combined ARF, and its level was positively correlated to NYHA classification. miR-125b displayed an opposite trend. In serum samples of HF combined ARF, expression level of lncRNA ROR was negatively related to that of miR-125b. Diagnostic potentials of lncRNA ROR and miR-125b in HF combined ARF were confirmed by ROC curve analyses (lncRNA ROR: AUC = 0.9199, cutoff value = 5.595, sensitivity = 92.22%, and specificity = 73.33%; miR-125b: AUC = 0.8509, cutoff value = 2.290, sensitivity = 81.11%, and specificity = 74.44%). After 2-year follow-up, 16 cases were dead. Higher incidences of death and rehospitalization were observed in HF combined ARF cases expressing higher serum level of lncRNA ROR or lower level of miR-125b. Conclusions Serum level of lncRNA ROR is upregulated, and miR-125b is downregulated in HF patients combined ARF. Their levels are linked to NYHA classification, which can be utilized as prognostic biomarkers in HF combined ARF.

Re: A case of acute renal failure requiring emergency hemodialysis due to hypothermia-associated rhabdomyolysis

We have read the article titled “A case of acute renal failure requiring emergency hemodialysis due to hypothermia-associated rhabdomyolysis” published by Vural et al. with great interest. Acute renal failure is an uncommon diagnosis in patients presenting to the emergency department, and rhabdomyolysis is a relatively rare cause. The etiologic factors for rhabdomyolysis may be classified as hereditary and acquired (traumatic, and non-traumatic) causes. We thank the authors for this informative and successful case presentation. In this letter we also would like to mention a few important points and present an interesting phenomenon that we encountered.

A case of acute renal failure with severe loin pain and patchy renal ischemia after anaerobic exercise (ALPE) by running at full speed

A case of acute renal failure with severe loin pain and patchy renal ischemia after anaerobic exercise (ALPE) by running at full speed

The Challenges of Diagnosing Nondilated Obstructive Uropathy: A Case Report

Rationale:Nondilated obstructive uropathy (NDOU) is a rare cause of acute renal failure reported in less than 5% of cases of obstructive uropathy. It is typically associated with intrapelvic malignancies and diseases causing retroperitoneal lymphadenopathy and retroperitoneal fibrosis. As these conditions may prevent radiographic dilation of the collecting system, the diagnosis of NDOU may be missed by usual diagnostic testing.Presenting concerns of the patient:We present a case of acute anuric renal failure in a middle-aged woman with metastatic breast cancer associated with abdominal and retroperitoneal lymphadenopathy. Acute kidney injury was initially deemed secondary to drug-induced acute tubular necrosis (ATN) from bisphosphonate; however, there remained a high clinical suspicion of NDOU due to the presence of enlarged retroperitoneal lymph nodes on CT abdomen and pelvis with concerns for encasement of bilateral renal pelvic regions and ureters.Diagnoses:The patient underwent a retrograde pyelogram which demonstrated questionable narrowing bilaterally at the level of the renal pelvices. This led to an even stronger clinical suspicion of NDOU and urology service was consulted for evaluation.Intervention:Bilateral ureteral stents were placed by urology which led to robust urine output and rapid reversal of renal failure over the next 24 to 48 hours.Outcomes:Despite 2 weeks of anuria and hemodialysis, this patient’s creatinine came back to her baseline. She was able to discontinue hemodialysis and her creatinine stabilized at 88.4 μmol/L (1 mg/dL).Teaching points:Nondilated obstructive uropathy is rare but important diagnosis that requires a high clinical suspicion in the appropriate clinical scenario. The lack of dilatation is believed to be related to encasement of the collecting system by tumor, fibrosis, or as in our case metastatic retroperitoneal lymphadenopathy. As this diagnosis cannot be overlooked, aggressive direct visualization or even intervention with internal or external stenting may be required to both diagnose and treat this condition.

Interactions between Babesia microti merozoites and rat kidney cells in a short-term in vitro culture and animal model

Babesiosis is one of the most common infections in free-living animals and is rapidly becoming significant among human zoonoses. Cases of acute renal failure in humans caused by Babesia spp. have been described in the literature. The kidneys are characterised by intense blood flow through the blood vessels, which increases the likelihood of contact with the intra-erythrocyte parasite. The aim of this study was to observe the influence of B. microti (ATCC 30221) on renal epithelial cells in vitro cultured (NRK-52E line) and Wistar rats’ kidney. Both NRK-52E cells and rats’ kidney sections were analysed by light microscopy, transmission electron microscopy (TEM) and fluorescence in situ hybridization (FISH). Necrotic changes in renal epithelial cells have been observed in vitro and in vivo. In many cross-sections through the rats’ kidney, adhesion of blood cells to the vascular endothelium, accumulation of erythrocytes and emboli were demonstrated. In NRK-52E culture, elements with a distinctly doubled cell membrane resembling B. microti were found inside the cytoplasm and adjacent to the cell layer. The study indicates a chemotactic tendency for B. microti to adhere to the renal tubules' epithelium, a possibility of piroplasms entering the renal epithelial cells, their proliferation within the cytoplasm and emboli formation.

Impact of anemia on outcomes in on-pump coronary artery bypass surgery patients.

Aim To study the contribution of preoperative anemia to the prognosis of adverse clinical events (mortality, complications, transfusion) in patients with ischemic heart disease (IHD) after myocardial revascularization in the conditions of artificial circulation.Material and methods This retrospective cohort study included 1 133 patients with IHD who had undergone isolated myocardial revascularization in the conditions of artificial circulation in 2019. The primary endpoints were mortality and a composite endpoint that included, in addition to mortality, cases of acute coronary syndrome, heart, respiratory and renal failure, neurological deficit, and infectious complications. The secondary endpoints were duration of artificial ventilation of more than 12 h, duration of stay in the resuscitation and intensive care unit (RICU) of more than one day, and duration of postoperative inpatient treatment of more than 7 days.Results Preoperative anemia was found in 196 (17.3 %) patients. The anemia was not associated with mortality but increased the risk of the composite endpoint, prolonged artificial ventilation, stay in RICU for more than one day, and red blood cell transfusion. Despite the absence of a relationship between red blood cell transfusion and mortality, the use of transfusion was associated with increased risks of the composite endpoint and prolonged stay in the RICU and hospital.Conclusion Preoperative anemia is a risk factor for adverse outcomes of myocardial revascularization in the conditions of artificial circulation. Timely treatment of preoperative anemia may improve outcomes of the treatment.

Do not Forget the ‘Forgotten Disease’ in the Covid Era: A Case Report of Lemierre’s Disease with a Rare Complication of Acute Renal Failure

<strong>Background:</strong> Lemierre’s disease, also known as the “Forgotten disease”, is a rare yet rapidly deteriorating clinical entity associated with high morbidity and mortality. We present a unique case of acute renal failure in Lemierre’s Disease which has not been previously reported in published literature. <strong>Case report:</strong> An obese 18-year-old female with intermittent asthma presented with a one-week history of sore throat, dysphagia and odynophagia associated with anuria. She was found to be in severe sepsis with tachycardia (163 bpm), hypotension (BP 113/43) and acute renal failure with bilateral tonsillar exudates, mild anterior neck swelling and trismus. Initial labs were also significant for leukocytosis (WBC 29.4 k/ul), transaminitis (AST 1115 u/L, ALT 240 u/L), and severe rhabdomyolysis (creatine kinase 96848 u/L). She received intravenous fluids with good response and started on vancomycin and piperacillin-tazobactam. Initial infectious work-up was negative for group A streptococcus (throat), SARS-CoV-2 PCR and antibody, HIV, RPR, EBV, hepatitis A/B/C. Initial chest x-ray revealed bilateral nodular opacities with likely miliary distribution for which TB evaluation was considered but later aborted. Admitting diagnoses were severe sepsis from soft tissue infection (neck vs. pneumonia) with possible bacteremia and acute renal failure (pre-renal exacerbated by severe rhabdomyolysis). The patient’s case was complicated early on by the development of anuric renal failure (creatinine 7.5 mg/dL) and hyperkalemia for which she required hemodialysis by day 3 of hospitalization. Other complications included respiratory distress and hypoxia requiring transient BiPAP support and transiently elevated pro-BNP and troponin which all spontaneously resolved. An echocardiogram revealed borderline normal LV systolic function. A non-contrast head and neck CT showed asymmetric enlargement of the left parotid gland and palatine tonsil with no obstruction and enlargement of left internal jugular lymph nodes compatible with reactive changes. On the 4th hospital day, the initial blood culture was found to be positive forFuscobacterium necrophorum, for which metronidazole was added pending culture sensitivity results. Due to concerns for septic thromboemboli, contrast CT studies of the head, neck and chest were done revealing multiple large bilateral pulmonary nodules with cavitation and bilateral lower lobe consolidation concerning for septic emboli and pneumonia as well as diminished calibre and poor opacification of the left internal jugular (IJV) concerning for thrombosis, solidifying the diagnosis of Lemierre’s Disease. A Doppler ultrasound of the neck showed diminished flow through the left IJV and a venogram study confirmed the presence of the left IJV thrombus. In consultation with vascular surgery and interventional radiology specialists, it was decided that medical anticoagulation with heparin was preferable over thrombectomy. An abdominal CT on hospital day 9 further revealed bilateral renal infarcts thought to be from septic emboli. The patient completed a course of piperacillin-tazobactam and transitioned from heparin infusion to apixaban once repeat studies showed resolution of LIJV thrombus. She underwent 8 cycles of dialysis over the period of two weeks with subsequent spontaneous return of adequate renal function without need for further dialysis. <strong>Discussion:</strong> Lemierre’s disease presents with fever, sore throat, lymphadenopathy, thrombosis of IJV and metastatic infection to other organs, mainly the lungs. This patient’s case was uniquely complicated by renal infarcts from septic emboli with acute kidney failure requiring hemodialysis. With antibiotics, anticoagulation and hemodialysis, the patient has fully recovered without any long-term organ system deficits.

Severe hemolytic anemia and acute renal failure after mitral valve repair associated with non-endothelialization of artificial chordae tendinae: case report

BackgroundMechanical hemolytic anemia and acute renal failure are rare complications of mitral valve repair.Case presentationWe report a unique case of severe hemolytic anemia and severe acute renal failure after mitral valve repair using artificial chordae tendinae. Conservative therapy including plasmapheresis and blood transfusion was not effective. The major cause of the mechanical hemolysis was mild mitral regurgitation originating from the centre of the valve and striking the annuloplasty ring. The hemolytic anemia resolved gradually after the replacement of mitral valve. The new artificial chordae tendinae was found to be completely non-endothelialized in the surgery. Non-endothelialization of artificial chordae tendinae may also play a role in the genesis of mechanical anemia.ConclusionsThe major cause of the mechanical hemolysis was mild mitral regurgitation originating from the centre of the valve and striking the annuloplasty ring. Non-endothelialization of foreign materials might be another mechanism of hemolysis after mitral repair.

Asymptomatic Hypercalcemia and Acute Kidney Injury as Presenting Manifestation of Sarcoidosis: A Case Report

Acute renal failure is rarely associated with the usual presentations of sarcoidosis. Sarcoidosis is associated with hypercalcemia and presents with granulomas within other organs, usually the lungs [1]. We present a case of acute renal failure with hypercalcemia in an African American female patient who was eventually diagnosed with sarcoidosis.

Analysis of diagnosis, treatment and risk classification of blunt thoracic aortic injury

Objective: Propose a new risk classification system for blunt thoracic aortic injury and explore its treatment strategies. Methods: After the retrospective analysis of clinical data from 68 patients with blunt thoracic aortic injury in the First Affiliated Hospital of Zhengzhou University from November 2016 to October 2020, there were 56 males and 12 females, among these patients, the median age was 45(21-69). According to the degree of aortic injury and the combined injury, the patients were scored for aortic injury, and the risk of the patients were graded into following three types: low-risk group (score ≤ 2 points) 12 cases, intermediate-risk group (3 points ≤ score ≤ 5 points) 41 cases, high-risk group (score ≥ 6 points) 15 cases. Analyzing the effects of treatments received by patients in different grades on the prognosis. Patients were followed up through hospitalization or outpatient clinics at 1, 3, 6, 12 months after surgery and every year thereafter. Results: Of the 68 patients, 21 received non-surgical treatment and 47 received surgical repair, including 6 open surgery and 41 thoracic aortic endovascular repair. There were 16 cases of emergency operation and 31 cases of delayed operation. Twelve low-risk patients were treated with non-surgical treatment, and only 1 patient died of lung infection, with a mortality rate of 8.3% (1/12). There were 8 deaths in 41 moderate-risk patients, with a mortality rate of 19.5% (8/41), and the aortic-related mortality rate was 9.8% (4/41), and the operative mortality rate was 10.8% (4/37). The total mortality of 15 high-risk patients was 40% (6/15), and the aortic-related mortality rate was 30.0% (5/15), and the mortality rate of surgical patients was 10% (1/10). During the follow-up period of 5 to 52 months, no deaths occurred outside the hospital. According to the risk grading, there were significant differences in the aortic-related mortality of each grade (χ²=7.840, P=0.020). During the follow-up of 5-52 months, 1 case had type Ⅰ endoleak, 1 case of cerebral infarction, and 1 case of acute renal failure. Conclusion: According to the patient's degree of aortic injury and combined injury, the risk classification helps to choose the appropriate treatment.

Perancangan Sistem Informasi Instalasi Hemodialisa Pada Rumah Sakit Umum Daerah Karawang

The use of information, media and communication technology has changed both the behavior of society and human civilization globally. The development of hospitals in Karawang is increasingly mushrooming, as well as the increasing number of degenerative diseases such as hypertension and diabetes, the increasing prevalence of chronic kidney disease. So it requires the handling of renal replacement therapy (Renal Replacement Therapy) because it is increasingly needed for cases of acute and chronic renal failure. The purpose of this research is to build an integrated and controlled information system that can simplify the patient administration process and reduce the effectiveness of the patient's time for dialysis. The methodology that the authors use in this study includes methods of identification and system design. System identification includes identification of the organization, running systems, and problem identification. The problems faced at this time in the Hemodialysis Installation. Patient data is not the same between patients who are served by hemodialysis (dialysis) and those in the application report, the transaction value for using tools and materials is sometimes empty or there is no transaction value in the application, it will cause losses to the customer. hospital. It is hoped that this system can eliminate the problems that have been happening so far.

A Case of Acute Renal Failure with Severe Loin Pain and Patchy Renal Ischemia after Anaerobic Exercise (ALPE) Diagnosed with MRI Diffusion-weighted Imaging

A Case of Acute Renal Failure with Severe Loin Pain and Patchy Renal Ischemia after Anaerobic Exercise (ALPE) Diagnosed with MRI Diffusion-weighted Imaging

Remdesivir and Acute Renal Failure: A Potential Safety Signal From Disproportionality Analysis of the WHO Safety Database.

Remdesivir is approved for emergency use by the US Food and Drug Administration (FDA) and authorized conditionally by the European Medicines Agency (EMA) for patients with coronavirus disease 2019 (COVID-19). Its benefit-risk ratio is still being explored because data in the field are rather scant. A decrease of the creatinine clearance associated with remdesivir has been inconstantly reported in clinical trials with unclear relevance. Despite these uncertainties, we searched for a potential signal of acute renal failure (ARF) in pharmacovigilance postmarketing data. An analysis of the international pharmacovigilance postmarketing databases (VigiBase) of the World Health Organization (WHO) was performed, using two disproportionality methods. Reporting odds ratio (ROR) compared the number of ARF cases reported with remdesivir, with those reported with other drugs prescribed in comparable situations of COVID-19 (hydroxychloroquine, tocilizumab, and lopinavir/ritonavir). The combination of the terms "acute renal failure" and "remdesivir" yielded a statistically significant disproportionality signal with 138 observed cases instead of the 9 expected. ROR of ARF with remdesivir was 20-fold (20.3; confidence interval 0.95 [15.7-26.3], P<0.0001]) that of comparative drugs. Based on ARF cases reported in VigiBase, and despite the caveats inherent to COVID-19 circumstances, we detected a statistically significant pharmacovigilance signal of nephrotoxicity associated with remdesivir, deserving a thorough qualitative assessment of all available data. Meanwhile, as recommended in its Summary of Product Characteristics, assessment of patients with COVID-19 renal function should prevail before and during treatment with remdesivir in COVID-19.